Former US Surgeon General Richard Carmona, MD, MPH, is urging against hasty adoption of laws that would legalize marijuana for medical or recreational purposes.

The physician, now the Distinguished Professor of Public Health at the Mel and Enid Zuckerman College of Public Health at the University of Arizona, Phoenix, offered his opinion in a November 4

“As of today, it appears that the proverbial cart has been placed before the horse and the horse is blinded by the cloud of smoke,” Dr Carmona writes.

On November 8, voters in nine states will take up ballot initiatives that would legalize marijuana for either medicinal or recreational use.

Voters in Florida, Montana, North Dakota and Arkansas will weigh measures that expand or establish the availability of medical marijuana. In California, Nevada, Arizona, Massachusetts, and Maine, voters will decide whether to legalize cannabis for adults aged 21 years or older.

Marijuana is already legal for recreational use by adults in Colorado, Washington, Oregon, Alaska, and Washington, DC. Twenty-five states, the District of Columbia, Guam, and Puerto Rico now have medical marijuana programs, according to the National Conference of State Legislatures.

Another 17 states allow use of products that have low levels of tetrahydrocannabinol and high levels of cannabidiol for medical reasons in limited situations or as a legal defense.

Only eight states prohibit access to marijuana for any purpose.

A Gallup poll of American adults conducted in early October found that 60% of respondents supported full legalization of marijuana – the highest percentage since the organization first asked about legalization in 1969.

Dr Carmona, who served as the 17th surgeon general of the United States from 2002 to 2006 under President George W. Bush, says that medical and recreational use of marijuana should be considered separately. Marijuana has been found to “impair normal

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