The Vermont Department of Health and key stakeholders conducted an HIA of the potential effects on the health of Vermont residents of regulating and taxing adult marijuana use. To evaluate possible impacts, the study team examined lessons learned from tobacco and alcohol policies that could be replicated to protect and improve health in a regulated marijuana market. Key takeaways include:
- Smoke-free policies reduce secondhand smoke, increase the number of people who quit smoking, reduce tobacco initiation rates, and reduce tobacco-related morbidity and mortality. Vermont’s smoke-free laws do not cover the use of marijuana.
- Limiting access to alcohol and tobacco reduces use. This has been achieved by:
- Controlling the number of stores that can sell a substance within a certain area.
- Restricting the type of outlets that can sell tobacco.
- Limiting the times of day that alcohol can be sold.
- Raising the age at which a person can purchase alcohol or tobacco.
- Increasing taxes, establishing minimum price laws, and prohibiting price discounting reduce the amount of alcohol or tobacco people use.
- Allowing local control over outlet density and advertising contributes to a culture of health in the community, even though people can easily travel from one town to another.
- Restricting the age of legal alcohol purchase to 21 or older decreases motor vehicle accidents, delays initiation of use, and reduces overall use of alcohol.
- Child-resistant packaging saves lives.
- Limiting advertising can reduce youth initiation and use. Prohibiting self-service displays, internet sales, free samples, mass media advertising, and flavored products can lower youth tobacco use.
- Enforcing these policies vigorously is effective in keeping alcohol and tobacco out of the hands of youth.
- The HIA offered the following recommendations should Vermont decide to regulate and tax recreational marijuana:
- Ensure that critical staff are hired, regulations and rules are in place, and testing infrastructure is built and functioning before allowing production, distribution, or retail of marijuana products.
- Expand and enhance tobacco laws and regulations to include the use of tobacco, marijuana, all smoke delivery systems, and tobacco substitutes.
- Do not allow use of marijuana in public places. Ensure that children and youth are not exposed to marijuana use or secondhand smoke.
- Fully fund enforcement and oversight.
- Standardize and test packaging and potency. Ensure that THC concentration regulations, particularly those relating to packaging, labeling, and testing, are in place before implementation.
- Prohibit retail sales of marijuana-infused products for nonmedical purposes.
- Set an active-THC blood-level limit for operating a motor vehicle based on the best available evidence.
- Implement a public education strategy about the dangers of driving under the influence of THC.
- Expand screening for substance use disorders and mental health problems and trauma in primary care.
- Consider implementing statewide buffer zones for the sale of marijuana around areas such as playgrounds, schools, and colleges.
- Fund surveillance and research efforts to monitor frequency of use and types and potencies of marijuana used by Vermont residents of all ages.
Vermont legalized possession but not the sale of marijuana. The Legislature may consider a full taxation and regulation system in the future.
This Health Impact Assessment Report first appeared in The Cross-Sector Toolkit for Health. The Cross-Sector Toolkit for Health was originally developed by the Health Impact Project, formerly a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. The creation of this resource was supported by a grant from the Health Impact Project. The views expressed are those of the author(s) and do not necessarily reflect the views of The Pew Charitable Trusts, or the Robert Wood Johnson Foundation.