The case for legalization is sound — but we don’t need to advertise it

Resist pot marketing, write Dr. Benedikt Fischer and Jean-François Crépault.

From a public health perspective, there is a strong case for legalizing cannabis, as initiated by the legislation tabled on Thursday. We at the Centre for Addiction and Mental Health (CAMH) have been making that case for years. Legalization provides the opportunity — and is in fact a prerequisite — for the implementation of regulatory measures that mitigate the health risks of cannabis use.

Boiled down to its essentials, the argument goes like this: Cannabis use is risky — and some individuals are particularly vulnerable — but criminalizing it has not succeeded in preventing cannabis use. Canada has among the highest cannabis-use rates in the world. Nor has criminalization reduced health harms; on the contrary, it has exacerbated them and entailed costly social harms as well. Decriminalization alone would reduce those social harms, but does not provide the authority to deal with the health risks of cannabis use. Legalizing and strictly regulating cannabis allows for essential control over many of the risk factors associated with cannabis-related harm.

The federal government has publicly emphasized principles of public health in its approach to the legalization of cannabis, and to its credit, Thursday’s legislation broadly follows the advice of its Task Force on the Legalization of Marijuana, which made evidence-informed recommendations on how to get there.

In a way, the hard part only begins now, with implementation. Many important decisions, including the minimum age for legal purchase, taxation and pricing, and the design of the distribution system, will be left to the provinces and territories. In addition, some crucial issues were only vaguely addressed in the tabled bill, with details to be spelled out via regulations. Among the most important of these: advertising and promotion.

A significant advantage of legalization is the opportunity for cannabis users to obtain reliable, accurate information about: a) the cannabis product itself (e.g. its strain, potency and psychoactive properties); and b) the risks and how to moderate them. But a distinction must be drawn between factual product information and advertising or branding that encourages consumption.

The task force recommended that advertising be allowed only at the point of sale (e.g., inside stores or other distribution points) and that products be sold in plain, standardized packaging that features only factual information about the product itself.

The cannabis industry has been lobbying against these restrictions, and can be expected to continue doing so. This is not surprising; the emerging cannabis producers in Canada are businesses — many of them publicly listed — seeking to maximize their profits. The function of advertising, promotion and branding is to increase sales. And it works.

A commercial approach might be fine for most consumer goods — say, for clothing or cosmetics. But unlike those products, cannabis comes with significant health risks, notably among youth, where use rates are highest. As such, it’s important that cannabis not be treated like an ordinary commodity. Commercialization must be restricted. This is a fundamental principle of public health approaches to legal psychoactive substances.

One may argue that cannabis sales should not be held to these standards when alcohol, a riskier substance in terms of health outcomes, is not. But the way alcohol is promoted in Canada is far from a public-health approach, with higher levels of alcoholrelated harm as a result. With cannabis we have a chance to avoid repeating those mistakes, creating a market in which public health prevails to the largest extent possible.

Very different models for legal cannabis markets are possible based on the types of regulations and their implementation, and the health impact will vary accordingly. A public health approach to cannabis sales places health considerations ahead of profits, making it available to people who use it, while avoiding undue increases in demand and use. Looked at from this perspective, clearly cannabis advertising must be prohibited, and products must be sold in plain packaging. Federal and provincial governments will need to stand firm on this point.