States with legal adult-use cannabis markets were far less likely to experience incidences of the vaping-related lung illness EVALI (e-cigarette or vaping product use-associated lung injury), which was responsible for several thousand hospitalizations in 2019. The US Centers for Disease Control and Prevention eventually acknowledged that vitamin E acetate – a diluting agent sometimes present in counterfeit, unregulated vape pen products – was responsible for the outbreak.

New data published in the journal Drug and Alcohol Dependence reported that cases of EVALI were more than 40 percent lower in legal cannabis states and that they were over 60 percent lower in jurisdictions that permitted home cultivation. Home grow laws were also associated with fewer incidences of consumers engaging in the use of marijuana vape pens.

Authors concluded: “Given that EVALI cases stemmed primarily from informally-sourced vaporizable marijuana concentrates, these results are consistent with crowd-out, whereby introduction of one market (legal marijuana) displaces utilization of another (informally-sourced marijuana products). Simply put, if the public can obtain products legally from reputable sources, there is less demand for illicit market products. Thus, RM [recreational marijuana] legalization could have dampened market penetration of tainted marijuana concentrates by reducing consumption of informally-sourced marijuana products more generally.”

The findings are consistent with those of several other studies also concluding that EVALI cases were largely concentrated in states where consumers did not have legal access to cannabis products.

Full text of the study, “State marijuana policies and vaping associated lung injuries in the US,” appears in Drug and Alcohol Abuse.

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