Rethinking weed policy amid rising health concerns

Three years after decriminalizing cannabis, Thailand is reviewing its policy as experts warn of rising youth use, health complications, and lax regulation.

At a recent forum, health and legal experts reported that cannabis use among 18- to 19-year-olds rose from under 1% in 2019 to nearly 10% in 2022. Although rates have slightly declined since, they remain significantly higher than pre-legalization levels. Cases of psychosis and acute intoxication have also increased, with healthcare costs in 2023 exceeding 15.8 billion baht.
Nearly 18,000 licensed cannabis shops now operate nationwide, alongside many unlicensed vendors, particularly in tourist areas where enforcement is weak and age verification often lacking. International travel advisories and legal uncertainty have added pressure on Thai authorities to tighten oversight.

Critics attribute the problems to the absence of a clear regulatory framework following the 2022 decriminalization. A proposed bill under review aims to restrict cannabis use to medical purposes and introduce stricter controls.

Campaign launched to tackle NCDs

Meanwhile, the Ministry of Public Health is intensifying efforts to reduce non-communicable diseases (NCDs), which cause over 1,000 deaths daily and threaten both public health and economic development.
On June 16, Public Health Minister Somsak Thepsuthin chaired a meeting to advance the national NCD prevention and control plan for 2023–2027. The session concluded with the launch of the “Slim Down, Stop NCDs” campaign, aimed at reducing premature deaths linked to heart disease, diabetes, and cancer.

NCDs account for more than 400,000 deaths annually, or 81% of all deaths in Thailand. These are largely driven by lifestyle and environmental risk factors, including poor diet, inactivity, smoking, and excessive alcohol use.
Some progress has been made, with reductions in smoking, sodium consumption, and alcohol intake. However, key indicators such as hypertension, diabetes, obesity, and physical inactivity remain off track. Officials stressed the need for stronger coordination across government, the private sector, and civil society.

The risk of early death from NCDs has declined slightly—from 14.8% in 2010 to 14.6% in 2022. The government’s target is to bring this down to 11.07% by 2025.

To promote implementation, a new sub-committee will oversee the rollout of the national plan, ensuring alignment with agency goals and measurable outcomes. Long-term success, officials say, will rely on collective action and encouraging individuals to take charge of their own health.

Related: Thailand to be first Asian country to legalize cannabis

Prime Minister Srettha Thavisin, who vowed to “rectify” cannabis laws within six months of taking office, seeks a more stringent approach even though recreational use was already illegal. This shift disappoints pro-legislation advocates and cannabis entrepreneurs who thrived under the prior relaxed regulations.

Reports indicate that individuals caught using cannabis recreationally may face fines up to 60,000 baht (US$1,711), while providers could encounter up to a year in prison, a 100,000 baht fine, or both. Additionally, the legislation seeks to criminalize the marketing and advertising of cannabis. The government’s move follows expressed concerns about potential addiction and the broader impact of recreational cannabis use.

Open for public feedback until January 23, the proposed bill reflects a significant change in direction for Thailand, which emerged as the first Asian country to fully decriminalize cannabis in June 2022. This move initially fueled a thriving cannabis industry, attracting both locals and tourists. However, the current government’s emphasis on stricter regulations signals a departure from the previously relaxed stance on cannabis.

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US states that have legalised recreational cannabis use are seeing an uptick in the current and daily use of the psychoactive stimulant, compared to states where cannabis use remains illegal. The joint study by Columbia University Mailman School of Public Health and The City University of New York (CUNY) also found that rates of cannabis use was even higher among adolescents aged 12-17 who smoked – respondents in this particular study were limited to the year 2017 and resided in states where cannabis use was legally accepted.

According to data from the 2004-2017 National Survey on Drug Use and Health, cannabis use and daily cannabis use increased in the US, from 2004 to 2017, with little difference owing to the state-level legal status of the drug. States with recreationally legal cannabis use reported higher frequency of use, relative to states with legal medical cannabis and those with no legal cannabis use.

The researchers found Americans who smoked cigarettes were likely to also smoke weed (cannabis): in 2017, one in three (33%) daily cigarette smokers reported cannabis use in the past month and almost one in five (18%) reported daily cannabis use. In contrast, cannabis use and daily cannabis use was markedly lower among non-smokers. These statistics were observed in states that had adopted recreational cannabis laws.

It was additionally reported that, among young Americans between the ages of 12-17 who used cigarettes daily, a majority (73%) had used cannabis in the past month and almost one in three (30%) used cannabis daily. And, among adolescents who did not smoke cigarettes, 5% used cannabis in the past month and one percent used cannabis daily.

“Based upon over a decade of data, cannabis use was markedly more prevalent in states where recreational use is legal for adults, relative to states where it was not in 2017. Yet, the increases in cannabis use during this time period were as fast, or faster, in states where cannabis use is prohibited by law, relative to states that had legalised for recreational use by 2017,” said Renee Goodwin, adjunct associate professor of epidemiology at Columbia Mailman School and professor of epidemiology at CUNY.

While US states are rapidly passing legislation for cannabis use, it fails to provide the requisite public education on how it can be used safely, Goodwin observed.

“It remains to be seen how increased lawful access and growing use of cannabis among adults in all states – almost regardless of legal status – will impact the adolescent population. Recent trends, however, outline a potential explosion in both of-age and under-age use.”