Alcohol and tobacco cause more harm than cannabis, reveals study in Canada

A scientific analysis conducted in Canada reignites an old debate from a new perspective: the real impact of psychoactive substances on society. By comparing 16 drugs based on criteria that go beyond individual effects, the study identified that alcohol and tobacco top the harm ranking, surpassing historically more stigmatized substances like cannabis.

Published in the Journal of Psychopharmacology, the research used the multicriteria decision analysis (MCDA) methodology to evaluate not only the pharmacological effects but also factors such as prevalence of use, social costs, and economic impacts.

Harm ranking challenges historical perceptions

The results show a significant difference between legalized substances and those still facing greater restriction. Alcohol ranks first with 79 points, followed by tobacco (45) and non-prescription opioids (33). Cocaine and methamphetamine then scored 19 points each, while cannabis appeared with 15.

Recently, we published an article on the Sechat Portal that mentioned how science views the differences between alcohol and cannabis and how they both affect our brains. 

The Cañamo Portal also highlighted the Canadian research pointing out that “alcohol and tobacco are considered more harmful than cannabis in Canada,” emphasizing that the most relevant data is not just the position of cannabis, but the distance between it and socially widely accepted substances.

According to the publication, “comparing a seemingly 'harmless' substance dismantles a deeply rooted hierarchy, where the legal is not necessarily the least harmful, and the prohibited does not always rank first in terms of overall harm”.

How harm was calculated

The methodology applied by the researchers considers two main axes: harm to the individual and impacts on society. Criteria include mortality, dependency, physical and mental harm, as well as economic and social costs.

The authors emphasize that the scores do not represent the isolated risk of use, but rather the collective impact. As the study explains, it is an analysis that takes into account “the prevalence of its use, its availability, and the regulatory framework in which it circulates”.

This point helps understand why alcohol ranks first: besides its health effects, it is a widely consumed and socially normalized substance.

Cannabis and public policies at the center of the debate

With a lower score in the ranking, cannabis appears as one of the substances with the least overall impact in the analysis. Nevertheless, the study does not dismiss risks but suggests that its effects should be analyzed within a broader context.

According to the Cañamo Portal, “harms depend not only on the substance itself but also on the public policies surrounding it”. In Canada, adult cannabis use is regulated by law, with control over production, distribution, and sale.

This scenario reinforces the importance of regulatory environment in defining the social impacts of each substance, shifting the debate beyond pharmacology.

Global data reinforce the impact of alcohol and tobacco

The study findings resonate with international data. The World Health Organization estimates that alcohol was associated with approximately 2.6 million deaths in 2019, while tobacco is responsible for over 7 million deaths per year.

In Canada, the report “Costs and Harms of Substance Use in Canada” indicates that alcohol represented 40.1% of attributable costs of substance use in 2020, followed by tobacco with 22.7%.

For the Cañamo Portal, these numbers reinforce that “this is not a rhetorical provocation from the cannabis community, but rather evidence that aligns with already available data on economic and health impacts”.

Regulation and scientific evidence take center stage

The analysis also contributes to reframing the debate on drug policies. By highlighting discrepancies between legal substances and their actual impacts, the study suggests the need for evidence-based decisions.

As emphasized by the Cañamo Portal, “the political value of this type of work lies in shifting the debate from slogans to proportionality”. From this perspective, criteria such as collective harm play a central role in shaping public policies.

Source: With original information published by the Cañamo.