In contrast, all four states relied on industry participation in the development of rules and regulations because of the lack in regulatory models for the novel industry,which led to inadequate adoption of policies to protect public health. For example, in Colorado, industry members of the 2014 working group on pesticide regulation delayed action on a 2013 Colorado Department of Agriculture draft list of allowable pesticides that would have required growers use only nontoxic forms, arguing that the proposed list was too restrictive,resulting in regulatory paralysis. Between 2014 and 2016, pesticide use in Colorado was unregulated during which time producers were reportedly using inappropriate or unsafe chemicals,including Eagle 20, a fungicide used to kill mites, mildew and assorted pests.Eagle 20, which was not among the list of approved pesticides as of 2016, contains myclobutanil, which when burned produces the poisonous gas hydrogen cyanide.In 2016, marijuana industry participation on the rule making board in Alaska led to the adoption of marijuana smoking clubs, despite the risks of exposure to secondhand marijuana smoke on cardiovascular function.A single market, in which all sales are regulated as retail — without a separate medical market — simplifies regulatory efforts, including licensing enforcement, implementation of underage access laws, prevention education programs, and taxation.The existence of a licensing system for medical marijuana in Colorado and Oregon before retail legalization led to regulators developing dual licensing systems for medical and retail; in Colorado marijuana businesses could apply for both.
As of October 2016, Alaska had not developed regulations for its medical marijuana licensing system through for profit dispensaries,rolling grow table though medical marijuana has been legal since 1998. All four US states that had legalized recreational use as of October 2016 maintained dual markets with medical marijuana subject to different rules than retail, including higher possession and cultivation limits, and lower age limits . In 2015, Washington legislators eliminated separate medical marijuana dispensaries. Retail marijuana stores that applied for and received a medical marijuana endorsement from the Department of Health could legally sell both medical and retail marijuana products. Otherwise, the same regulatory inconsistencies still existed in all four states. Medical marijuana is exempt from state and local taxes, which created price differences between the two markets, and likely has contributed to the continued growth of the medical marijuana market.The experience from tobacco is that regulatory complexity ultimately favors corporate interests with the financial resources to manipulate and weaken public health policies to reduce use. The tobacco companies use their extensive legal resources and more detailed information about market structure to take advantage of complexity in regulations to make enforcement more difficult for government regulators, which general move slowly and are subject to political constraints. It is unknown what effect these complex legal environments that often favor large corporate interests, and that complicate implementation of effective public health policies, will have on marijuana prevalence at the population level.While the Netherlands de facto legalized possession and use of marijuana in 1976,in 2014 Uruguay became the first country to legalize the cultivation, processing, distribution, and supply of marijuana for recreational purposes.
Uruguay’s law mandates that the government control the manufacture, distribution, and sale of cannabis under the authority of the Regulation and Cannabis Control Institute a new agency created to oversee cultivation licensees and pharmacies, cannabis clubs, and at-home cultivation.The agency would produce generic, unbranded cannabis, eliminating the incentive to market and advertise competitive products.The state would use its licensing power to grant licenses to qualified professional farmers and limit the number of licenses, depending on demand, to avoid an illegal market. As of November 2016 Uruguay was still developing a government monopoly over marijuana production and distribution system.It had implemented regulations for personal cultivation and the operation of cannabis co-operatives, where Uruguayans pay membership fees to be part of collectives that grow marijuana,but was still in the process of drafting the rules for cultivation licenses for private companies and distribution through pharmacies.Because the four US states elected to adopt commercially-focused marijuana regulatory schemes, it is unlikely that these state governments will legally be able to prohibit all forms of marketing and advertising, particularly if marijuana is legalized at the federal level. While it is theoretically possible for government to limit advertising and promotion in the United States, it is extremely difficult to craft such restrictions in light of how the courts have interpreted the US First Amendment protections of free speech. Other governments have successfully restricted tobacco advertising much more extensively than was possible in the United States. Uruguay in 2013 prohibited all forms of marijuana marketing, advertising, and promotions, modeled on its provisions for tobacco products.As discussed above, the alcohol industry has voluntarily committed not to advertise in mass media outlets where more than 30% of the audience is “reasonably” expected to be under age 21.Also as discussed above, the 30% threshold is high enough to allow the alcohol industry to reach youth with their marketing.In Colorado, event sponsorship, including sporting events and concerts, were permitted as long as less than 30% of the audience is under age twenty-one, whereas in Washington these events were subject to the same location restrictions as traditional mass media advertising . None of the states prohibit online advertising or the use of social media. Colorado prohibits the use of unsolicited pop-up advertisements on the Internet; otherwise in Colorado and Oregon internet advertising is subject to the same 30% threshold for underage exposure. Neither state has specific rules on how the age restriction on internet advertising will be defined or enforced. Washington included an unenforceable guideline suggesting that businesses “use social media with caution and be mindful not to appeal to, or solicit, viewers under the age of 21. If possible, please restrict views to adults age 21 and older.”Indeed, in 2015, within two years of implementation of legalization laws in Colorado and Washington, the marijuana industry was already taking advantage of the weak advertising restrictions. Online advertising is widely used by the marijuana industry. Eighty-five percent in Colorado and 65% in Washington of marijuana companies advertise online through company websites. A little less than half of marijuana companies that had operational websites used age verification systems in Colorado or Washington . Among those with age verification systems,indoor plant table more than half in Colorado and in Washington require viewers hit “yes” to gain access to the website, while only 5% in both states require information on the viewer’s birth date.Advertising restrictions could be designed to protect consumers and vulnerable populations. However, state laws in Colorado and Washington were unable to prevent marijuana companies from using false or misleading health claims to advertise their products online. Among websites of marijuana companies, 61% in Colorado and 44% in Washington made health claims about their products.The most common health claim was on treatment for anxiety and depression , insomnia , and pain management ,even though the scientific literature is either mixed or has low evidence of these therapeutic effects.
None of the states prohibit marijuana companies from using directories or store locator websites which often are de facto advertising.Seventy-five percent in Colorado and 56% in Washington of marijuana companies were listed on WeedMaps. In addition to not requiring age-verification to create an online account, WeedMaps allows marijuana companies to circumvent advertising restrictions by listing product descriptions, prices, price promotions and coupons, and post images of their products without warning statements . In addition, WeedMaps provides a platform for publication of online testimonials in which users make health claims on the therapeutic benefits of marijuana use. Online testimonials undermine enforcement of truth-in-advertising laws that prohibit marijuana companies from making false or misleading claims on their products. The same issues that make age-verification systems for tobacco advertising ineffective have already occurred with online marijuana advertising.Uruguay acted to protect public health by prohibiting marketing and advertising entirely, which would likely prevent the issue of directories and store locator websites.Labels provide information to the consumer on its content, including product potency and serving size. As such, it is important that marijuana labels are accurate so as to avoid marijuana intoxication and accidental use. Poor production and premarketing testing procedures to accurately measure THC concentration contained in a marijuana product had led to inconsistent concentration levels in marijuana edibles.A 2015 study of the accuracy of labels in San Francisco and Los Angeles, California. and Seattle, Washington found that marijuana products were unlikely to be accurately labeled in terms of THC content.While 17% of the sample was accurately labeled, 23% reported THC levels 10% higher than indicated on the label, and 45% reported THC levels 10% below its labeling content.Although not yet in place as of November 2016, Uruguayan authorities had indicated that the IRCCA will develop requirements for generic, non-appealing packaging. None of the four US states require plain packaging, although under the Oregon Liquor Control Commission’s rules, marijuana companies that use generic labels without graphics, pictures, or logos are not required to submit their packages to the OLCC for pre-approval.Colorado prohibits the words “candy” or “candies” on marijuana packaging and Oregon prohibits product packaging that contains “cartoons, including use of comically exaggerated features, attribution of human characteristics to animals, plants or other objects, or the similar use of anthropomorphic technique, or attribution of unnatural or extra-human abilities, such as imperviousness to pain or injury, X-ray vision, tunneling at very high speeds or transformation.”While the four US states prohibit false or misleading health claims on marijuana labeling,6, 364 the regulations do not specify what would invalidate such claim or how the liquor control boards in charge of overseeing packaging regulations would enforce these laws. State laws do not prohibit the use of “natural,” “pure,” “clean,” “additive-free,” “fair trade,” “omega 3, 6, and 9,” or any other descriptor that would increase product appeal or reduce risk perceptions on packaging, labeling, or advertising, which permit marijuana companies to use package design and ingredient lists to circumvent restrictions on health claims. For example, in 2016 the Colorado marijuana company Dixie Elixirs sold an orange zest flavored product labeled as “awakening” and a peppermint flavored product labeled as “relaxing,” and included an ingredient list with supplements including “Siberian ginseng” and “ashwagandha,” an herb promoted as reducing stress and promoting well being, despite the fact that no clinical trials have verified these claims.Another Colorado company that produced Ebbu Raw, used its labeling and package design to “[build] trust with customers.Evergreen Herbal’s 4.20 Bars were labeled with descriptors “fair trade,” “With Omega 3, 6, 9,” and “cacao,” which may signal users that these products are environmentally safe or may produce health benefits. Washington packaging requirements allowed marijuana companies to design marijuana packages with brand names such as Mirth “Relax. It’s Legal” in Rainier Cherry Soda flavor,or Evergreen Herbal’s 4.20 Bars in milk or dark chocolate, and flavored with sea salt, toffee, hazelnut or hemp crunch. One way to prevent marijuana companies from taking advantage of weak language for restrictions on health-related messaging would be to require that all advertising and marketing statements and claims be evidence-based and approved by the health authority, including claims about the product improving sex, energy, sleep, weight reduction, vitamin supplements, among other health-related claims that would increase product appeal. Edibles that lack accurate product labeling pose a serious public health risk to adult consumers as well as children.It appears that the regulations on potency limits, labelling and standardization of dose, and packaging in Colorado and Washington were not strong enough to prevent cannabis-related harm. Adults that have used highly potent products have been increasingly reporting unpleasant psychological experiences such as psychosis, anxiety ,and depression symptoms. There is cause for concern that marijuana edibles in the US states have high THC content, which may responsible for many of these observed effects. In 2015, product regulation laws in Colorado were updated to require clear demarcation or individually wrapped servings .There were no changes to the THC limits per serving size or per package, which could have helped reduce marijuana intoxication in both children and adults. After reviewing the evidence from Colorado and Washington that edibles were causing harm in children and inexperienced users, Oregon reduced its maximum THC limit to 5 mg per serving, and 50 mg per package.This experience illustrates the importance of health authorities having the power to adjust maximum serving size and related packaging as scientific evidence on the harms associated with different doses accumulates.