Getting it Right from the Start

Advancing Public Health & Equity in Cannabis Policy


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They say the devil is in the details.

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Today, 15 states, the District of Columbia, and two US territories have legalized recreational marijuana use. In most states legalization  has focused more on creating a legal profit-making  system than on putting in place the guardrails to protect public health, youth or social equity.  Our project works with states that have legalized or are considering legalizing cannabis, as well as  cities and counties, to develop and share models for safer cannabis policy and provide guidance on policies that can reduce harm, protect against youth and problem cannabis use, and promote social equity. We draw on the best science available from research on cannabis policy and lessons from tobacco and alcohol control. 

We have conveyed our research into best practices

Model Ordinances

Guidance on public health & equity measures that states, cities and counties should consider adopting  if cannabis legalization is under consideration or has already occurred.  Specific models appropriate for California cities and counties are available.

Model Comments & Letters

Based on the best scientific evidence, we draft model comments & letters on proposed cannabis regulations.

Basic Principles of Action

We have prepared an abbreviated version of key principles and action steps for regulating.

Press Release: The State of Cannabis Policy in California's Cities & Counties


California’s Local Cannabis Policies Can’t Keep Pace With Surging Sales,

Leaving Public Health and Equity Behind

Scorecards Reveal Pathway Forward for Cities and Counties

OAKLAND, CALIF., DECEMBER 2, 2021 … While legal cannabis sales in California are increasing dramatically, local policy efforts to protect youth and public health have lagged behind, according to a statewide study conducted by the Public Health Institute’s Getting it Right from the Start Project.

The Project, which generates scorecards evaluating policies passed by cities and counties that allow cannabis sales, found only limited progress in cannabis policy since 2020, with many jurisdictions not yet opting to go beyond basic state law to promote public health, protect youth or advance social equity.

“Until the state takes up its responsibilities to protect our kids, it falls on local governments to do what’s necessary to protect our public health and prevent the cannabis industry from evolving into yet another ‘Big Tobacco,’” says Dr. Lynn Silver, MD, MPH, the Project’s Principal Investigator. “These scorecards provide a clear roadmap for cities and counties.”

Some local governments are choosing to lead the way, taxing more dangerous high potency products and prohibiting flavored products—such as flavored grape vaping cartridges and strawberry “pre-rolls”— known to attract youth, and capping the number of retailers to avoid oversaturation. While 52 percent of all jurisdictions in the state allow some form of legal cannabis retail, only three of them, Contra Costa County and the cities of San Luis Obispo and El Monte, scored at or above 50 out of a possible 100 points on the scorecard, with a statewide average score of 17 across all jurisdictions allowing any form of retail sales. Turlock improved the most, rising from 11 to 31 points from 2020 to 2021.

“The legal market in California is growing,” says Dr. Alisa Padon, the Project’s research director. “Sales, and consequently tax revenue, grew by 55 percent in just the past year, with the number of licensed retailers skyrocketing to 1,361. Yet the state and many local jurisdictions have failed to put in the urgently needed guardrails necessary to protect kids and public health, or advance social equity. Some communities are beginning to step up to the plate, but many more need to take action.”

Based on a 100-point scale and three years of data, the scorecards measure 27 storefront-specific and 24 delivery-specific local policies across six categories: retailer requirements, taxes and prices, product limits, marketing, smoke-free air, and equity and conflicts of interest. PHI worked with state and national subject matter experts, including cannabis businesses, regulatory officials, policymakers, municipalities and community partners, to identify best practices that can help communities better safeguard their youth and support social equity through passage of more thoughtful and effective cannabis policies.

Again, San Luis Obispo scored highest of all by limiting the number of retailers and distancing them from places that serve youth. Contra Costa County showed statewide leadership by prohibiting the sale of flavored products for inhalation or combustion, widely known to hook kids. El Monte dedicated tax revenue to youth programs and addiction prevention, established equity laws and limited marketing. The top scorer among delivery-only jurisdictions, San Benito County, with 39 points, only allows deliverers located outside the county to serve residents and established a licensing program, restricted delivery locations, prohibited billboards, blocked temporary events and passed a local tax.

“The practical information these scorecards offer is indispensable to cities and counties, and was used to formulate our local rules,” says Ryyn Schumacher, deputy director of Public Health for Santa Barbara County. “Local governments’ decisions over the next few years will be critical. If we do this right, we can provide safer legal access while reversing increases in youth vaping and use of marijuana. But without swift action, we could expose our young people to harm for decades to come.”

The Project found that by January of 2021, 173 of California’s 539 cities and counties allowed storefront sales of cannabis, and an additional 108 allowed sales by delivery only. Most jurisdictions had low scores, averaging 21 points for storefront scorecards and 12 for delivery-only. However, overall scores did improve by an average of one point between 2020 and 2021. Highlights of the findings include:

  • 74% (a 4% increase) of jurisdictions allowing storefront retailers limited the number of outlets.
  • 45% established stronger buffers to distance storefront outlets from schools and youth.
  • 157 implemented local cannabis taxes, and 12 dedicated revenues to substance abuse prevention, youth education or mitigating the impact of the war on drugs.
  • Two cities, Grass Valley and Cathedral City, taxed products by the amount of THC.
  • Contra Costa County and Watsonville prohibited flavored products for inhalation, which are known to be appeal to youth, while Chico and Mammoth Lakes severely limited them.
  • Mono County, Chula Vista, San Diego County and Pasadena prohibited “cannapops”— cannabis-infused beverages like orange soda.
  • Most kept storefront retailers smoke-free, though 40 (up from 34) went backwards on smoke-free air by allowing on-site cannabis consumption, bringing back the era of “smokefilled rooms.”
  • 20 had specific policies for equity in hiring or licensing, up from 13 in 2020 and five in 2019.
  • Pasadena and Imperial Beach prohibited discount coupons, while Pomona and Chico prohibited paraphernalia giveaways.

To assist local governments, the Getting it Right from the Start Project offers model policies for cannabis retailing, marketing and taxation that cities and counties can adopt. The Project also offers complementary resources and expert technical assistance to state and local regulatory agencies, policymakers and their staff, as well as community organizations and advocates.

NEWS!! California State Governor Newsom Vetoes Bill That Would Allow Cannabis Billboards Along Most CA Highways

Gov. Gavin Newsom on Friday, October 8, 2021, vetoed AB 1302 (Quirk), a bill that would render Prop 64’s promised protections against exposing children to cannabis marketing ineffective by allowing cannabis licensees to advertise on highway billboards or similar devices as long as it is placed further than 15-miles from the California border.

Gov. Newsom sided with groups like the Public Health Institute, an independent nonprofit, and Youth Forward, a Sacramento-based youth advocacy organization, that cannabis ads on billboards would “further expose our children and young people to cannabis ads every day.” In his veto message, Newsom states that he rejected AB 1302 because “allowing advertising on these high-traffic thoroughfares could expose young passengers to cannabis advertising.”

Two Cannabis Bills Detrimental to Public Health and Food Safety


We can allow safer legal access to cannabis and useful hemp products without going backward in our commitments to public health and food safety. Commentary originally published on CalMatters on September 7, 2021.

Legalizing cannabis was supposed to be about social justice. About ending mass incarceration of people of color for possessing a small amount of marijuana. About safer legal access.

But there are many things legalization should not be about. It should not be about initiating and hooking more kids, or adding neurologically active and psychoactive substances to our food.

Yet all these things are happening. The cannabis lobbyists are no longer off-the-grid farmers from the Emerald Triangle. They are Altria, one of the world’s largest tobacco companies and Constellation, a major alcohol company. The halls of our state Capitol are replete with cannabis and hemp lobbyists successfully selling their goods.

As this legislative session winds down, at least two dangerous cannabis and hemp-related bills are moving forward.

Assembly Bill 1302, which recently passed by one vote, will assure that our kids grow up seeing billboards for cannabis, just as I grew up with the Marlboro Man and Joe Camel. When we legalized cannabis, Proposition 64 promised that California would have stringent protections for children, and prohibited billboards. The state turned around and allowed them through regulation. Angered San Luis Obispo parents sued, and this year the courts concurred that the regulation violated Prop. 64’s intent to protect children.

AB 1302, introduced by Assemblymember Bill Quirk, a Democrat from Hayward, will make those billboards OK, while a dozen other states effectively prohibit cannabis billboards. Companies use billboards because they work. Research confirms they increase interest in and use of unhealthy products by youth. One study found increased cannabis use and dependency in teen cannabis users exposed to billboards after legalization in six states. Gov. Gavin Newsom should veto this bill that will expose kids to cannabis ads.

A second bill, Assembly Bill 45, introduced by Assemblymember Cecilia Aguiar-Curry, a Democrat from Woodland, claims to create a regulatory system for hemp, but poses different problems. An 11th-hour amendment deal only made public Thursday night will legalize production of a new class of smokable hemp products prohibited in previous versions. It will include flavored hemp e-cigarettes and cigarettes that attract kids – provided the flavors are “natural.” If AB 45 passes, smokable hemp will be the new path to introduce youth to smoking.

Cannabis products, what are they?

Product diversification is a key and concerning strategy of today’s cannabis industry. From traditional flowers to inhaled products to edibles, the world of cannabis products and their modes of consumption is constantly changing. To shed some light on this topic we created a short brief on Cannabis Products, with some basics and examples of commonly used products currently available in the industry.

Access our most recent Webinar on Mobilizing Local Cannabis Tax Revenue in the COVID-19 Era

In 2018, 289, or 58% of California cities and counties legalized some form of commercial cannabis activity, including cultivation, manufacturing, distribution, retail or testing. Of those, at least 53% did not levy a tax. 

What legal limits have cities and counties adopted since California legalized marijuana use for adults, and to what extent do these legal limits incorporate public health recommendations and lessons from tobacco control?

Assessment of Incorporation of Lessons From Tobacco Control in City and County Laws Regulating Legal Marijuana in California

California legalized medical marijuana in 1996 and adult recreational use in 2016, effective in January 2018.

California Cannabis Tax Revenues Padding Law Enforcement Budgets

As activists across the country call to reduce funding for police departments, a report from Youth Forward and PHI’s Getting It Right from the Start shows cities across California are spending cannabis revenues on city and county law enforcement.

Program Goals

  • Protect children and youth
  • Don’t exacerbate existing health inequalities such as low birth weight, poor mental health outcomes, or lower high school graduation rates
  • Minimize cannabis dependency and attendant health and social harms
  • Minimize creation of a powerful new tobacco-like industry
  • Reduce social harms related to the war on drugs
  • Promote economic and social justice

Reach Us

Getting it Right from the Start
Public Health Institute
555 12th Street, Ste 290
Oakland, CA 94607

About Us

We collaboratively develop and test models for  optimal cannabis policy (retail practices, marketing & taxation), based on the best available scientific evidence,  with the goal of reducing harms, youth use & problem use and promoting social justice and equity. 

We provide technical assistance to jurisdictions which have legalized cannabis or are considering legalizing or decriminalizing cannabis, and to community partners. Please contact Aurash Soroosh for more information.