Congrats, California, you’ve built the largest legal cannabis market in the world! Taxes on same pour $1 billion into public coffers each year.

In the handful of Orange County cities that allow the biz, this means money. In Santa Ana, cannabis generates some $10 million for youth services and public safety programs per annum. In Costa Mesa, it’s about $3.6 million a year; in Stanton and La Habra, more than $1 million a year each; and in Laguna Woods, some $750,000 a year.

But public health types worry. Are the state and cities doing enough to educate folks about, and help protect them from, the risks and down sides of marijuana products?

Cannabis, they warn, can have severe negative effects on the adolescent brain, including problems with memory, learning and coordination. Use during pregnancy can be problematic for both mother and baby. Car accidents, psychosis and schizophrenia have been associated with marijuana use; and the higher potency products on the market today — along with kiddie-pleasing flavors and candy-like packaging and presentation — pose particular challenges, according to the National Academies of Science, Engineering and Medicine, the U.S. Surgeon General, et al.

Recent changes to California law, allowing an “ice cream truck” delivery model for medical marijuana (even if a city forbids storefront retail sales), expands access even further.

(An aside: While this can be a good thing for many, we have too-intimate knowledge of how easy it is for underage kids to get their hands on this stuff. A gummy from a friend in San Diego. A 17-year-old stomping up the stairs in a panic, heart racing, fearing death. A call to 911…fire engines…ambulances…curious neighbors pouring into the street. Bad things happen when 100-pound people eat gummies containing 10 mg of THC! Legalization, inexperience and easy access can be a very scary mix.)

Enter now Getting it Right from the Start, a project of the Public Health Institute, an Oakland-based nonprofit that seeks to prod cities toward stronger health protections, especially for kids.

As part of ‘Getting it Right,’ the nonprofit scores cities based on the safeguards they employ. The group wants to see cannabis businesses located far from schools, parks and other places where kids congregate, and it wants distance requirements between such businesses as a way to prevent overconcentration. The group wants prominent warnings about the dangers of cannabis overuse. And they want a nix on products that are appealing to kids.

A perfect score on the Public Health Institute’s test is 100.

No city in California came close.

Passing grades?

The group’s highest-ranking city was Pomona, with 60 points, far eclipsing any municipality in Orange County.

Pomona caps the number of retail licenses, bans temporary cannabis events and on-site consumption, requires a 1,000-foot buffer from schools and other youth-sensitive sites, mandates in-store health warnings, prioritizes equity in hiring and dedicates local cannabis tax revenue to youth programs and prevention, the organization said. It takes in about $500,000 per year from cannabis revenue.

In O.C., the highest scorer was Santa Ana, with 40 points. The city goes beyond the requirements of state law by limiting the number of retailers and requiring a distance of at least 600 feet from schools and a distance between retailers. It requires health warnings to be displayed and it restricts cannabis business signage. Santa Ana also imposes a local retail tax on cannabis, and dedicates that revenue to youth and prevention programs.

Laguna Woods got the next-highest score, at 25 points. It also went beyond state requirements by requiring distance between retailers; having a local retail tax; limiting billboards; prohibiting temporary event permits; and prohibiting on-site consumption.

Costa Mesa scored 21 points. It requires cannabis businesses be at least 1,000 feet from schools and other kid areas; imposes signage restrictions, and prohibits on-site consumption. The city was praised for requiring independent, third-party ID verification for cannabis delivery (as were Los Angeles, San Jose and a few others).

La Habra scored 21 points as well. It doesn’t allow cannabis stores, but delivery is OK. For that, the city requires local permits while limiting delivery destinations and imposing a local retail tax. But research has shown that rates of youth cannabis use are highest in places that only allow delivery sales, the public health folks point out.

Stanton scored 18. It limits the number of retailers; has a local retail tax; signage restrictions; and prohibits on-site consumption.

Several O.C. cities that don’t allow cannabis storefronts do have regulations on deliveries.

“Garden Grove, Irvine and La Habra all require deliverers to obtain a local permit, which is great, as it allows them to monitor the retail sales occurring within their boundaries,” said Alisa A. Padon, a research scientist with the Prevention Policy Group and Public Health Institute.

“Garden Grove, Tustin, and La Habra all limit delivery destinations, for example, prohibiting delivery to schools, parks, or youth centers. We’d like (cities) to prohibit delivery to college dorms and campuses, too. Cypress and Tustin both prohibit temporary cannabis events, such as those at county fairs and in parks, where children and adolescents are inevitably exposed, even when certain areas are age-limited.”

But there’s much more, however, that cities can and should do.

“California built the largest legal cannabis market in the world, but we still lack the public-health guardrails required for a legal but addictive product,” said Dr. Lynn Silver, senior advisor to the groups, in a prepared statement. “As cannabis products grow more potent and marketing more aggressive, the evidence of harm is mounting. Local leaders must respond to what the science tells us — not to industry narratives.”

Pot and kids

Legalization has gone hand-in-hand with the notion that pot is safe. Back in 2000, more than 58% of high school seniors said that regular cannabis use was risky. In 2023, only 31% said the same — even as the potency of products increased.

One-third of high school seniors said they’ve used cannabis, “a number far exceeding that for tobacco use and one that should be concerning to all of us,” the report said. “Those who start young and use frequently are at the highest risk for developing dependence and adverse effects; therefore, minimizing use by this group should be a key policy objective.”

Among young adults aged 19-30, close to half — 43.6% — reported using cannabis in the past year.

California teens living closer to cannabis retailers have higher rates of use and dependence, studies have found, while national data show daily use among young adults has quadrupled, with one in 10 using daily.

The California State Auditor documented widespread failure to enforce rules prohibiting products and marketing targeting young people.

And the California Department of Public Health reports that since pot was legalized cannabis-related emergency room visits have spiked.

-In 2016, before legalization took full effect, there were 289.7 cannabis-related emergency visits for every 100,000 California residents.

-In 2019, after legalization, emergency visits peaked at 351.6 for every 100,000 residents.

-In 2023, emergency visits dipped to 331.5 per 100,000 residents, still well above pre-legalization levels.

Young people are impacted the most — more than half of cannabis-related emergency room patients were age 15 to 35.

Peer-reviewed evidence found that placing strategic limits on cannabis retailers can have a positive impact on youth cannabis use, the report said. A study of 103,000 California teens found that problematic cannabis use in that age group was 21% lower in jurisdictions with bans, and that longer drive times to the nearest cannabis retailer, as well as a lower density of storefront retailers, were associated with lower teen use.

That echoes the experience with alcohol and tobacco, the report said.

“The legalization of cannabis has potential social benefits as well as potential harms,” the report said.

“As the transition to a legal market moves forward in California, communities have a collective responsibility to act to protect youth and keep this emerging market from boiling over in harmful ways.”

Making it work

Costa Mesa has been one of the pioneers — and is doing just that, city officials said.

“We’re not seeing or hearing about any increased use of cannabis by minors under 21,” said Costa Mesa Mayor John Stephens. “If you go into our brick and mortar stores, they’re very well regulated. There’s a conditional use permit with a lot of different conditions and — for the purpose of this issue — you have to present your ID no matter how how old you are. I’m 63 — 21 times 3 — and I have to show ID.

“They keep your information on file and every time you go in, you have to present ID before you enter the store. You have an ante area, you have a security person there checking IDs before going in where merchandise is.”

The city’s 1,000-foot buffer rule, to distance legal shops from child-centric places, exceeds state rules that call for a distance of at least 600 feet.

The city’s rules have evolved over the years as a counter to “trap shops” — unlicensed cannabis pop-ups that you might have found in an underutilized strip mall — that proliferated during the early days of legalized weed, straining code enforcement and police resources in many cities. Those places were unregulated, untaxed and, typically, not particularly conscientious about checking ID.

“We spent a lot of time shutting those trap shots down,” Stephens said.

Now, if a shopping center wants to host a legal cannabis store, it must show that it has not had a trap shop for at least six months and that it has repaid the city for the cost of responding to any (trap shops) it might have had in the past.

Of course, the illegal sales are something the police in Costa Mesa — and, really, everywhere — continue to grapple with, but trap shops aren’t a primary source of such business.

From a fiscal standpoint, cannabis businesses have been good for Costa Mesa. In fiscal year 2023-24, they pumped $2.9 million into city coffers. In 2024-25, they pumped $3.6 million into city coffers.

But the market creates a saturation point, said Stephens, who added that it’s “been a long time” since Costa Mesa issued a cannabis-related conditional use permit.

“One of the things that’s very beneficial about these stores is they can take a blighted area and make it into a beautiful, attractive retail store. A couple have been entitled on Newport Boulevard and on Adams, but haven’t opened. I’d love to see them open up, but the city doesn’t control the market. People have to make their own decisions.”

The mayor feels that concerns about these businesses have been addressed.

“What we really see in the community, now, is improved retail stores, a quiet, low-impact use where adults go in, buy a produce that’s in many cases high-end, and then go home.”

The ideal: ‘boring’

The public health folks want to ensure that cannabis businesses are not close to schools, parks or other places where kids congregate. They want distance requirements between the businesses themselves, to prevent overconcentration. And they want prominent warnings, in stores, so consumers know the dangers of overuse.

They also want cannabis tax revenue to fund youth services and prevention programs.

“We know one of the most effective strategies for preventing youth substance use is keeping kids busy,” Padon, the research scientist, said. “Having tax-supported youth programs and services would be a great use of that money.”

And they don’t want cannabis products to appeal to kids.

“We’d like cannabis to be generally pretty boring,” Padon said.

“Adult consumers don’t need cannabis-infused root beer or banana cream pie-flavored vapes. But teens, especially novices, find those products familiar and inviting and are more likely to initiate use on a product like that.”

Only 14 of California’s 539 localities have enacted any restrictions on cannabis products. And marketing should not be appealing to youth; promotions shouldn’t be on social media where young folks are more likely to be exposed than adults.

Potency is also an issue, and should be capped, or taxed by the percentage of THC in a product. Cathedral City has imposed such a tax.

“California local governments have strong authority to regulate and license cannabis commerce, restrict more harmful product types or those attractive to children, require consumer information, limit marketing, and levy taxes and specify their use,” the report said.

“Our research showed that jurisdictions should build on state law, which has still failed to put in place adequate guardrails, by implementing additional public health and social equity provisions to exercise our collective responsibility to protect youth and public health and advance equity.”