Commentaries on Hall & Kozlowski (2018)
AMERICAN EXCEPTIONALISM AND THE
FAILURE TO LEARN FROM MISTAKES OF THE
Commercial cannabis legalization need not be the end result.
Ignoring lessons from tobacco policy, the United States is
likely to repeat these errors with cannabis policy.
Policymakers should look elsewhere to see how lessons from
tobacco control can be applied to cannabis policy.
Hall & Kozlowski  touch upon important policy
orientations and goals relevant to US cannabis and tobacco
policies, including that diverging regulatory goals for these
substances are often ignored by policymakers and the
electorate. As more jurisdictions relax cannabis laws, it is
important to keep in mind the lessons learned from tobacco
and alcohol regulation.
The debate concerning cannabis policy in the United
States is cast as a false dichotomy, often resulting in two
suboptimal choices. Both proponents and opponents to
cannabis legalization recognize that the status quo of
criminal prohibition is untenable, yet fail to articulate a
set of policies that promote temperate cannabis use.
Therefore, voters are forced to dispense with prohibition
by adopting commercial legalization. However, repeal of
cannabis prohibition does not have to result in commercial
legalization on the lines of the alcohol trade in many US
For example, Uruguay is, instead, undertaking a policy
oriented towards public health [3,4]. Learning from
tobacco control, Uruguay has incorporated many features
that protect against the trappings of commercial legaliza-
tion. These include heavy regulations on how much,
where and to whom cannabis can be sold, while the law
and regulations further ban promotion and advertising,
require plain packaging and limit the strains, potency
and cannabinoid proﬁles of products sold in pharmacies.
Uruguay has also adopted the cannabis social club
model, pioneered in Europe, as an additional outlet ac-
cessible to a limited number of connoisseurs who wish
to obtain product of varied quality [5,6]. These regula-
tions limit the role of private actors, an aim which Hall
& Kozlowski note is absent in the discussion over the fu-
ture of US cannabis policy. The goal in Uruguay aligns
more with traditional tobacco control and differs from
cannabis policy in US jurisdictions, which often seeks to
maximize tax revenues and gives little consideration to
This should not surprise scholars and observers. In
2008 Uruguay was the ﬁrst Latin American country to
adopt stringent anti-smoking regulations based on the
Framework Convention for Tobacco Control, which
included smoke-free zones, prohibitions on advertising or
sponsorship and plain packaging . International
tobacco companies, including Phillip Morris International,
sued the country in international commercial arbitration
courts . Although Big Tobacco lost its suit against
Uruguay’s anti-tobacco laws, the fact that commercial
interests will go to great lengths to protect their trade
should give us pause for thought. Going forward,
Uruguay has sought to limit the private for-proﬁtrolein
the trade in cannabis.
Canada, too, will apply lessons from tobacco control
and its partial state monopoly over the alcohol market as
it repeals cannabis prohibition. Although details are not
ﬁnal, the framework guidelines recommend that cannabis
be sold in plain packaging and that limits be placed on
advertising and promotion . Some provinces are also
considering selling cannabis products only in govern-
ment-owned stores [9,10]. Although Canada will not
adopt as stringent regulations as Uruguay, its legal frame-
work will be less favorable to commercial interests than
those found in the United States.
Hall & Kozlowski are right to point out the incongruity
with which US jurisdictions both restrict access to tobacco
while loosening access to cannabis. For example, between
May and November 2016, California raised the minimum
age for tobacco purchases from 18 to 21 years while voting
to legalize the sale of cannabis by private, commercial
actors . Regulations are not ﬁnal, but the state will
probably adopt a loose set of rules, also seen in other US
states, which do little to moderate use.
Such policy divergence is puzzling. Research sug-
gests that cannabis and tobacco are complements, al-
though this may be due to cultural practices of
mixing tobacco with cannabis [12–15]. It is unclear
how the market will respond to these diverging sets
of policies or if new forms of tobacco administration
(vaping) will encourage individuals to take up canna-
bis as markets move away from herbal marijuana to-
ward oils and concentrates, or vice-versa.
netheless, US jurisdictions eager to obtain
additional tax revenues will continue to face pushback
from the cannabis industry which seeks to weaken
regulations aimed at protecting public health [16,17].
Countries should learn from these diverging sets of
policies. Efforts in the United States to include private
actors in the distribution of psychoactives are likely to
generate unnecessary challenges, making the ‘American
model’ a good case study on how not to regulate cannabis.
Jurisdictions considering relaxing cannabis prohibition
may want to look elsewhere, such as Canada or Uruguay,
© 2017 Society for the Study of Addiction Addiction, 113,602–609