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Methods: Using the California Adult Tobacco Survey (CATS), we compared cannabis use and attitudes towards cannabis policy in California before (2016; N=2016) and after (2017; N=3065) a vote to legalize recreational cannabis. The CATS surveys California adult residents using a web-based panel in English and Spanish, with smokers and African-Americans oversampled.
Results: Compared to Californians in 2016, respondents in 2017, after the proposition passed and before its implementation, were more likely to have seen cannabis billboard ads in the past year (16% vs. 25%) and to be exposed to cannabis smoke in the past two weeks (23% vs. 34%). They were more likely to believe that the law should prohibit cannabis use where tobacco use is not allowed (85.5% vs. 90.5%), more likely to agree that cannabis should not be sold in stores accessible to children (82% vs. 85%), and more likely to prefer that edible products have child resistant packaging (86.2% vs 92%; all p<.001). Cannabis users were more likely to report past month vaporizer use (30% vs. 22%; p=.02) and less likely to report exclusive medical use (44% vs. 22%; p<.001).
Conclusion: Following passage of the California recreational cannabis law—but before its actual implementation—residents described a greater presence of cannabis advertisements, second-hand cannabis smoke, and increases in recreational use. Californians’ views on public health protections in the state law grew more restrictive, with higher margins supporting protections for children and prohibitions on second-hand smoke exposure. Policymakers should track state residents’ concerns about public health protections as legalization is implemented.