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. Author manuscript; available in PMC: 2025 Dec 17.
Published in final edited form as: Int J Drug Policy. 2025 Oct 28;146:105041. doi: 10.1016/j.drugpo.2025.105041

Concurrent availability of cannabinoid and tobacco products in licensed tobacco retailers in three U.S. cities

Torra E Spillane a,*, Joanna E Cohen a, Tory R Spindle b, Johannes Thrul c, Meghan Moran a, Hye Myung Lee d, Daniel P Giovenco d
PMCID: PMC12707458  NIHMSID: NIHMS2120646  PMID: 41161101

Abstract

Background:

Federal hemp legalization and expanding state cannabis laws have increased cannabinoid availability across U.S. retailers. Given health risks of tobacco-cannabis co-use, this study documented cannabinoid availability in tobacco retailers across cities with differing cannabis policies New York City and San Francisco (recreational cannabis legal) and Philadelphia (medical only) and analyzed associations with tobacco product offerings.

Methods:

A stratified random sample of 20 % of licensed tobacco retailers (n = 1402) was selected from each city. From June to December 2023, trained researchers conducted in-person visits to brick-and-mortar locations to document availability of tobacco and cannabinoid products. Descriptive analyses characterized product availability by store type, and logistic regression examined associations between tobacco product offerings and cannabinoid availability.

Results:

THC and CBD were each available in 9.8 % of stores with no significant differences observed across cities. After adjustment, with stores not selling each product as the reference groups, stores selling e-cigarettes had higher odds of selling THC (aOR=3.2, 95 % CI: 1.9–5.6) and CBD (aOR=3.0, 95 % CI: 1.7–5.2). Stores selling cigars also had higher odds of selling THC (aOR=2.6, 95 % CI: 1.5–4.7) and CBD (aOR=1.8, 95 % CI: 1.0–3.2). Conversely, cigarette-selling stores had lower odds of cannabinoid availability (THC: aOR=0.5, 95 % CI: 0.3–0.9; CBD: aOR=0.4, 95 % CI: 0.2–0.9).

Discussion:

This study identified a significant presence of cannabinoids in tobacco retailers across three U.S. cities with differing cannabis laws, with higher odds of being sold in stores selling e-cigarettes and cigars. Findings indicate an interconnected retail landscape for tobacco and cannabinoid products, highlighting a need for enhanced regulatory oversight and improved compliance with existing policies.

Keywords: Tobacco, Cannabis, Retailers, Co-use, Policy, Availability, Cannabinoids

Background

Tobacco and cannabis are commonly used substances in the United States. In 2024, 16.7 % of individuals aged 12 or older reported past-month use of any tobacco product, and 15.4 % reported past-month cannabis use (Substance Abuse & Mental Health Services Administration, 2025). Co-use of these substances also occurs; pooled nationally representative data from 2021 to 2023 found that 16.1 % of adults reported tobacco-only use, 7.3 % reported cannabis-only use, and 8.2 % reported past-month use of both tobacco and cannabis (Lee et al., 2025).

The harms of tobacco use, including cancers, cardiovascular disease, and stroke, are broadly recognized (National Center for Chronic Disease Prevention & Health Promotion, 2014; The National Academies Press, 2007), and concerns regarding co-use with cannabis are rising (Hindocha & McClure, 2021; Meier & Hatsukami, 2016). Cannabis use has been linked to increased initiation of tobacco products among U.S. adults and youth (Ksinan et al., 2020; Weinberger et al., 2018; Weinberger et al., 2021). Among those who have used tobacco, cannabis use is associated with lower odds of quitting and higher relapse (Voci et al., 2020; Weinberger et al., 2020). Additionally, national data indicate a rise in cigarette dependence among non-daily cannabis users from 2002 to 2019, and co-use is linked to greater cannabis dependence (Weinberger et al., 2023). The use of tobacco for cannabis administration, such as blunts (i.e., hollowed cigar filled with cannabis) and spliffs (i.e., tobacco and cannabis combined in rolling paper) (Kumar et al., 2020; Schauer et al., 2017), highlights further overlap between these substances (Smith et al., 2021). Similar modes of delivery such as vaping or smoking may further drive co-use, and some individuals may modify electronic nicotine delivery systems (ENDS) to vape cannabis (Agrawal et al., 2012; Ouellette et al., 2024). Notably, those who co-use are more likely to use non-cigarette tobacco products (e.g., cigars and ENDS) and multiple tobacco products (Osibogun et al., 2018; Reboussin et al., 2021). These findings suggest that those who co-use may have distinct tobacco use tendencies and highlight the need to investigate exposure to these products together, as overlapping access points may contribute to sustained use patterns.

Developments in cannabinoid legalization may promote overlapping exposure to tobacco and cannabinoids. As of 2024, 24 U.S. states and three territories have legalized recreational cannabis (e.g., that containing delta-9 THC), with most allowing sales via licensed dispensaries. Prior to that, the Agriculture Improvement Act of 2018 (The “Farm Bill”) legalized the sale of “hemp,” defined as cannabis containing <0.3 % of delta-9 THC, and any constituents derived from hemp (aside from delta-9 THC) throughout the U.S. (Harlow et al., 2022). This created a regulatory loophole as the cannabis plant contains many constituents beyond delta-9-tetrahydrocannabinol (THC, the primary psychoactive component in cannabis), including non-intoxicating compounds like cannabidiol (CBD) and diverse intoxicating cannabinoids beyond THC (Radwan et al., 2021; Schilling et al., 2020).

This loophole allowed cannabis constituents aside from delta-9 THC to be sold nation-wide, including in states where recreational cannabis remains illegal (Harlow et al., 2022). Thus, products containing CBD, minor cannabinoids (e.g., CBN), or isomers of delta-9 THC (e.g., delta-8 THC and THC-O acetate) have increased in availability and visibility in the U.S. (LoParco et al., 2023). Notably, the spread of delta-9 THC isomers is concerning as these compounds are close chemical relatives of delta-9 THC and may produce comparable or stronger psychoactive effects (Sabaghi; Livingston et al., 2022). The relevance of cannabinoids to tobacco co-use likely differs by compound. Most evidence on tobacco and cannabis co-use reflects intoxicating THC products, typically in smoked or vaped forms, with practices such as blunts and spliffs highlighting intentional overlap between the substances (Schauer et al., 2017). In contrast, there is limited evidence directly linking CBD or other non-intoxicating hemp products with tobacco co-use. Importantly, many studies, including those using large national survey data, do not specify delta-9 THC when asking about cannabis or marijuana use (PATH; Substance Abuse and Mental Health Services Administration), making it difficult to parse out the exact cannabinoids reported in affirmative responses.

In response to the concerning availability of intoxicating cannabinoids, some states have moved to close this regulatory loophole by restricting the sale of delta-8 THC and other hemp-derived intoxicating cannabinoids though enforcement has proven difficult (Christensen, 2024; Marihuana Regulation and Taxation Act (MRTA)). The availability of cannabinoids outside of licensed dispensaries, driven by enforcement complications and industry exploitation of legal loopholes, has enabled the simultaneous sale of cannabinoids and other regulated substances in shared retail settings.

One area where this overlap is already evident is within the tobacco retail environment. One study examining shifts in product availability among vape shops in six U.S. cities found that cannabis paraphernalia and CBD availability more than doubled between 2018 and 2021 and that the majority of shops (62.2 %) sold THC products (Berg et al., 2023). An earlier study utilizing retail sales data found a sharp increase in vape pens containing CBD oil sold in tobacco retailers from 2017 to 2019 (Gammon et al., 2021). To date, no study has examined cannabis product prevalence across all types of licensed tobacco retailers (e.g., gas stations, convenience stores) in addition to vape shops. Furthermore, no study has examined how availability of cannabinoid products overlaps with diverse tobacco and nicotine products (e.g., cigars, e-cigarettes).

This study documents the prevalence of cannabinoid products in licensed brick-and-mortar tobacco retailers in three populous U.S. cities with varying cannabis regulatory approaches: New York City, Philadelphia, and San Francisco. In New York, recreational cannabis was legalized in 2021, allowing sales in licensed cannabis dispensaries, where only cannabis and related products can be sold. However, New York State has prohibited the sale of delta-8 THC and other THC isomers, including within licensed dispensaries, since 2021 (Marihuana Regulation and Taxation Act (MRTA); Office of Cannabis Management). Philadelphia permits medical cannabis under Pennsylvania state law but prohibits recreational use, with possession of small amounts decriminalized through local ordinance (Medical marijuana program in Pennsylvania, 2023). Pennsylvania and Philadelphia did not prohibit the sale of THC isomers such as delta-8 THC at the time of data collection, though some district attorneys considered delta-8 sales illegal under their interpretation of state law (Legislative Data Processing Center; Schweigert, 2023). Retailers could therefore sell hemp-derived intoxicating cannabinoids under the federal regulatory loophole described previously, though the status of these products was described at the time as a legal ‘gray area,’ with uncertainty about enforcement influencing retailer risk tolerance for sales (Baker, 2022). San Francisco, under state law, has had legalized recreational cannabis use since 2016 (Office of Cannabis Laws and Regulations | San Francisco). In California, during the period of data collection, hemp products containing federally legal amounts of delta-9 THC (i.e., <0.3 %) could be sold through general retailers without requiring cannabis dispensary licensing, while THC isomers (e.g., delta-8 THC) were treated as cannabis and required to be sold through licensed dispensaries if they exceeded 0.3 % total THC (including all THC isomers) by dry weight (AB 45 Industrial hemp products, 2022, p45). This study examines cannabinoid prevalence in tobacco retailers in these cities and measures associations with store-level characteristics, such as store type and the availability of diverse nicotine and tobacco products.

Methods

Retailer sampling

Names and addresses of all licensed tobacco retailers active in 2022 were obtained for New York City, Philadelphia, and San Francisco. These cities are study sites for a parent project investigating tobacco retail licensing policies; each had adopted licensing initiatives that capped the number of tobacco retailers at the district or neighborhood level, making them early adopters of this type of policy (Bright Research Group, 2016; Giovenco et al., 2024; Lawman et al., 2020). Address lists were obtained from the New York City Open Data portal, the City of San Francisco, and the Philadelphia Department of Public Health. Each dataset was reviewed to resolve any errors, including misspellings, missing address information, and duplicates. Google Earth Pro was used to geocode all addresses in the sample. Geocoded addresses were imported into QGIS (Version 3.28.14 LTR) and linked to their underlying administrative districts (i.e., Community Districts, Planning Districts, and Supervisorial Districts,) using the spatial join tool. A random sampling approach, stratified at the district level, was adopted to select 20 % of tobacco retailers within each city. This resulted in a sample size comprising 1066 retailers in New York City, 120 retailers in San Francisco, and 392 in Philadelphia (total n = 1578).

Data collection

The data collection was completed by five research team members. Before initiating store visits, data collectors completed a two-day, classroom-based training adapted from established tobacco retailer assessment protocols developed in prior work by our team and others (Giovenco et al., 2019). Training included modules on tobacco and cannabis retail landscape (e.g., product categories, common brands), study protocols (e.g., data collection instrument, route planning), and field safety. Materials were derived from field-based observations of tobacco retailers (e.g., tobacco “power walls”) as well as images of cannabinoid products from publicly available product listings and manufacturer websites, selected to illustrate variation in THC and CBD labeling. Training was followed by a series of assessments, practice exercises, and supervised store assessments to demonstrate proficiency and identify any areas for further training. The same team of trained data collectors carried out the study for its duration, adhering to a written protocol and coding manual and meeting regularly with senior investigators to address questions and reinforce consistency.

Data collection took place between June-December 2023. Each store was visited by one data collector, who entered and assessed the stores unobtrusively, a strategy frequently employed in tobacco retailer assessment studies (Lee et al., 2014). The assessment process included a comprehensive evaluation of the store environment, including both interior and exterior areas, with particular attention to the sales counter and its immediate vicinity. Data collection on cannabinoid/tobacco products was limited to visible items during store visits. Products were not physically handled, and data collectors were instructed not to inquire about cannabinoids if products were not displayed, given the sensitive nature of this issue in the context of potential violations of the law. Interior point-of-sale advertising for tobacco or cannabinoid products was not systematically documented. Data were entered into Fulcrum (Spatial Networks, 2025), a mobile application that collects geocoded survey data and photos. Fulcrum has been used successfully in other studies assessing tobacco product availability (Giovenco et al., 2019). To assess interrater reliability, a randomly selected 10 % subset of retailers was double visited during the first few months of data collection by the project’s principal investigator (DPG), who has over a decade of experience in retailer assessment methodologies. All measures included in this study had Kappa statistics greater than 0.8 except for smokeless tobacco availability, which had a Kappa statistic of 0.75, demonstrating a high degree of agreement. Data collection proceeded independently thereafter.

Measures

Data collectors recorded information on the availability (yes or no) of cigarettes, cigars (e.g., large cigars, cigarillos), e-cigarettes, oral nicotine pouches (ONPs), and oral smokeless tobacco (e.g., moist snuff, snus). For cannabinoids, availability (yes or no) was recorded for three categories of products. The category for CBD products was defined as products labeled as containing CBD with no clearly visible reference to any THC component. The category for THC products was defined as products labeled or indicating THC; this category was applied to items labeled with delta-9 THC, a THC-containing strain category (i.e., indica, sativa, or hybrid) and to THC-isomer products (e.g., delta-8 THC) labeled with THC and/or strain categories. The study instrument did not distinguish whether THC products were marketed as hemp-derived or non-hemp products. In this study, “THC” henceforth refers to the coded variable representing this broad category of THC-containing products unless a specific cannabinoid (e.g., delta-8 THC, delta-9 THC) is noted.

CBD refers to the coded variable for products labeled as CBD. When data collectors were not able to differentiate between THC or CBD categories, products were documented in a general (unknown) cannabinoid category. A recoded variable, any cannabinoid product availability, was generated to indicate sale of any of these products (i.e., THC, CBD, general/unknown). The mode of cannabinoid administration (e.g., combustible, edible, or vaporized forms) was not recorded. Data collectors further documented the presence (yes or no) of cannabis paraphernalia; this item was defined as delivery tools (i.e., pipes, bongs, bowls, cannabis vaporizers) and other accessories (i.e., rolling trays, ash trays, and rolling papers) that were explicitly labeled with cannabis terminology or imagery (e.g., depicted cannabis leaf).

Store type was initially coded into seven categories: (1) chain convenience store (2) non-chain convenience store (e.g., small corner store), (3) bar or liquor store, (4) grocery store, (5) smoke/vape shop, (6) gas station, and (7) other, which included retailers such as restaurants, newsstands, and casinos.

Statistical analysis

Stata/BE 18.0 software was used to conduct analyses (Stata statistical software, 2019). Descriptive and bivariate analyses with Chi-square tests characterized product availability and store type and identified differences across cities. Chi-square tests also assessed differences in the prevalence of cannabinoid products by store characteristics (tobacco/nicotine product availability and store type). Due to small cell sizes for certain retailer categories and associated modeling issues, store type was recoded into a new variable, which included non-chain convenience stores, gas stations, smoke/vape shops, and other. Store types representing <3.5 % of the sample were collapsed into the ‘other’ category. Simple logistic regression models were estimated on two cannabinoid outcomes (CBD and THC availability) to test the odds of cannabinoid availability by store characteristics with no adjustments. Multivariable logistic regressions were then conducted with sequential adjustment: first adjusting for other nicotine and tobacco products sold (Model 1), adding store type (Model 2), and further adjusting for city (Model 3).

Results

Data collectors successfully obtained data for 89.0 % of the original sample, resulting in a final dataset that included 1402 retailers. The proportion of successful visits did not significantly differ by city. Reasons for not conducting observations in all sampled stores included store closures (n = 126), inability to locate stores (n = 38), duplicate entries (n = 4), perceived safety concerns (n = 3), being asked to leave a store (n = 1), and store in private building with restricted public access (n = 1). Comparable proportions of unsurveyable stores have been reported in prior U.S. tobacco retailer assessment studies (Berg et al., 2021; Farley et al., 2020).

Product availability and store characteristics

The majority (68.1 %) of tobacco retailers were non-chain convenience stores, followed by gas stations (7.9 %) and smoke and vape shops (7.5 %) (Table 1). San Francisco had a notably higher proportion of bar or liquor stores (19.6 %) and grocery stores (12.1 %) licensed to sell tobacco compared to New York City and Philadelphia. Gas station outlets were more prevalent among stores sampled in Philadelphia (10.9 %) and San Francisco (9.4 %) than stores sampled in New York City (6.7 %). Philadelphia had a higher proportion of “other” retailers due to the prevalence of Chinese take-out restaurants with attached convenience stores, a phenomenon not observed in other cities.

Table 1.

Store type and product availability overall and by city, 2023.

Overall (n = 1402) New York City (n = 954) Philadelphia (n = 341) San Francisco (n = 107) p-valuea
n % (95 % CI) % (95 % CI) % (95 % CI) % (95 % CI)
Store type
 Convenience (non-chain) 956 68.1 (65.6 – 70.6) 75.8 (72.9 – 78.5) 53.4 (47.9 – 58.8) 46.7 (37.0 – 56.6) <0.001
 Gas station 112 7.9 (6.5 – 9.4) 6.7 (5.2 – 8.5) 10.9 (7.7 – 14.7) 9.4 (4.6 – 16.5) 0.044
 Smoke/vape 105 7.5 (6.2 – 9.0) 8.3 (6.6 – 10.2) 5.3 (3.1 – 8.2) 7.5 (3.3 – 14.2) 0.195
 Convenience (chain) 50 3.6 (2.6 – 4.7) 3.2 (2.2 – 4.6) 5.0 (2.9 – 7.9) 1.9 (0.2 – 6.6) 0.205
 Grocery 47 3.3 (2.4 – 4.3) 2.4 (1.5 – 3.6) 2.9 (1.4 – 5.3) 12.1 (6.6 – 19.9) <0.001
 Beer, wine, liquor store, or bar 39 2.8 (2.0 – 3.8) 0.1 (0.0 – 0.5) 5.0 (2.9 – 7.9) 19.6 (12.6 – 28.4) <0.001
 Other 93 5.4 (4.3 – 6.8) 3.2 (2.2 – 4.6) 12.9 (9.5 – 16.9) 1.9 (2.3 – 6.6) <0.001
Nicotine product availability
 Cigarettes 1131 80.7 (78.5–82.7)) 76.7 (73.9–79.3) 87.7 (83.7–91.0) 93.5 (87.0 – 97.3) <0.001
 Cigars 760 54.2 (51.5 – 56.8) 43.2 (40.0 – 46.4) 80.6 (76.0 – 84.7) 68.2 (58.5 – 76.9) <0.001
 E-cigarettes 476 33.9 (31.5 – 36.5) 35.0 (32.0 – 38.1) 39.0 (33.8 – 44.4) 8.4 (3.9 – 15.4) <0.001
 Oral nicotine pouches 403 28.7 (26.4 – 31.2) 31.5 (28.6 – 34.6) 16.4 (12,6 – 20.8) 43.0 (33.4 – 52.9) <0.001
 Oral smokeless tobacco 233 16.6 (14.7 – 18.7) 16.2 (14.0 – 18.7) 12.9 (9.5 – 16.9) 31.8 (23.1 – 41.4) <0.001
 Any tobacco product 1222 87.2 (85.3 – 88.9) 84.2 (81.8 – 86.5) 93.0 (89.7 – 95.4) 94.4 (88.2 – 97.9) <0.001
 2+ tobacco products 849 60.5 (57.9–63.1) 52.1 (48.9–55.3) 80.0 (75.4–84.1) 73.8 (64.4–81.8) <0.001
Cannabis product availability
 THC 137 9.8 (8.3 – 11.4) 10.5 (8.6 – 12.6) 8.8 (6.0 – 12.3) 6.5 (2.7 – 13.0) 0.336
 CBD 137 9.8 (8.3 – 11.4) 10.3 (8.4 – 12.4) 7.3 (4.8 – 10.6) 13.1 (7.3 – 21.0) 0.142
 Any cannabinoidsb 179 12.8 (11.1 – 14.6) 13.3 (11.2 – 15.6) 10.3 (7.2 – 14.0) 15.9 (9.5 – 24.2) 0.211
 Paraphernalia 280 20.0 (17.9 – 22.2) 24.2 (21.5 – 27.1) 11.7 (8.5 – 15.6) 8.4 (3.9 – 15.4) <0.001
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a

P-value represents omnibus chi-square test of between city differences.

b

Includes cannabis products coded as general cannabis, where data collectors could not specify between THC or CBD products.

c

Multivariate test of means.

Tobacco product availability varied by city. Overall, tobacco products were found in 87.2 % of sampled licensed tobacco retailers. New York City had the lowest proportion (84.2 %) of sampled retailers selling tobacco or nicotine products. Cigarettes were the most commonly available product (87.0 %) followed by cigars (54.2 %), e-cigarettes (33.9 %), ONPs (28.7 %), and oral smokeless tobacco (16.6 %). Cigars were notably more prevalent in Philadelphia (80.6 %) than in San Francisco (68.2 %) or New York City (43.2 %). San Francisco had lower availability of e-cigarettes, which were only available in 8.4 % of sampled retailers, but had the highest availability of nicotine pouches (43.0 %) and oral smokeless tobacco (31.8 %).

A total of 12.8 % of sampled retailers offered some form of cannabinoid product (i.e., THC, CBD, or general cannabinoids), with no significant differences across cities. THC and CBD products were available in a substantial proportion of stores (9.8 % for each), with no discernible differences among the cities. Cannabis paraphernalia was found in 20.0 % of all sampled stores, with a higher prevalence in New York City (24.2 %) compared to Philadelphia (11.7 %) and San Francisco (8.4 %).

Cannabinoid prevalence by tobacco product availability and store type

Compared to stores not selling each product, THC prevalence was higher in stores selling e-cigarettes (21.6 % vs. 3.7 %; p < 0.001), cigars (14.2 % vs. 4.5 %; p < 0.001), ONPs (17.1 % vs. 6.8 %; p < 0.001), and oral smokeless tobacco (14.6 % vs 8.8 %; p = 0.007) (Table 2). Conversely, THC was significantly more prevalent in stores not selling cigarettes (13.6 % vs. 8.8 %; p = 0.017

Table 2.

Cannabis product availability in retailers by store characteristics, 2023.

N THC sold p-valuea CBD sold p-value Any cannabinoids sold p-value
Nicotine products % (95 % CI) % (95 % CI) % (95 % CI)
 Cigarettes 0.017 0.009 0.057
  Available 1131 8.8 (7.2–10.6) 8.7 (7.1–10.5) 11.9 (10.1–14.0)
  Unavailable 271 13.6 (9.8–18.3) 14.0 (10.1–18.7) 16.2 (12.0–21.2)
 Cigars <0.001 <0.001 <0.001
  Available 760 14.2 (11.8–16.9) 13.7 (11.3–16.3) 17.9 (15.2–20.8)
  Unavailable 642 4.5 (3.0–6.4) 5.1 (3.6–7.1) 10.0 (4.9–8.9)
 E-cigarettes <0.001 <0.001 <0.001
  Available 476 21.6 (18.0–25.6) 20.8 (17.2–24.7) 26.5 (22.5–30.7)
  Unavailable 926 3.7 (2.5–5.1) 4.1 (2.9–5.6) 5.7 (4.3–7.4)
 Oral nicotine pouches <0.001 <0.001 <0.001
  Available 403 17.1 (13.6–21.2) 18.4 (14.7–22.5) 23.1 (19.1–27.5)
  Unavailable 999 6.8 (5.3–8.5) 6.3 (4.9–8.0) 8.6 (6.9–10.5)
 Oral smokeless tobacco 0.007 <0.001 <0.001
  Available 233 14.6 (10.3–19.8) 16.7 (12.2–22.2) 21.0 (16.0–26.8)
  Unavailable 1169 8.8 (7.2–10.6) 8.4 (6.8–10.1) 11.1 (9.4–13.1)
Store type <0.001 <0.001 <0.001
 Convenience store (non-chain) 956 6.0 (4.5–7.6) 5.6 (4.3–7.3) 8.7 (7.0–10.6)
 Gas station 112 6.2 (2.5–12.4) 3.6 (1.0–8.9) 6.2 (2.5–12.5)
 Smoke/vape shop 105 66.7 (56.8–75.6) 69.5 (60.1–78.1) 77.1 (67.9–84.8)
 Other 229 1.3 (0.2–3.8) 2.6 (1.0–5.6) 3.5 (1.5–6.8)
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a

Results of chi-square test between retailers with and without each nicotine product and omnibus test among store types.

Similar patterns emerged for CBD, with higher prevalence in stores selling e-cigarettes (20.8 % vs. 4.1 %; p < 0.001), cigars (13.7 % vs. 5.1 %; p < 0.001), ONPs (18.4 % vs. 6.3 %; p < 0.001), and smokeless tobacco (16.7 % vs. 8.4 %; p < 0.001), while being more common in stores without cigarettes (14.0 % vs. 8.7 %; p = 0.009). By store type, smoke/vape shops had markedly higher prevalence of THC (66.7 %), CBD (69.5 %), and any cannabinoids (77.1 %) compared to non-chain convenience stores (6.0 %, 5.6 %, and 8.7 %, respectively; all p < 0.001).

Store-level correlates of CBD and THC sales

Tables 3 and 4 present adjusted and unadjusted odds of tobacco retailers selling CBD and THC, respectively. For CBD (Table 3), unadjusted models showed higher odds in stores selling e-cigarettes (OR=6.1, 95 % CI: 4.1–9.1), ONPs (OR=3.3, 95 % CI: 2.3–4.8), cigars (OR=2.9, 95 % CI: 1.9–4.4), and smokeless tobacco (OR=2.2, 95 % CI: 1.5–3.3), with lower odds in cigarette-selling stores (OR=0.6, 95 % CI: 0.4–0.9). In the fully adjusted model (Model 3), significant positive associations persisted for e-cigarettes (aOR=3.0, 95 % CI: 1.7–5.2), cigars (aOR=1.8, 95 % CI: 1.0–3.2), and ONPs (aOR=2.0, 95 % CI: 1.1–3.7), while cigarette-selling stores maintained lower odds (aOR=0.4, 95 % CI: 0.2–0.9). Smoke/vape shops were significantly more likely to sell CBD than non-chain convenience stores (aOR=18.8, 95 % CI: 10.9–32.6), and San Francisco stores showed higher CBD sales odds than New York City stores (aOR=3.0, 95 % CI: 1.3–6.8).

Table 3.

Odds of a tobacco retailer selling CBD products (yes/no) as a function of store-level characteristics in three U.S. cities, 2023.

Unadjusted Model 1 Model 2 Model 3
OR (95 % CI) aOR (95 % CI) aOR (95 % CI) aOR (95 % CI)
Tobacco/nicotine product availabilitya
 Cigarettes 0.6 (0.4–0.9) ** 0.2 (0.1–0.3) ** 0.5 (0.3–0.9) * 0.4 (0.2–0.9) *
 Cigars 2.9 (1.9–4.4) ** 2.6 (1.6–4.3) ** 1.9 (1.1–3.3) * 1.8 (1.0–3.2) *
 E-cigarettes 6.1 (4.1–9.1) ** 5.2 (3.3–8.3) ** 2.4 (1.4–4.0) ** 3.0 (1.7–5.2)**
 Oral nicotine pouches 3.3 (2.3–4.8) ** 2.2 (1.3–3.6) ** 2.2 (1.2–3.9) ** 2.0 (1.1–3.7) *
 Oral smokeless tobacco 2.2 (1.5–3.3) ** 0.7 (0.4–1.2) 0.8 (0.4–1.6) 0.8 (0.4–1.5)
Store type
 Convenience store (non-chain) REF – REF REF
 Gas station 0.6 (0.2–1.7) – 0.4 (0.1–1.2) 0.4 (0.1–1.2)
 Smoke/vape shop 38.1 (23.2–62.7) ** – 20.1 (11.7–34.7) ** 18.8 (10.9–32.6) **
 Other 0.4 (0.2–1.0) – 0.4 (0.2–0.8) * 0.4 (0.2–0.9) *
City
 New York City REF – – REF
 Philadelphia 0.7(0.4–1.1) – – 1.0(0.5–1.8)
 San Francisco 1.3(0.7–2.4) – – 3.0 (1.3–6.8)**
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a

Reference groups are stores that did not sell each product.

**

p < 0.01,

*

p < 0.05.

Table 4.

Odds of a tobacco retailer selling THC products (yes/no) as a function of store-level characteristics in three U.S. cities, 2023.

Unadjusted Model 1 Model 2 Model 3
OR (95 % CI) aOR (95 % CI) aOR (95 % CI) aOR (95 % CI)
Tobacco/nicotine product availabilitya
 Cigarettes 0.6 (0.4–0.9) * 0.2 (0.1–0.3) ** 0.5 (0.3–0.9) * 0.5 (0.3–0.9) *
 Cigars 3.5 (2.3–5.3)* * 3.3 (2.0–5.5) ** 2.6 (1.5–4.5) ** 2.6 (1.5–4.7) **
 E-cigarettes 7.2 (4.8–10.9) ** 7.0 (4.3–11.3) ** 3.5 (2.1–5.8) ** 3.2 (1.9–5.6) **
 Oral nicotine pouches 2.8 (2.0–4.0) ** 1.8 (1.1–2.9) * 1.7 (1.0–2.9) 1.7 (0.9–3.1)
 Oral smokeless tobacco 1.8 (1.2–2.7) ** 0.5 (0.3–0.9) * 0.6 (0.3–1.1) 0.6 (0.3–1.1)
Store type
 Convenience store (non-chain) REF – REF REF
 Gas station 1.1 (0.5–2.4) 0.8 (0.3–1.9) 0.8 (0.3–1.9)
 Smoke/vape shop 31.5 (19.4–51.3) ** – 16.1 (9.4–27.8) ** 16.3 (9.4–28.2) **
 Other 0.2 (0.1–0.7) ** – 0.2 (0.1–0.7) * 0.2 (0.1–0.7) *
City
 New York City REF – – REF
 Philadelphia 0.8 (0.5–1.3) – – 1.0 (0.5–1.8)
 San Francisco 0.6 (0.3–1.3) – – 0.9 (0.3–2.6)
Open in a new tab
a

Reference groups are stores that do not sell each product.

**

p < 0.01,

*

p < 0.05.

For THC (Table 4), unadjusted models showed higher odds in stores selling e-cigarettes (OR=7.2, 95 % CI: 4.8–10.9), cigars (OR=3.5, 95 % CI: 2.3–5.3), ONPs (OR=2.8, 95 % CI: 2.0–4.0), and smokeless tobacco (OR=1.8, 95 % CI: 1.2–2.7), with lower odds in cigarette-selling stores (OR=0.6, 95 % CI: 0.4–0.9). After full adjustment (Model 3), positive associations remained significant for e-cigarettes (aOR=3.2, 95 % CI: 1.9–5.6) and cigars (aOR=2.6, 95 % CI: 1.5–4.7), while cigarette-selling stores continued to have lower odds (aOR=0.5, 95 % CI: 0.3–0.9). Smoke/vape shops had substantially higher odds of selling THC compared to non-chain convenience stores (aOR=16.3, 95 % CI: 9.4–28.2), while no significant city differences were observed.

Discussion

This study highlights cannabinoid products in licensed tobacco retailers across three major U.S. cities with differing cannabis legality, identifying overlap between cannabis and tobacco retail environments. Smoke/vape shops had significantly higher odds of selling cannabinoid products compared to other retailer types. Stores selling e-cigarettes and cigars had elevated odds of offering cannabinoid products while retailers selling cigarettes were less likely to sell cannabinoids.

Notably, cannabinoid availability was consistent across cities with differing cannabis legalization statuses, suggesting that regulatory differences in state (e.g., medical-only vs. recreational) and local (e.g., THC isomer ban or relegation to cannabis dispensaries) cannabinoid regulations may not impact the overall availability of cannabinoid products, including intoxicating and non-intoxicating cannabinoids, in tobacco retailers. In contrast, variation in tobacco product availability across cities, including lower e-cigarette availability in San Francisco and lower overall availability in New York City, likely reflects local tobacco control policies such as e-cigarette restrictions. City policy contexts may also have influenced the types of THC products observed. In Philadelphia, where isomers were not prohibited, hemp-derived products labeled with THC may have been more commonly displayed, whereas in New York City, isomer bans alongside legalized recreational cannabis suggest that observed products may have more often reflected delta-9 THC. Although both types represent intoxicating cannabinoids relevant to this study, these potential differences in THC make-up complicate city-level comparisons.

Findings from this study align with a recent phone-interview-based study that found that intoxicating cannabis products (e.g., delta-8 THC, delta-9 THC) were sold in 74 % of vape shops across the U.S., with availability even in states that with restrictions or bans on delta-8 THC and other hemp-derived cannabinoids (Rossheim et al., 2024). This finding is consistent with the 66.7 % (95 % CI: 56.8–75.6) visible availability of THC-labeled products in smoke/vape shops identified in this study. While smoke/vape shops appear to be the most common outlet for co-availability, this present study further identified a notable THC cannabinoid prevalence in gas stations (6.2 %, 95 % CI: 2.5–12.4) and non-chain convenience stores (6.0 %, 95 % CI: 4.5–7.6), suggesting co-availability extends beyond specialty retailers. These general retailers, unlike vape shops, engage a wider public, potentially increasing incidental exposure. Tobacco retailers differ from licensed cannabis dispensaries as they often lack age verification procedures and other regulatory measures (West et al., 2024). This consistency across studies highlights the widespread accessibility of intoxicating products outside of regulated cannabis retailers.

Studies have found that commercially available cannabinoid products, including those sold in unlicensed retailers, often contain concerning chemicals and contaminants (Spindle et al., 2022). For example, research has detected harmful substances such as Escherichia coli, salmonella, heavy metals, and pesticides in cannabinoid products sold at unlicensed storefronts (Gidal et al., 2024). Further complicating matters, a recent trend has emerged where delta-9 THC products are sold outside of licensed dispensaries under the claim that the products contain <0.3 % THC by volume and/or “hemp-derived THC” (Berger, 2022). Future research can examine specific cannabinoid prevalence in more detail as strategic and timely adaptations by industry may lead to continued availability of cannabinoids in tobacco retail environments.

This study also documented the visible presence of tobacco products sold alongside cannabinoids, allowing for a detailed examination of patterns in co-availability. The co-availability of e-cigarettes, cigars, and cannabinoid products in tobacco retailers may shape patterns of initiation and sustained use for both substances. These findings can be interpreted in relation to previous research that has examined specific product administration routes and co-use. A nationally representative study of adolescents and young adults engaging in co-use found that most initiated with nicotine e-cigarettes (63.3 % and 66.7 %, respectively), whereas fewer began with combustible tobacco (24.4 % and 19 %) (McCauley et al., 2024). Additionally, a cross-national study of youth aged 16–19 in Canada, the United States, and England found that those using e-cigarettes were nearly five times more likely to vape cannabis oil or liquid, while those using combustible tobacco were almost three times more likely to smoke cannabis with tobacco (e.g., blunt use with cigars) (Smith et al., 2021). The findings from the present study highlight how the co-availability of cannabis, e-cigarettes, and cigars in tobacco retailers may contribute to patterns of dual initiation and sustained use among adolescents. By reinforcing pathways of co-use through shared points of sale, the retail environment may shape future substance use trajectories.

The lower odds of cannabinoid product availability in stores selling cigarettes, alongside the higher odds observed in stores selling cigars and e-cigarettes, may reflect differences in consumer demand, product positioning strategies or perceived relative health risks of cannabinoids and cigarettes. Cannabis may have wellbeing/health connotations at odds with the widely recognized negative health impacts of cigarettes (Goodman and Hammond, 2022). A shift away from combustible tobacco products among younger generations may be leading newer stores to opt out of carrying such items, reflecting broader trends in tobacco product consumption (Mantey et al., 2024). Interestingly, this pattern was not observed with cigars, the other combusted tobacco product documented in this study. This may be because cigars are frequently used to create blunts, a form of co-use of cannabis and tobacco that may be perceived as less harmful than cigarettes (Majeed et al., 2018; Sterling et al., 2017).

This study had limitations. New York City, Philadelphia, and San Francisco present unique policy contexts as each had adopted licensing initiatives that capped the number of retailers at the city district level; thus, findings may not be generalizable to other large urban centers with different regulatory conditions, or to smaller or rural communities or communities with different demographic representation. The stratified random sampling design, conducted at the district level to capture geographic representativeness, may have reduced the precision of cannabinoid prevalence estimates for less common store types such as gas stations and grocery stores. Store type information was not consistently available in licensing lists and stratifying by store type would have required assumptions based on store names. While this limited store-type comparisons, the design strengthened the study’s ability to estimate overall and city-level prevalences. In addition, cigars and cigarillos were combined into a single category for tobacco product availability, which prevented examining cigarillos as a distinct product commonly co-used with cannabis.

Data collectors were not always able to capture cannabis products that were hidden from view or sold discreetly, which may have underestimated availability. This study did not collect information on the mode of administration for cannabinoid products (e.g., cannabis flower, edible cannabis, vaped cannabis), which could be related to possible co-use behaviors. However, recent evidence from New York City during the same time period demonstrates that unlicensed cannabis retailers, including smoke shops, sold products labeled as delta-9 THC in flower and vape forms (Becker et al., 2025). This suggests that cannabinoid availability in tobacco retail settings likely included intoxicating products consumed through smoking or vaping, routes of administration that overlap directly with tobacco use. Hemp-derived products marketed for their THC content, such as delta-8, are also commonly consumed through smoking and vaping, further reinforcing their relevance to tobacco co-use (Olsson et al., 2025; Robichaud et al., 2025). Additionally, this study did not systematically document interior point-of-sale marketing for cannabinoid products. Future research should examine how such marketing strategies shape consumer perceptions and may reinforce patterns of tobacco and cannabis co-use. Importantly, unlicensed tobacco retailers may also carry cannabinoid products. Results from this study may also not be generalizable to other U.S. locations. Strengths of this study included a large and representative sample from geographically and policy diverse U.S. cities.

Policymakers should be aware of a significant presence of cannabinoid products in licensed tobacco retailers, particularly in smoke and vape shops, and the potential for these environments to reinforce patterns of tobacco and cannabis co-use through the co-availability of e-cigarettes, cigars, and cannabinoid products. Tobacco retailers selling e-cigarettes and cigars had significantly higher odds of offering cannabinoid products, while retailers selling cigarettes were less likely to carry them. These patterns highlight the evolving nature of the retail landscape and suggest that purchasing tobacco products such as e-cigarettes may serve as points of access and exposure to cannabinoids. The availability of cannabinoid products in tobacco retailers, even in cities with no recreational cannabis and restrictions on THC isomer sales, reflects regulatory and implementation gaps that allow intoxicating cannabinoids to be sold outside of licensed dispensaries.

International policy approaches provide examples of measures that limit the concurrent availability of tobacco and cannabis products in the same retail settings. One approach, used in both Canada and U.S. states with recreational cannabis laws, is to restrict what products can be sold in licensed cannabis outlets (e.g., limiting sales to cannabis and cannabis accessories) (Gagnon et al., 2022). A related model is Uruguay’s initial policy of retail cannabis being sold exclusively in specific pharmacies (Cerdá and Kilmer, 2017). Another approach is the adoption of a broad legal definition of cannabis that includes intoxicating cannabinoids beyond delta-9-THC; in Canada, the Cannabis Act definition of cannabis includes cannabinoids such as delta-8-THC and THC-O, reducing the likelihood of regulatory loopholes that could allow sales in unlicensed retailers (Health Canada, 2023). To address co-exposure through proximal sales in distinct retailers, Canadian municipal bylaws can set minimum separation distances between cannabis and tobacco retailers (Gagnon et al., 2022). Such approaches highlight how channeling cannabinoid sales into regulated retail venues and spatial planning may reduce cannabis and tobacco co-availability. Moving forward, research may examine how such policy strategies operate in practice, including monitoring any influence on cannabinoid availability in tobacco outlets or other unlicensed retailers. Further work is also needed to examine how the spatial proximity of tobacco and cannabis outlets, any retail or purchasing overlap in different tobacco and cannabis administration forms, and in-store marketing practices shape patterns of co-use.

Acknowledgements

The authors acknowledge support from the National Cancer Institute Training Grant (T32 CA009314) at Johns Hopkins Bloomberg School of Public Health. We thank Syed Nishi Rahman, Rose Monet Little, Neha Ali, and Sophie Yagoda for their assistance with data collection. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA269848.

Footnotes

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

CRediT authorship contribution statement

Torra E Spillane: Writing – review & editing, Writing – original draft, Visualization, Project administration, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Joanna E Cohen: Writing – review & editing, Writing – original draft, Supervision, Methodology, Investigation, Formal analysis, Conceptualization. Tory R. Spindle: Writing – review & editing, Writing – original draft, Validation, Supervision, Methodology, Investigation, Formal analysis. Johannes Thrul: Writing – review & editing, Writing – original draft, Supervision, Methodology, Investigation, Conceptualization. Meghan Moran: Writing – original draft, Supervision, Methodology, Investigation, Conceptualization. Hye Myung Lee: Writing – review & editing, Resources, Project administration, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Daniel P Giovenco: Writing – review & editing, Validation, Supervision, Resources, Methodology, Investigation, Funding acquisition, Data curation.

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