Association between cannabis retail outlet availability and sources of cannabis acquisition among young adults in Washington State, 2015–2021

Abstract

This study examined associations between cannabis retail outlet availability and sources of cannabis acquisition among young adults, with particular focus on age-specific patterns and the potential modifying effects of the COVID pandemic. Data were from surveys from 4,252 young adults 18–25 years that used cannabis and were participating in the Washington Young Adult Health Survey (2015–2021). Cannabis retail outlet availability was defined as the presence of at least one licensed outlet within a 2-kilometer road network buffer of the participant’s residence. Primary outcomes were five self-reported sources of cannabis acquisition in the past 30 days: retail outlet, friends, family, party, and gave money to someone to get it for me. Logistic regression models were used to examine associations between retail outlet availability and each source, with models stratified by age group (18–20 versus 21–25) and pre COVID pandemic (2015–2019) versus COVID pandemic timing (2020–2021). Models adjusted for demographic and neighborhood covariates. Sensitivity analyses used a 1-kilometer buffer to define cannabis retail outlet availability. Adjusting for covariates, retail outlet availability within a 2-kilometer buffer was statistically significantly associated with the source “Gave money to someone to get it for me” for the 18–20 age group. For the 21–25 age group, after adjustment, retail outlet availability was positively associated with obtaining cannabis from a retail outlet and inversely associated with giving money to someone to obtain cannabis. When stratified by pandemic timing, among 18–20-year-olds, the association between retail outlet availability and giving money to someone was stronger in the pre-pandemic period compared to during the pandemic. During the pandemic, the association for giving money to someone was in the opposite direction for the 21–25 age group. Additionally, associations between retail outlet availability and obtaining cannabis from friends or at parties were stronger during the pandemic compared to the pre-pandemic period for the 21–25 age group. Sensitivity analyses using a 1-kilometer buffer yielded similar findings for the 21–25 age group; however, for the 18–20 age group, retail outlet availability was statistically significantly associated with obtaining cannabis from friends. Findings underscore the importance of considering how cannabis access and acquisition sources, shaped by age and legal context, may contribute to patterns of use and associated risks. Results, if replicated, may have implications for tailored public health messaging strategies.