Massachusetts Repeal Campaign Cites Teen Use Data; Experts Dispute Claims

Campaign Claims and Ballot Question 4

The Coalition for Safe Communities, the committee backing Question 4 on the November 2026 ballot, released a briefing September 17 asserting that teen cannabis use in Massachusetts has increased 18 percent since retail sales began in 2018. The measure would repeal Chapter 334 of the Acts of 2016, the ballot initiative that legalized possession, home cultivation, and commercial sale of cannabis for adults 21 and older. Campaign chair Dr. Kevin Sabet, president of Smart Approaches to Marijuana, told reporters the youth-use figure came from the Massachusetts Department of Public Health's Youth Risk Behavior Survey. He called it a clear policy failure.

Question 4 requires a simple majority to pass. Approval would shutter the state's 286 licensed retailers and cultivation facilities by January 1, 2027, and reinstate criminal penalties for possession of more than one ounce. The Cannabis Control Commission reported $1.9 billion in adult-use sales in fiscal 2026, generating $394 million in excise and sales tax revenue.

Researchers Challenge Methodology and Causation

Dr. Sharon Levy, director of the Adolescent Substance Use and Addiction Program at Boston Children's Hospital, said the 18 percent figure conflates two non-comparable survey cohorts and doesn't account for pandemic-era disruptions in school-based data collection. The Youth Risk Behavior Survey shifted from in-person to hybrid administration in 2021. The CDC has flagged that change as introducing potential response bias. Massachusetts teen cannabis use rates remain below the national median, Levy noted, and haven't diverged significantly from trends in states without legal adult markets.

Dr. Randi Melissa Schuster, director of neuropsychology at the Center for Addiction Medicine at Massachusetts General Hospital, told the Globe that state-level youth consumption data show no statistically significant uptick when adjusted for pre-legalization baseline trends. Schuster pointed to peer-reviewed studies in JAMA Pediatrics and the Journal of Adolescent Health. Both found no association between state legalization and increased youth prevalence.

Federal Survey Data and State Comparisons

National Survey on Drug Use and Health data for 2022–2025 show Massachusetts ranking 28th among states for past-30-day cannabis use among 12- to 17-year-olds, at 6.4 percent, compared to a national average of 6.8 percent. Colorado, which launched retail sales in 2014, reported a teen use rate of 7.1 percent in the same period. States without legal markets such as Texas and Georgia reported rates of 6.2 percent and 5.9 percent, respectively. The overlapping confidence intervals suggest no clear policy signal, according to researchers at the RAND Corporation's Drug Policy Research Center.

Teen access to cannabis has historically been driven by illicit supply chains, not licensed retail, noted Dr. Rosalie Liccardo Pacula, a RAND senior economist. Licensed stores require ID verification and face compliance audits. Massachusetts Cannabis Control Commission enforcement data for 2025 recorded 14 violations for sales to minors out of 47,000 compliance checks—a rate of 0.03 percent.

Campaign Funding and Opposition Coalition

The Coalition for Safe Communities has raised $4.2 million as of the September 10 campaign finance filing deadline, with $3.1 million contributed by SAM Action, the advocacy arm of Smart Approaches to Marijuana. Additional donors include the Massachusetts Medical Society ($250,000), the Massachusetts Chiefs of Police Association ($180,000), and the archdiocese of Boston ($150,000). The campaign hasn't disclosed individual donor names for contributions under $200.

Opposing Question 4 is the Committee to Protect Massachusetts Cannabis Laws, which has raised $8.7 million, primarily from multi-state operators including Curaleaf ($2.4 million), Trulieve ($1.9 million), and Verano ($1.1 million). Repeal would restore criminal penalties for possession, eliminate regulated testing and labeling, and redirect consumer demand to unregulated markets, the committee argues. Spokesperson Jim Borghesani called the campaign's youth-use claims "a recycled scare tactic unsupported by credible epidemiology."

Polling and Voter Outlook

A Suffolk University/Boston Globe poll conducted September 5–9 found 58 percent of likely voters oppose Question 4, with 34 percent in favor and 8 percent undecided. Support for repeal was highest among voters 65 and older (47 percent) and lowest among voters 18 to 34 (19 percent). The poll of 800 likely voters has a margin of error of ±3.5 percentage points. A separate UMass Amherst poll released September 12 showed similar results: 56 percent opposing repeal.

For full background on this story, see the CannIntel topic hub on the Massachusetts legalization repeal campaign. Early voting begins October 21. If Question 4 fails, Massachusetts will remain one of 24 states with legal adult-use markets. If it passes? It'd be the first voter-approved repeal of cannabis legalization in U.S. history.