Cannabis regulatory agencies in the United States report significantly more public health goals and activities than their alcohol counterparts, despite campaigns to “regulate cannabis like alcohol”, a new study has found.
The research, published in the International Journal of Drug Policy, analysed annual reports from state regulatory agencies in all 24 US states where adult-use cannabis is legal as of mid-2025. Researchers compared how cannabis and alcohol agencies outlined their goals, reported collaboration with health agencies and described public health activities.
“Cannabis regulatory agencies largely outperform alcohol regulatory agencies in terms of their articulated public health goals, activities, and policies,” wrote the authors, all affiliated with the University of Maryland’s Department of Criminology and Criminal Justice.
The study found that 68% of cannabis regulatory agencies referenced public health goals in their mission statements, compared with just 35% of alcohol oversight bodies. Cannabis agencies also reported engaging with public health data and initiatives more frequently, while alcohol agencies focused more heavily on law enforcement efforts.
The research, funded by a grant from the California Department of Cannabis Control, revealed differences among states depending on how legalisation was achieved. States that legalised cannabis through their legislatures reported more public health indicators for both cannabis and alcohol regulators compared to those that legalised through ballot initiatives.
“States adopting adult-use cannabis legalization more recently have predominantly legalized through their state legislatures and have cannabis regulators that report on a greater number of cannabis-related public health issues,” the authors noted.
The findings suggest that whilst “regulate cannabis like alcohol” is a common demand of reform advocates, cannabis is regulated more robustly than alcohol when it comes to key public health measures in practice.
The study adds weight to growing evidence that cannabis legalisation provides net benefits to public health.
Since Germany legalised cannabis in 2024, youth cannabis use has declined, undermining prohibitionist claims that legalisation increases adolescent consumption.
UK drug policy experts have argued that criminalisation itself causes disproportionate harms, including racial disparities in policing, stigmatisation and reduced life chances, which may outweigh the moderate health risks of cannabis use. Regulated legalisation, they argue, enables better public health interventions such as education, quality control and targeted harm reduction.
The Transform Drug Policy Foundation has proposed regulatory frameworks for the UK that prioritise public health alongside economic benefits. Their research suggests legalising cannabis could generate £1.1 billion in tax revenue annually, create more than 15,000 new jobs and save £284 million in criminal justice costs.
Transform’s hybrid model would combine non-profit associations, home growing and commercial retail under strict regulation – an approach designed to maximise public health safeguards whilst generating economic benefits and eliminating the illicit market.
