Legalization of Non-medical Cannabis: A Public Health Approach to Regulation

  • Cannabis is the most commonly consumed illegal substance. The current system of prohibition and its sanctions do not prevent the use of this substance. The most recent data indicate that about 15% of the Québec population report having used cannabis in the past 12 months. More than half of those who have used cannabis report having used it less than once a month. Those who use it weekly or daily represent about a quarter of cannabis users.
  • Cannabis is not an ordinary product. It carries risks for public health and safety. Its psychoactive effects affect the ability to drive motor vehicles, can lead to dependence, can impair brain development in youth, and can potentially give rise to mental disorders. Smoking cannabis can also cause respiratory diseases. The legalization of non-medical cannabis provides an opportunity to create a regulatory system aimed at reducing the social and health problems associated with the use of this substance.
  • There are several possible regulatory scenarios or options. The choices made concerning the production, distribution and consumption of cannabis are necessarily interrelated and should be the subject of integrated reflection. These choices will be key to the success of the legalization process, the flattening of the illicit market and the achievement of public health goals.
  • The choices made for regulating the distribution and consumption of cannabis should avoid tending toward a trivialization of the substance. In addition, they should not produce setbacks in other areas of public health, for example, by leading to the social renormalization of smoking.
  • The commercialization of cannabis products, even within the context of a strict regulatory framework, sets up an opposition between the profit motive of businesses and the public health goal of reducing cannabis use within the population as a whole. In contrast, a not-for-profit approach makes it possible to focus squarely on prevention, health and safety.
  • The legalization of non-medical cannabis carries its share of uncertainties and requires innovation on the part of Canada and Québec. Moreover, flexibility must be built into the system so that it can be adapted to the evolving portrait of cannabis use prevalence and practices within the Québec population. Caution should also guide the choices made concerning the regulation of this substance.
Onil Samuel
B. Sc., expert et conseiller scientifique, Institut national de santé publique du Québec
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