The Importance of Restricting Youth Access to Marijuana in the Age of Legalization: Lessons Learned From Tobacco Control Efforts and COVID-19 Restrictions

After a year of uncertainty regarding the effects COVID-19 on youth substance use, data are starting to come in and picture is less dire than anticipated. Undoubtedly, young people with significant individual family risk factors—such as high levels emotional distress, anxiety, or financial strain—struggled this both terms their mental health use [[1]Deolmi M. Pisani F. Psychological psychiatric impact pandemic among children adolescents.Acta Biomed. 2020; 91: e2020149PubMed Google Scholar,[2]Horigian V.E. Schmidt R.D. Feaster D.J. Loneliness, health, US adults during COVID-19.J Psychoactive Drugs. 2021; 53: 1-9Crossref PubMed Scopus (156) Scholar]. Still, two most commonly used addictive substances by people, e-cigarettes alcohol, appears have declined [[3]Stokes A.C. Declines electronic cigarette era COVID-19: A critical opportunity stop vaping its tracks.JAMA Netw Open. 3: e2028221Crossref (11) Scholar,[4]Jackson K.M. Merrill J.E. Stevens A.K. et al.Changes alcohol drinking context due pandemic: multimethod study college student drinkers.Alcohol Clin Exp Res. 45: 752-764Crossref (47) Scholar] adolescents students course stay-at-home orders U.S., even tobacco, opioids, other drugs increased [[5]Panchal N. Kamal R. Cox C. The implications for use. KFF website.https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/Date: February 10, 2021Date accessed: May 8, 2021Google Although multiple factors likely contributed apparent decline pandemic, including heightened parental supervision, peer contact [[6]Richter L. use.J Adolesc Health. 67: 467-468Abstract Full Text PDF (19) Scholar], fewer social engagements which typically [[4]Jackson one notable finding from recent research that reduced physical access was significantly associated lower rates [[7]Gaiha S.M. Lempert L.K. Halpern-Felsher B. Underage adult e-cigarette before coronavirus disease 2019 pandemic.JAMA e2027572Crossref (98) This finding, unique circumstances surrounding retail outlets venues were closed operating under considerable restrictions, important consider growing numbers states move toward marijuana legalization. States considering implementing recreational laws acknowledge potential adverse legalization youth; however, concerns about protecting being exposed accessing drug where it becomes legal inevitably commercialized tend be eclipsed arguments favor commercialization. At juncture country’s movement legalization, behooves us reflect upon lessons we learned tobacco control efforts what helps protect harmful health. Of all prevention employed, those parents, schools, media campaigns—all undeniably critical—the tide smoking distinctly turned when policies put place enforced restrict exposure products. State local products through higher minimum age laws, indoor outdoor clean air restrictions advertising promotion, tax increases, better oversight enforcement effectively altered youth’s tobacco-related attitudes behaviors, reversing decades [[8]Tobacco interventionsCenters Disease Control Prevention website. Updated June 2017.https://www.cdc.gov/policy/hst/hi5/tobaccointerventions/index.htmlDate 7, That is, advent vaping. epidemic underscores how successes undermined unrestricted marketing promotion made them readily available appealing [[9]Jenssen B.P. Walley S.C. Section Tobacco ControlE-cigarettes similar devices.Pediatrics. 2019; 143: e20183652Crossref (62) Conversely, exponential growth only began steady finally wane past 2 years once governments impose more restrictive regulations help curb With spreading throughout country, must look prior experience unfettered an appeals will end up causing harm. legalizing include provisions these not task. Restricting deliberate essential element any law, afterthought. advertising, sale should at least same imposed cigarettes, prohibited near locations frequented entertainment, print, can seen youth. Marketing targets colorful packaging, child-oriented product names, enticing flavors, edibles resemble candy, soda, treats consumed banned. Labels required indicate clearly contains marijuana, along accurate descriptions dose tetrahydrocannabinol ingredients. Packages provide clear warnings danger ingesting child-resistant. And home delivery prohibited, cigarettes and, recently, [[10]Treatment E-cigarettes Mail. Federal Register April 19, 2021.https://www.federalregister.gov/documents/2021/04/19/2021-07976/treatment-of-e-cigarettes-in-the-mailDate Scholar]; such services facilitate underage purchase exception protected using Finally, policymakers taking another lesson seek nicotine restricting products, dramatically over [[11]Marijuana PotencyNational Institute Abuse 1, 2021.https://www.drugabuse.gov/drug-topics/marijuana/marijuana-potencyDate would reduce youth, well poisoning who ingest them. None minimize influence evidence-based school community programs parent interventions preventing However, tendency emphasis parents schools underestimates power commercialization promote very real industry prevention. calls legalize learn our mistakes substances, like nicotine. In inextricably linked consequent perceptions safety, addiction problems. liberalizing ensure remains highest priority despite flurry wishful thinking benefits