Minimum Legal Age of Nonmedical Cannabis Purchase Laws and Cannabis-Related Hospitalizations in Canada, 2015 to 2022
<b>Objectives.</b> To determine whether the minimum legal age (MLA) for cannabis purchases is associated with reductions in cannabis-related hospitalizations in youths. <b>Methods.</b> We performed a population-based study examining all hospitalizations for cannabis use in Canada for individuals aged 15 to 44 years (n = 14.6 million in 2018) between January 1, 2015, and March 31, 2022. MLAs varied across Canada. We used a controlled interrupted time series design to compare changes in cannabis-related hospitalizations between individuals above and below the MLA. <b>Results.</b> There were 137 901 cannabis-related hospitalizations during the study. Prelegalization rates of hospitalizations were increasing by 2% per quarter for individuals above and below the MLA. After legalization, hospitalizations began declining by 2% per quarter in individuals below the MLA (rate ratio [RR] quarterly slope change = 0.96; 95% confidence interval [CI] = 0.95, 0.98) with no slope change for individuals above the MLA. The total effect, 3.5 years after legalization, was a 34% reduction (relative difference = 0.66; 95% CI = 0.49, 0.91; <i>P</i> = .011) in hospitalizations for those below relative to those above the MLA. <b>Conclusions.</b> Nonmedical cannabis legalization in Canada was associated with reductions in cannabis-related hospitalizations for youths below the MLA and with ongoing increases for individuals above the MLA. <b>Public Health Implications.</b> The results suggest that cannabis legalization may increase cannabis-related hospitalizations in adults but that MLAs may prevent such increases for at-risk young people in regions pursuing cannabis legalization. (<i>Am J Public Health</i>. 2025;115(7):1166-1174. https://doi.org/10.2105/AJPH.2025.308090).
Authors
- Robert Talarico (ORCID: https://orcid.org/0000-0001-5060-680X)
- Douglas G. Manuel (ORCID: https://orcid.org/0000-0003-0912-0845)
- Peter Tanuseputro (ORCID: https://orcid.org/0000-0002-4409-0795)
- Lauren Konikoff (ORCID: https://orcid.org/0009-0006-2786-7933)
- Rosalie Liccardo Pacula (ORCID: https://orcid.org/0000-0002-6145-9865)
- Daniel T. Myran (ORCID: https://orcid.org/0000-0002-8038-300X)
- Monica Taljaard (ORCID: https://orcid.org/0000-0002-3978-8961)
- Erin Hobin (ORCID: https://orcid.org/0000-0001-6335-2984)
- Jennifer Xiao
Institutions
- Ottawa Hospital (CA)
- University of Hong Kong (HK)
Publication Details
- Journal
- American Journal of Public Health
- Published
- 2025-05-22
- DOI
- https://doi.org/10.2105/ajph.2025.308090
- Citations
- 1
- Primary Topic
- Cannabis and Cannabinoid Research
- Type
- article
- Field-Weighted Citation Impact
- 1.39