Abstract
INTRODUCTION: This study examined associations between retail alcohol and cannabis availability, use, and simultaneous use of these substances among youth and potential explanatory variables. METHODS: In 2023-24, 1082 15- to 20-year-olds were surveyed in 40 California cities. The survey included questions about past-year alcohol use, binge drinking, cannabis use, and simultaneous alcohol and cannabis (SAC) use, exposure to opportunities for these behaviours in different contexts, normative and health-related beliefs, and demographic characteristics. City-level measures included retail alcohol and cannabis outlet density and demographic characteristics. Analyses examined associations of these substance use behaviours with retail availability of alcohol and cannabis and potential explanatory variables. RESULTS: On-premises alcohol outlet density was significantly associated with past-year alcohol use (b = 0.36, p < 0.05) and binge drinking (b = 0.23, p < 0.05). Licensed cannabis retail outlet density was positively associated with past-year cannabis use (b = 6.4, p < 0.01), while unlicensed cannabis outlet density was negatively associated with cannabis use (b = -21.1, p < 0.01). On-premises alcohol outlet density was positively associated with past-year SAC use (b = 0.18, p < 0.01). These associations were at least partially explained by greater exposure to opportunities for alcohol, cannabis, and SAC use in different contexts/situations and beliefs related to these behaviours. DISCUSSION AND CONCLUSIONS: Retail availability of alcohol and cannabis is associated with alcohol and cannabis use and SAC use among youth. These associations are at least partly explained by greater exposure to opportunities to engage in these behaviours and related beliefs.