Online Cannabis Marketing Practices and Regulatory Compliance: A Surveillance Study Across 5 US Cities in States with Different Cannabis Regulations.

BACKGROUND: Cannabis marketing and regulation have rapidly evolved. This study examined online cannabis marketing across different regulatory contexts. METHODS: In 2022 and 2025, we assessed cannabis retailer websites from 5 US cities: Denver, Colorado; Seattle, Washington; Portland, Oregon; Las Vegas (LV), Nevada; and Los Angeles (LA), California. We assessed age verification, online sales, products, marketing, and warnings, and compared by city in 2025 (N = 171) and by year (N = 130). RESULTS: In 2025, most verified age (83.6%) and offered online sales (96.5%). Frequently promoted health benefits included sleep (58.5%) and pain (48.5%), most often by Denver, LV, and LA retailers (P's < .05). Targeted populations included veterans/military (40.9%) and racial/ethnic minorities (24.0%), especially in LV and LA (P's < .05), as well as seniors (29.2%), women (25.7%), LGBTQ+ (13.5%), young adults (13.5%), and underage (7.6%). Price promotions included daily/weekly/monthly specials (78.9%) and membership/loyalty programs (75.4%). Most (73.7%) displayed health/safety warnings (range: 57.6% in Portland to 96.9% in LV, P = .003), commonly adults-only (57.9%) and keep from children (46.8%). Most (58.5%) displayed regulation-related warnings (range: 41.9% in LA to 71.9% in Seattle, P = .011), common purchase/amount restrictions (49.1%) and no public use (27.5%). There were increases (P's < .05) from 2022 to 2025 in beverage offerings (74.6% in 2022 vs 90.0% in 2025), membership/loyalty programs (64.6% vs 78.5%), and targeting veterans/military (28.5% vs 40.0%), seniors (4.6% vs 27.7%), LGBTQ+ (5.4% vs 13.1%), and racial/ethnic minorities (4.6% vs 19.2%). CONCLUSIONS: Stronger regulations and enforcement are needed to address online retail, including limiting product access, price promotions, and marketing practices targeting specific populations.