Reassessing Recreational Cannabis Cultivation Through a Sustainability Lens: Public Health Externalities and Agricultural Opportunity Costs in Canada

Canada was the first G7 country to legalize non-medical cannabis use, which rapidly expanded recreational cannabis consumption. This has implications for public health and land-use sustainability, particularly as agricultural systems face increasing pressure from land-use conflicts, which can cause food insecurity in a growing population. This study evaluates sustainability implications of recreational cannabis cultivation in Canada by integrating population-level health risk estimates with an agricultural land-use opportunity costs. Using published epidemiological studies, the population-attributable mortality associated with cannabis use across multiple health outcomes is estimated, including cardiovascular disease, neurocognitive disorders, cancer, injury-related mortality, suicide, and opioid-related poisoning. In parallel, counterfactual scenarios are modelled in which the >2 million m 2 of land used for recreational cannabis cultivation is reallocated to nutrient-dense food crops to assess potential caloric availability. Results of the land-use analysis indicate that reallocating existing cannabis cultivation areas to food production could supply annual nourishment for >3600 people. In addition, cannabis-associated health risks account for ~28,000–30,000 premature deaths annually when aggregated, with cardiovascular disease and dementia representing the largest shares. From a sustainability perspective, the results underscore the need for continued evaluation of cannabis policy and production systems in relation to public health externalities, food security, and land-use opportunity costs.