Background. Cannabis legalization resulted in different models. Quebec’s provincial authorities have opted for a singular, not-for profit, distribution regime. Some prospective analysis have outlined some potential benefits and undesirable consequences for public health.
Methods. Québec’s public health outcomes are compared to those of Colorado, Oregon and Washington (USA) and Alberta, British Columbia, and Ontario (Canada). A vote-count synthesis is performed on the 97 selected evaluative documents. The 1070 measures of public health indicators contained in these are classified into five categories: cannabis consumption; consumption of other psychoactive substances; perceptions of consumption; mortality, morbidity and associated situational and behavioural risk factors and; social determinants of health. They are also classified according to whether they are favourable, neutral or unfavourable to public health. A complimentary content analysis is also performed.
Results. The distributions of measures regarding ‘cannabis consumption’, ‘perceptions of consumption’ and ‘mortality, morbidity and associated behavioural and situational risk factors’ suggest less unfavourable outcomes for public health in these regards in Quebec. The distributions of outcomes related to the ‘consumption of other substances’ are largely neutral in all jurisdictions. A general comparison of ‘social determinants’’ distributions is impossible.
Discussion.The less unfavourable outcomes in Québec are probably related to regulatory choices regarding cannabis products, place, promotion and governance. Price-related choices could have played a moderating role. For comparisons to prove more complete, research efforts are needed to address knowledge gaps. Knowledge synthesis methods that can characterize the magnitude of the changes could also be deployed.