Using Retailer Data and Subjective Resident Experience to Assess Legal Cannabis Access in Massachusetts
Authors: Colby Alexander , Pensky Hailey , Sarkis Marianne , Johnson Julie 
Published: September 2022

Adult-use cannabis retail storefronts first opened in Massachusetts in November 2018. Forty months later, there are 366 cannabis retailers across the Commonwealth, but it remains unclear which areas have adequate access to safe, regulated (“legal”) cannabis products, and which areas are underserved. In this study, we use open census and retailer data and self-report surveys from Massachusetts residents to estimate access to legal cannabis across Massachusetts. We used populations from the 2020 census and the Cannabis Control Commission’s Licensing data to approximate the cannabis retailer density per 100,000 people in each of Massachusetts’ fourteen counties. Counties were collapsed by Region to provide trend estimates by general geographic location. Cannabis retailer density were highest in Berkshire, Franklin, and Hampshire Counties (Western), and lowest in Norfolk (Southeast), with less than one retailer (0.7) per 100,000 people, followed by Barnstable (Southeast) and Suffolk (Northeast) counties. Massachusetts resident data from the International Cannabis Policy Study (ICPS) for 2019 (N = 2,476) and 2020 (N = 2,207) were used to determine whether the subjective experiences and purchasing behaviors of residents support the results of our objective measure. Binomial regressions were run at the Region-level to lower the risk of Type I error. Participants were first asked why they bought from an illegal rather than legal source, and comparisons were made between Regions based on the amount of individuals answering “Legal sources were too far away.” The Southeast region served as reference group, as it had the lowest retail density and was believed to have more people reporting dispensaries were too far away. Results show that only residents of the Central region [RR .52, CI(.28, .91), p = .031] were less likely to report that legal sources were too far away than Southeast residents. All other regions did not reach significance. We asked participants where they were purchasing their cannabis products and compared the number of residents of each Region that reported purchasing from a “licensed recreational store.” We included Western as the reference group for this model as it was the Region with the highest retail density and was likely home to many residents buying from stores. Residents of Western Massachusetts were significantly more likely to purchase their products from legal stores than residents of the Central [.72, CI(.6, .87), p <.001], Northeast [.74, CI(.64, .86), p<.001], or Southeast [.81, CI(.7,.94), p=.005] Massachusetts. It has been six years since Massachusetts legalized cannabis, yet notable inequities still exist in residents’ access to legal, nonmedical, adult-use cannabis products. Western Massachusetts was the best-served region for cannabis consumers by our estimates, where Southeast Massachusetts remained largely underserved through 2020. These inequities may have implications for cannabis law enforcement in the state, as illicit sources of cannabis could flourish in the absence of easily accessible legal dispensaries. Future work should consider the scope of the illicit market(s) and whether individuals in underserved areas are at higher risk of committing cannabis-related offenses either at the state (distribution) or federal level (trafficking cannabis across state lines).