States that legalized recreational cannabis saw a slight population-level uptick in alcohol consumption that was largely driven by young adults and men, according to new research by University of Pittsburgh School of Public Health policy scientists.

The increase in alcohol use, recently reported in JAMA Health Forum, suggests that states that legalize recreational cannabis should also consider targeted public health messaging around alcohol and other policy interventions aimed at mitigating problem drinking.

“Recreational cannabis laws have made cannabis legally accessible to nearly half of U.S. adults, but it has been unclear how this affects the use of other substances, such as alcohol,” said senior author Coleman Drake, Ph.D., assistant professor in the Department of Health Policy and Management at Pitt Public Health. “It appears that cannabis use increases the probability that people drink, at least in the three years after legalization.”

Drake and his team obtained data on alcohol use by more than 4.2 million adults through the Centers for Disease Control and Prevention’s annual Behavioral Risk Factor Surveillance System surveys administered from 2010 through 2019 — at which point 11 states had legalized recreational cannabis.

The survey inquired about any alcohol use, binge drinking and heavy drinking within the last month, and the researchers looked at differences in responses before and after recreational cannabis legalization.

Any drinking — measured as having “at least one drink of any alcoholic beverage” in the past month — increased by 1.2 percentage points in the first year after recreational cannabis was legalized, but diminished in the following two years. There was no change in binge or heavy drinking in the overall population.

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