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Office of Policy and Planning


A Health Impact Assessment of Adult Use Cannabis Legalization in San Francisco


On November 8, 2016, California voters passed Proposition 64, the “Adult Use of Marijuana Act”. This proposition made it legal for individuals age 21 and older to use, possess, and make non-medical cannabis available for retail sale. While the legalization of cannabis may have direct benefits to communities, from the regulation and taxation of cannabis sales to the substance’s continued de-criminalization, the public health impacts of legalization are lessor known.

SFDPH Office of Policy and Planning developed a report to assess the most up-to-date health information and draw together evidence from multiple sources to better understand the potential health impacts from adult use cannabis legalization in San Francisco. The report aims to inform discussions on the legalization process by providing a health lens to better understand its implications. This report uses a health impact assessment (HIA) framework to evaluate the potential health effects or harms to communities from legalization and strategies for their preventions and/or mitigation.

Data sources for the assessment included epidemiological data, scientific literature, expert and key informant opinions collected from interviews and focus groups, and diverse quantitative indicators associated health and the neighborhood environment. Based on the assessment findings, evidence-informed recommendations are proposed that aim to mitigate the identified health risks associated with legalization, especially as it relates to youth exposure and cannabis retailers, and any disproportionate impacts they may have on certain populations and/or communities.

For more information on this report, contact Cyndy Comerford at


What is a Health Impact Assessment (HIA)?

Health Impact Assessment (HIA) is a practice to consider public health in decision-making. Internationally, HIA is defined as a combination of procedures, methods and tools that systematically judges the potential, and sometimes unintended, effects of a policy, plan, program or project on the health of a population and the distribution of those effects within a population.


Report Documents