November 13, 2025
Key Points
- The combination of increased use and collateral health effects of recreational marijuana raises the questions of how government should educate the public and whether it should discourage or limit cannabis use.
- A review of cannabis packaging warning labels reveals wide variation across states, with many states requiring the labels to provide only minimal information about health risks.
- In this regulatory free-for-all, it would make sense for some federal entity to suggest standardized warning labels and graphics.
Introduction
The legalization of recreational marijuana sale and use has spread dramatically since it was first adopted by Colorado in 2012. As of 2025, 24 states and the District of Columbia have legalized cannabis or passed enabling legislation to do so. The majority of the US population lives in these jurisdictions. Owing in part to those changes, Americans’ use of marijuana and cannabis-based products has increased dramatically. Survey research has found that self-reported daily marijuana use increased by 15 times between 1992 and 2022, becoming more common than daily alcohol use.1
At the same time, ongoing medical research continues to reveal new health risks related to marijuana use, including increased risk of “major cardiovascular events.”2 The federal Centers for Disease Control and Prevention warns that cannabis users are “more likely to develop psychosis . . . and long-lasting mental disorders, including schizophrenia,” especially users “who start using cannabis at an earlier age and use cannabis more frequently.”3 Further, because of its effects on “coordination, memory, and judgment,” “cannabis use can impair important skills required for safe driving.”4 The Journal of Studies on Alcohol and Drugs found that recreational marijuana legalization has been “associated with a 6.5 percent increase in injury crash rates and a 2.3 percent increase in fatal crash rates.”5
The combination of increased use and collateral health effects of recreational marijuana raises the questions of how government should educate the public and whether it should discourage or limit cannabis use as it does with tobacco, another legal but dangerous product. Unlike tobacco, however, marijuana’s unusual legal standing means any attempts to discourage its use must be undertaken not by the federal government but by each state that has legalized the drug. Although marijuana is technically still illegal under federal law, “the federal response to states’ legalizing marijuana largely has been to allow states to implement their own laws.”6 The absence of federal policy means there is no standard nationwide package warning for cannabis products as there is for tobacco, which includes 11 “cigarette health warnings, consisting of textual warning statements accompanied by color graphics, in the form of concordant photorealistic images, depicting the negative health consequences of cigarette smoking” required by the Food and Drug Administration.7
This report examines how thoroughly state-required health warnings on cannabis packaging highlight the products’ health risks compared with a National Institutes of Health (NIH) study’s list of all risks that should be included.8 Furthermore, it examines the character of graphic warnings in the context of what makes such visuals most effective.
It also updates the NIH study regarding the extent to which states include some or all of 12 warnings the NIH cites as appropriate. No states cite all the concerns. The closest any states get to citing all of them is listing seven of the 12 concerns. Those states are Nevada and California. Nine states merely note that the products should be kept away from children and avoided by pregnant women.9
In addition, this report examines the extent to which recreational marijuana tax revenues are devoted to public health education about cannabis’s effects and whether such appropriations are required by state law. It looks further at how state-level cannabis-related public health education and prevention compare with state support for tobacco use prevention in the context of whether tobacco campaigns are funded at a higher level than cannabis prevention. This is notwithstanding the fact that tobacco use has fallen sharply in the US even as marijuana use has risen.
Finally, the findings described above are used to assign a public health rank and grade for each of the 24 jurisdictions that have legalized recreational marijuana.
More: https://www.aei.org/research-products/report/cannabis-use-warning-shortcomings-by-state/
