Limited Evidence on Cannabis Taxation Effects in the United States: A Rapid Review of Use, Purchasing, and Risk...

The global cannabis policy landscape has changed dramatically in recent decades. In the United States, there is significant variation in cannabis tax structures, and there is limited consensus on how to implement cannabis tax policy to mitigate related harms. Therefore, the objective of this rapid review was to synthesize current evidence on the impact of cannabis taxation on purchasing behavior, use, and risk perceptions among U.S. adults.

We systematically searched for peer-reviewed studies published in English (2014-present) in PubMed, SCOPUS, and Google Scholar. Two reviewers independently screened all relevant articles for eligibility using Covidence software. Out of the 1,342 references identified, 1,337 were not eligible for inclusion.

The five included studies examined excise taxes on cannabis. Outcomes measured across the studies included cannabis use, cannabis demand, purchasing patterns, and perceptions. The data sources ranged from participant-level to state-level to nationally representative. One study found a negative association between taxes and past-30-day cannabis use, although it was statistically insignificant. A higher cannabis tax was linked to a decrease in cannabis demand. Another study demonstrated evidence of consumer stockpiling and increased cross-border substitution in response to higher cannabis tax rates. In terms of perceptions, policymakers rated taxes as a highly efficacious public health tool, and cannabis users viewed taxation as an important factor in their purchase decisions.

The limited number of articles identified in this rapid review highlights the need for future studies to better understand consumer behavior and inform policy.