Québec State Sells More Cannabis Than Black Market

On October 17, 2018, the state-owned Québec Cannabis Society (SQDC) was launched to educate consumers about cannabis consumption and integrate them into the legal market by selling quality, lower-risk products that minimize its health impacts.

Almost 6 years on, it seems to be working.

“Since the legalization of cannabis in Québec, the transfer from the illicit market to the legal market has occurred more quickly than initially expected,” Marie-Claude Lacasse, communications director for Québec’s Ministry of Health and Social Services, told Medscape Medical News. “Although there is still some way to go, it is important to note that progress has been significant,” she said.

According to the SQDC’s latest annual report (French only, at press time), the SQDC achieved a sales volume of 122,478 kg cannabis in the fiscal year ending March 30, 2024; a 15% increase from 2022 to 2023. Total sales were $662.1 million, 10% higher than those of the previous year.

“The latest report shows a capture percentage estimated at 62.8% of the total market by the SQDC, representing an increase of 6.8% compared to the 2023 assessment,” said Lacasse.

“Cannabis consumption in Québec has been really stable over time, at about 17%-19% of the population,” SQDC Corporate Communications Director Vanessa Roland told Medscape Medical News. Since the overall consumption has been stable, the increased sales for the SQDC can be attributed to the company shifting consumers over to the legal market, she said, rather than an overall increase in cannabis use.

Harm Reduction Key

The SQDC’s profits go to the Cannabis Prevention and Research Fund, which is managed by Québec’s finance ministry and earmarked for cannabis-related education, prevention efforts, and research.

The fund supports consumption-monitoring activities; researching the effects of cannabis on population health; curative care related to cannabis use; and programs for preventing the harms of cannabis and promoting health, Lacasse said. “Since 2018-2019, more than CA$300 million from the sale of cannabis have been invested in these interventions, carried out in collaboration with various partners, like the public health network, community organizations, etc.”

Roland added, “The legal framework in Québec is helping for harm reduction because customers need to be 21 and older to get into a store, THC [tetrahydrocannabinol] levels are maxed at 30%, and we cannot sell anything that would be appealing to people under 21, such as chocolate gummies.”

“In addition, we train our employees, and we’re not sales driven or judgmental,” she said. “We try to build relationships based on trust to make sure that customers come back and consume our products instead of ones from the illegal market.”

François-Olivier Hébert, PhD, a research associate at the University of Montreal’s affiliated hospital research center, the CRCHUM, told Medscape Medical News that many of cannabis’s harms are due to an inappropriate use and the lack of knowledge about the product and the dose, essentially “not knowing how to consume what, when,” he said. Such harms could include motor vehicle accidents, psychosis, nonlethal overdoses, panic attacks, and paranoia.

“SQDC uses various strategies to work on these harms,” said Hébert who, along with a team of medical doctors and experts on cannabis use and public health, helped design the standardized employee training program. “All employees have a basic understanding of the products, how different modes of administration affect the body, and how to counsel customers on protective behavioral strategies to reduce the risks.”

“We need to be able to tell people how to consume something that was prohibited for 90 years, during which time they could buy it, but no one was telling them how to use it,” he said. Another harm-reduction strategy is to offer a wide range of products with lower THC concentrations, so employees can advise people who are new to cannabis on selecting products that contain more cannabidiol and less THC.

“Newbies are also counseled to try liquid tinctures in very small amounts first or droplets or sprays rather than ingesting a capsule that can have a very late onset with high psychoactive effects,” he said.

Stores also offer pamphlets that cover the potential risks and benefits of using cannabis and tips on safer consumption. These resources are also available on the SQDC website for individuals who purchase products online or want to learn more.

Evolving Market

The SQDC also needs to remain competitive in an evolving market. “Looking at trends, we see that the way that people consume cannabis is changing, and we’re trying to prepare and make sure we’re ready to sell similar products within the legal framework,” Roland said. An example is edibles. “We can’t sell gummies, but we have used our creativity and now we sell beef jerky and crisps.”

The preferred methods of consumption are also changing, she said. When the SQDC launched, most people chose smoking as their first and preferred method. “But now vaping is big, and we need to address it because of the health impact. If people buy vaping products on the illegal market, the risks could be greater. So it’s a very fine line, and I would say this is our biggest struggle: To stay on this line and offer products while making sure people know that we are thinking about their safety.”

“Finding a balance between health protection and converting the illicit market is possible but remains a challenge,” Lacasse affirmed. “The stricter measures in force in Québec with regard to certain products aim to reduce the trivialization of cannabis, the attraction of young people to cannabis, the risks of involuntary intoxication, and the health risks associated with cannabis products with a high concentration of THC.”

Furthermore, edibles such as cannabis candy, desserts, and chocolate carry a higher risk for accidental ingestion, particularly for children, she noted. A recent study showed that Canadian provinces that do not restrict the sale of these types of edibles registered more emergency room admissions of children due to edible poisoning.

Looking Ahead

Given the size of the illegal market and that many websites offer products as well, the SQDC is shifting its focus, Roland said. “For the last 5 or 6 years, we mainly focused on opening stores, and we will soon have more than 100, covering the whole market.”

“Now we’re going to focus a bit more on the customer experience,” she said. “That’s something the illegal market is really good at, so we have to find ways to do it within the legal framework to make sure that customers keep coming back to us. We need to offer the products they want. We need to make sure they can order efficiently and that they have a store nearby. So that is an ongoing effort.” 

Going forward, there’s also a need for hard data on how the initiative is performing and on the relationship between legalization models and cannabis-related harms, Hébert said. “We’re getting there but, as with everything in research, we need more time and more money.”

For now, he said, “the most important message is that many people are using cannabis for medical and nonmedical reasons, and these people need information. Many will start with their healthcare providers. So we suggest that medical doctors seek information on cannabis and be comfortable talking about it openly and in a nonjudgmental way with their patients. Otherwise, people will seek information on the internet and elsewhere, and it might be the wrong information, leading to bad consumption habits, adverse events, and major health consequences for individuals and for the public health.”

Marilynn Larkin, MA, is an award-winning medical writer and editor whose work has appeared in numerous publications, including Medscape Medical News and its sister publication MDedge, The Lancet (where she was a contributing editor), and Reuters Health.