Cannabis stores: How easy access is changing adult behavior in good ways and bad

A new study tracked more than 60,000 Oregon adults over nine years. Adults living near more licensed cannabis stores used cannabis more often, and were less likely to report heavy drinking.

The link was strongest among ages 21 to 24 and adults 65 and older. The analysis covered the statewide retail rollout from 2014 through 2022.

Cannabis store location matters

Retail stores lower effort, set prices, and display products that can nudge choices. Access often shapes behavior even when people do not pay attention to every storefront.

The work was led by David Kerr, a professor of psychological science at Oregon State University (OSU). His research focuses on how policies and local settings influence substance use across the lifespan.

“These and other findings suggest that age-informed, multilevel prevention efforts are needed,” said Kerr.

The analyses considered proximity and density together to capture how access works at the neighborhood level.

People respond to cues they see often, including product variety, hours, and promotions. Over time, those cues can shift what people try, how often they buy, and what they keep using.

Measuring access to cannabis stores

The researchers linked self-reported use from CDC telephone surveys to a retail density score for each ZIP code. The score captured how many stores were nearby and how close they were to where people live.

The team also reported an adjusted odds ratio (AOR), a statistic comparing chances while controlling for other factors.

Compared with pre-market years, the odds of any past month cannabis use were 1.31 in low access areas, 1.47 in middle access areas, and 1.59 in the highest access areas.

This pattern matches evidence from Washington, where shorter drive times predicted more frequent use outside big cities.

A 2021 open access paper found adult marijuana use responded to increased local access measured by drive time.

Tracking change across nine years helps separate one time shocks from sustained shifts. The models also adjusted for statewide trends to isolate access effects.

What changed for alcohol

Where access to cannabis retail was closer, adults were less likely to report heavy alcohol use. The decrease showed up most clearly in the youngest legal buyers and the oldest adults.

The CDC defines heavy drinking as eight or more drinks per week for women or 15 or more for men. That definition anchors the finding and makes the alcohol shift clearer.

“It’s a complicated picture,” said Kerr. The net effect depends on who substitutes, what they use, and why they use it. He noted that shifts in local access may change community norms, gradually redefining what feels typical or acceptable behavior for nearby residents.

Less alcohol does not automatically lower health risk for every person. Patterns, product potency, medications, and chronic conditions all matter.

Behavioral ripple effects

Frequent exposure to cannabis retail signs, storefronts, and advertising can influence perception even among non-users. Visual familiarity often blurs the line between novelty and normalcy, subtly shaping attitudes about safety, frequency, and social acceptance.

Over time, people may begin to view cannabis as a low-risk, routine part of adult life, similar to alcohol or caffeine. That shift can lower barriers for new users and make prevention messages harder to communicate effectively.

At the same time, communities with more visible cannabis retail may also experience shifts in local identity and commerce. Small clusters of stores can change how a neighborhood feels, drawing different crowds and altering spending habits. 

Those ripple effects make retail density a social factor, not just an individual choice variable, in shaping public health outcomes.

Over time, collective exposure can shift community norms and local policies, reinforcing a feedback loop where access and acceptance grow together.

Age groups that stand out

For ages 21 to 24, legal access lined up with a stronger cannabis response and a drop in heavy drinking. That mix points to both opportunity and risk during early adulthood.

Older adults, 65 and up, showed distinct shifts in both substances. NIH noted all-time highs in adult cannabis use in 2023.

Clinicians also watch for cannabis use disorder, continued use despite harm, problems, or unsafe situations. Older adults may start for pain or sleep, which can complicate risk discussions.

Reasons for use were not tested here, so motivations remain open. Future work can probe whether relief seeking, convenience, or price drives changes across age groups.

Cannabis stores and public health

Oregon allows adult use retail sales and gives local governments the option to prohibit licensed facilities. The OLCC maintains an opt out page that shows which cities or counties have barred producers, processors, wholesalers, or retailers.

That patchwork means retail exposure can look very different across town lines. Communities that opt out reduce storefront exposure, while neighboring areas may see clusters form.

Prevention is not one size fits all for a map like that. Young adults in store dense neighborhoods may need different supports than older adults who reduce drinking as retail access grows.

Public health leaders will want to watch three threads at once. Access is changing, products are changing, and the mix of alcohol and cannabis use is changing as well.

The study is published in the American Journal of Preventive Medicine.

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