Canada legalized recreational cannabis in October 2018, but the new legal industry took time to develop. Between spring 2019 and spring 2023, the number of licensed stores grew 13-fold while retail prices fell 28%. This observational study first tested whether self-reported cannabis use prevalence, daily usage, age of initial use, or product preferences changed during that 4-year commercialization period. It then analyzed whether the changes were associated with rising store numbers or falling retail prices.

From 2019 to 2023, there were no significant changes in prevalence of use among men or among young adults, nor in the proportion of cannabis consumers using the substance daily. Prevalence among women and among older adults increased; those increases showed negative associations with price levels but no associations with store densities. Dried cannabis use decreased and was positively associated with prices, whereas edibles use increased and was negatively associated with prices; neither change was associated with stores. The average initial age of use increased; it was negatively associated with prices and positively with stores.

Overall, Canada’s substantial retail cannabis developments were accompanied by only modest usage changes. Increasing product affordability might have encouraged more older adults and women to try cannabis, and more consumers to switch from dried cannabis to edibles. Increasing retail availability also might have encouraged more older adults to try cannabis.