Applying Lessons Learned from Cannabis, Alcohol, and Tobacco to the Legalization of New Substances

February 02, 2026 | Ali Maffey

As new substances such as psilocybin, ibogaine, and kratom gain legalization support, states are once again tasked with balancing public health, innovation, unintended access, and safety. The emerging market for these products — along with kratom-derived compounds like 7-hydroxymitragynine, or 7-OH — offers an opportunity to apply public health lessons learned from cannabis legalization as well as tobacco and alcohol. States and territories are navigating how to establish effective regulatory frameworks that protect public health and safety while preventing future health concerns, such as substance misuse among adolescents or increased risks to vulnerable populations.

Over the past two decades, widespread changes in cannabis laws have expanded access to cannabis and hemp-derived intoxicating products. These policy shifts have led to a broader range of products (e.g., edibles, oils, gummies) and greater availability across communities, increasing the need for public health protections that ensure product safety and prevent youth substance use.

Experience with cannabis regulation and years of public health research on other substances demonstrate that well-designed policies at the national, state, and local levels can address these public health concerns. Translating these lessons learned from cannabis to new substances requires thoughtfully adapting new policies to each substance’s unique characteristics, risks, and jurisdictional context. The following strategies outline potential approaches public health agencies may consider when developing or refining regulations for newly legalized substances.

Expand Funding for Public Health Protections

Decades of research in public health interventions show that the public, and youth in particular, are less likely to access and use higher priced substances. Using taxes to increase the price of intoxicating substances may act as one of many prevention strategies considered by a jurisdiction. Additionally, the approaches listed throughout this blog require significant financial investment to implement well and at the scale needed for each jurisdiction. Initiating data, public education, and regulatory services prior to legalization is vital to protect public health and safety, yet this does pose budgetary challenges.

State and territorial governments can use tax or licensing fee revenue to:

• Hire and train an adequate workforce to implement and enforce the regulatory frameworks.
• Support public health data collection and analyze the impacts of legalization.
• Expand relevant substance use prevention, screening, treatment, and recovery programs.

Improving Public Health Data Collection

Together with partners, health agencies can enhance data collection to inform prevention, intervention, treatment, and enforcement actions over time. Jurisdictions may consider expanding public health data surveillance by funding improvements that provide meaningful and timely data about who is using, why, and how they are using the substance. Additional funds may help expand data collection representative of all populations — including demographic groups, rural areas, and/or professions — sub-state estimates on use and impact of the substance, and provide insights on populations uniquely vulnerable to substance exposure (i.e., youth and people who are pregnant or breastfeeding).

Epidemiologists often collaborate across jurisdictions to identify standardized approaches to collecting data about each substance and its methods of use, allowing data to be compared across the country. The Council of State and Territorial Epidemiologists made incredible progress in data alignment for cannabis surveillance. During cannabis legalization, many public health agencies set up commissions that released comprehensive research reports on evidence-based health outcomes of concern. This information was used to drive public health messaging and prevention strategies and provided a shared message about any health concerns (i.e., risks of children eating infused food).

Educating about New Substances and Related Health Concerns

Educating health care providers and the public about potential risks of these new substances is an important role of public health. This can help reduce risks among vulnerable populations like youth and those who are pregnant or breastfeeding.

Any public education or social marketing campaigns should follow best practices, which include setting clear educational objectives, testing messages with the intended audience, and using design appropriate to the language and context of the intended audience. Most often, education campaigns focus on preventing use among populations at higher risk for complications from the substance. When messaging for youth prevention, focus on facts, not scare tactics. Young people respond better when messages promote connecting with their goals rather than scaring them from substance use. Additionally, campaigns should avoid ineffective messages and messengers.

Whether a substance is legalized for medicinal or adult-use purposes, public health can make recommendations that prevent medical claims of benefit in public messaging. Additionally, health agencies can develop unique clinical prevention guidance for patients and health care providers related to risks of the substance.

When substances are legalized for medicinal purposes, health agencies may consider providing oversight for those medical recommendations, supporting evidence-based standards for the determination of qualifying or debilitating conditions, and developing regulations around bona fide patient/provider relationships under which the substance may be recommended.

Regulating and Ensuring Product Safety

To protect public health and the safety of new products, health agencies can consider regulations and product testing that ensure they meet development standards. Health agencies can establish laboratory testing standards that include concentration and contaminant testing.

Health agencies may want to outline quality and safety standards for any food products that include a new substance. They may also consider restricting product flavors or additives or product types (i.e., candies) that uniquely appeal to youth. Some public health agencies have also prevented products from being infused with multiple intoxicating substances (i.e., both alcohol and cannabis in one product). Additionally, agencies may consider limiting the concentration of products to a safe level that is less likely to harm anyone, especially children, who might access the substance unintentionally.

Product packaging could include labeling that lists product concentration, testing results, and any health-related warnings. Jurisdictions can also require that labels include product batch numbers to be used in case of recalls for product safety concerns. In order to reduce unintentional poisonings among children, regulations may require packaging be child-resistant, resealable, and opaque.

Regulating Points of Sale

Public health research on alcohol and tobacco outlets has shown that retail store regulations and licensing can have a significant impact on public health outcomes by limiting the hours per day of sale, prohibiting medical advice at point of sale, and restricting underage access to the retail environment. Jurisdictions may consider limiting the proximity of retail outlets to residential areas or other locations where youth are often present (i.e., schools, libraries, parks, or recreation centers). Health agencies may also consider limiting the density of retail outlets permitted within certain communities, making sure that lower socioeconomic communities do not end up saturated by retailers. Finally, it is vital that the legalization of new substances is not used to roll back Clean Indoor Air Act restrictions that prevent secondhand exposure to combustible products.

Regulating Product Promotion and Advertising

Public health agencies may want to limit the marketing of new substances to prevent adolescent substance use. Marketing limitations that were effective with other substances and may also be impactful for newly legalized substances include:

• Preventing retailers from using price promotions, like coupons and happy hours.
• Limiting ads via channels where youth are more likely to see or hear it (i.e., streaming services and billboards). 
• Restricting packaging design to reduce the appeal to youth, such as limiting use of cartoons or requiring packaging/product be distinct from common branded commercial foods.

Preventing Use of New Substances Among Vulnerable Populations

CDC recently released a toolkit outlining the evidence-based strategies to preventing substance use among youth, a priority of the current federal administration. The toolkit outlines strategies that jurisdictions can implement to:

• Enhance knowledge and skills.
• Nurture family environments.
• Give youth access to resources and activities.
• Amplify protective community environments.
• Guide efforts to lessen immediate and long-term harms.
• Encourage provider and health system engagement.

SAMHSA’s Focus On Prevention reinforces many of the same approaches to preventing youth substance use. State and territorial health agencies can advocate for sufficient funding and help implement effective programs and strategies.