There’s a “strong negative association” between tobacco use and legal medical marijuana sales, according to a new international study—indicating a “strong potential substitution effect” where people choose to use cannabis where it is allowed instead of smoking cigarettes.
The study, based on data from 20 countries, also found that amphetamine use is “negatively associated” with medical cannabis sales, “suggesting substitution dynamics.”
The researchers additionally concluded that a “well-regulated [medical cannabis, or MC] market can generate sustained economic benefits, emphasizing the need for comprehensive legal frameworks that address licensing, production standards, and access pathways,” adding that “removing barriers to access and enhancing consumer education will support the development of a responsible and sustainable market.”
The analysis also showed “a sustained growth trajectory” in medical cannabis sales after legalization, finding that the policy change is “associated with an average annual increase of 26.06 tons of MC sales in legalizing countries.” After excluding the U.S., which the researchers called “a major outlier in market size,” there was “a slightly lower average effect of 20.05,” which “still supports the persistent market expansion.”
The authors, based in Germany and Lebanon, cautioned that “given the ecological nature of the design, these results should be interpreted as population-level associations rather than individual-level causal effect.”
“Nonetheless, they highlight the potential economic relevance of cannabis legalization in expanding regulated markets and reshaping consumer behavior,” the paper says. “The study contributes to debates on legalization, public health, and economic policy by providing empirical evidence on the associations between legal reforms and market dynamics.”
The study comes amid new research indicating that marijuana use is linked to lower alcohol intake and diminished cravings in heavy drinkers, according to a new federally funded scientific paper.
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