Self-Report of Cannabis Dispensaries in Neighborhoods and Tobacco and Cannabis Co-Use among US Adults

OBJECTIVE: With cannabis legalization, the number of cannabis dispensaries and rates of tobacco and cannabis co-use (past 30-day use of both substances) have increased. However, the impact of living near a dispensary on tobacco and cannabis co-use remains understudied. Examining factors associated with co-use is important for public health, as co-use may pose increased health risks compared to single product use. METHODS: We conducted a web-based survey in English and Spanish in November 2023 using Ipsos KnowledgePanel, a probability-based panel designed to be representative of the U.S. population. We restricted our survey to those over 18 years old who reported past 30-day use of cigarettes or e-cigarettes and lived in states with medical or non-medical legal cannabis (n=1929). We used weighted, multivariable logistic regression models to estimate the adjusted association of self-reported awareness of a cannabis dispensary in the neighborhood and tobacco/cannabis co-use. RESULTS: Awareness of vs. no awareness of a cannabis dispensary in the neighborhood was associated with increased odds of tobacco/cannabis co-use (OR 1.80, 95% CI 1.33-2.44). This association of dispensary awareness and co-use was found for smoking (p<.001), vaping (p<.001), and edible forms of cannabis (p=.003), but not cannabis concentrates (p=.11). CONCLUSIONS: Self-reported awareness of a cannabis dispensary in the neighborhood was associated with nearly twice the odds of co-use of tobacco and cannabis, independent of sociodemographic factors. As more states legalize cannabis, laws and public policies need to take into account the locations of dispensaries and their impact on community health.