Cannabis chains of influence from a US perspective.

Adams et al. provide a useful taxonomy for analyzing the avenues of influence wielded by cannabis corporations [1]. There are further points to bemade under each of their three categories from the US perspective. Regarding the public good chain, as Adams et al. point out, alcohol and tobacco industries have consistently argued that: ‘the downsides of consuming negatively originate from individuals and not from... systems and environments’. Activists in alcoholism recovery movement in the United States have begun to push back on this perspective, at least regarding alcohol. They have taken the lead in recent campaigns to raise alcohol taxes in Alaska and Oregon. One of their arguments is that the industry’s stance of blaming drinkers for the problem simply adds to the stigma experienced by people in recovery or seeking treatment, and interferes with their efforts to access treatment resources [2]. Public good has been a key element of the cannabis industry’s argument for legalization. In the absence of meaningful federal regulation, the cannabis industry in the United States has focused upon the health benefits of cannabis and its derivatives. The name of the largest US cannabis company, Curaleaf Holdings, embodies this focus, as does that of the second-largest, Trulieve. The US cannabis industry has also partnered with organizations such as the American Civil Liberties Union in framing cannabis law reform as essential to a social justice agenda. However, legalization has had mixed results regarding a key part of that agenda—the disproportionate impact of cannabis prohibition on people of African heritage in the United States. While cannabis arrests have decreased in legalized states, studies in Colorado and Washington State have documented that significant racial disparities persist [3,4]. State revenues from legalized cannabis have been less than anticipated, and several states have prioritized using those funds to help cannabis entrepreneurs in the disproportionately affected communities, a policy thatmay lead to an over-concentration of cannabis stores in communities that already have more than their share of alcohol outlets. Addiction industries’ activities in the public good chain are perhaps best understood as efforts to distract attention from their own public ‘bad’: a comparison of corporate social responsibility (CSR) reporting among stigmatized industries such as alcohol, tobacco and gambling compared to non-stigmatized firms found the stigmatized companies more likely to issue standalone CSR reports, as an integral part of their strategic goal to distract attention from their own controversial activities and lessen the negative consequences of stigmatization of their industries [5]. CSR, of course, also affects the knowledge chain. However, one of the most potent and ubiquitous arenas for this chain lies in information environments created by the widespread marketing of products such as cannabis. While such marketing is still absent from the airwaves in the United States, it is widespread in social media, including through ‘business pages’ created by cannabis firms. A survey of 482 adolescents (aged 15–19 years) in states where cannabis use has been legalized for adult use found youth exposed to and engaging with this marketing, with higher levels of exposure and engagement associated with greater odds of past-year cannabis use [6,7], and the odds of cannabis use disorder rising with increased exposure to billboard advertising, ownership of branded merchandise and having a favorite brand [8]. A search of PubMed for the words ‘cannabis advertising marketing’ produced just eight relevant studies, showing how the cannabis industry’s marketing activities have thus far been left out of knowledge chain activities. Finally, in the political chain, cannabis firms are indeed active players in the United States. From 2016 to 2019 cannabis growers and sellers spent nearly US$16 million on lobbying in state legislatures [9]. They spent more than US$6 million on 95 lobbyists at the federal level in Washington, DC in 2019, and another US$4 million in 2020 [10]. Meanwhile, alcohol conglomerate Constellation Brands reportedly has three lobbyists of its own working on federal cannabis policy, and Anheuser-Busch, the alcohol giant that on its own spent nearly $11 million on federal lobbying in 2019 and 2020 [11], disclosed in a federal lobbying report that it, too, had assigned a lobbyist to monitor government actions on cannabis and CBD in food products [12].