Cannabis Legalization in Canada: The Public Health Discussions We're Barely Having

On October 17, 2018, cannabis use was legalized in Canada. In June, public health researchers presented to the Canadian Senate that legalization of marijuana is “not a public health or safety threat”, based on a study of other jurisdictions where pot has been legalized for use by adults for some time.1

I have no interest myself in imbibing in cannabis in any form, but I am in support of legalization. While this post is not a pro-con list for/against legalization (it’s happening here, the debate is done), even as a person with asthma, I want to be clear in my perspective from the outset. I believe there are many reasons cannabis should not be criminalized (and should be legalized). For just two examples 1) there are already standing exceptions for medical use (for which there would no longer need to be exceptions), and 2) more than half2 (and in some reports over two-thirds 3) of all drug offenses in Canada are cannabis-related 2; with a cost to the government of somewhere between $500 million and $1 billion 3. Not all of the judicial and policing costs would be eradicated, of course, but a substantial portion of those funds could be reallocated (not to mention recouped by taxation of pot). Oh, and also, criminalization isn’t working: cannabis has been illegal for 95 years now, yet 43% of Canadians studied report to having used it.3

Impact of second-hand smoke on asthma

However, there’s a public health conversation that’s not happening: while lawmakers, policy analysts, and pundits have been busy talking about the saliva test not yet available for on-road policing check stops and (the good news) that opioid-overdoses and related deaths and a drop in alcohol sales come from legalization1, I’m still wondering as I have been since before April about the effects of more frequent passive, non-intentional, exposure to second-hand cannabis smoke on my messed up, asthmatic lungs.

Within this big public health discussion, very few seem to be talking about the effects of second-hand smoke/vapors, and what this means for both the general public and Canadians with lung disease: the 10% of Canadians with asthma, the 4% of Canadians with COPD 4, the 4100 Canadians with cystic fibrosis5, and those with other lung diseases who are already caused harm by cigarette smoke and e-cigarette vapor. Depending on local laws about where to smoke, with increased exposure to cannabis smoke or vapor will come increased harm or risk. Instead, the lung health discussion is centering on people who choose to use cannabis—while discussing the risk of lung damage, cancer and allergic reaction is important, they don’t encapsulate my right to breathe, and to breathe clean air free of second-hand smoke.

Even from organizations that are supposed to serve Canadians with asthma and other lung diseases, we seem like the afterthought. The Canadian Lung Association statement on marijuana does not mention asthma or COPD—or even clean air, which is a staple advocacy point of theirs! The last discussions I had with another organization were focused at educating those with asthma and dissuading them from smoking pot—less than six weeks from legalization, they’re not even talking yet, nor have they released a position statement they were discussing a year ago.

Extent of cannabis use and how it impacts asthma

Here in Manitoba, our provincial government has been hard to sway and putting up a fight where it comes to legalization (which doesn’t align with my own thoughts). However, that tenacity may positively affect those of us with lung disease: cannabis use will be prohibited in outdoor public places, which includes streets and sidewalks, beaches, parks, school grounds, restaurant patios, health-care facility grounds and others.5 British Columbia (which is politically much more progressive than Manitoba) is slated to have more lax regulation and will allow cannabis use in “public spaces where tobacco smoking and vaping are permitted,” though will not be allowed in “areas frequented by children, including community beaches, parks and playgrounds,”6—notably, this speaks nothing of streets and sidewalks, which is where I’ve primarily had to deal with exposure on a personal level.

Even with legalization, greater restriction on where one can consume cannabis will keep the air cleaner for the rest of us, especially children and those with asthma. And even though more than 68% of Canadians agree with “relaxing marijuana regulations” in Canada 3, it doesn’t mean we all actually want to use it.
After all, my mom saw someone walking a pig on a leash yesterday, so while that’s apparently legal, I don’t really want a pet pig. (Nor a pet bear like you can have in Indiana, apparently.)

In places that cannabis is legalized, do you believe enough forethought was given to its use in outdoor public areas? Why or why not? Let us know in the comments.

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