Background:
Changing government regulations in Ontario, Canada over the past two years have altered the accessibility to controlled substances like alcohol, cannabis, and vape liquids. In January 2020, the province banned exterior vaping-related advertising from all retailers, causing some retailers to discontinue their license. In March 2020, the province made changes to liquour license regulations allowing restaurants to sell sealed beer, wine, and mixed spirits for takeout and delivery. Additionally, over the past two years the number of licensed cannabis retail outlets has exponentially increased in the province. What are the health-equity implications from these changes to the retail landscape in accessing controlled substances?

Methods:
Alcohol, cannabis, and vape retailers were mapped from January 2020 to January 2022, and changes were evaluated using a spatial accessibility model in a geographic information system. This change is evaluated at the dissemination area scale based on the sociodemographic characteristics of these areas, with a health equity lens.

Results:
At the dissemination area scale, access to alcohol and cannabis has increased, while access to vape products has decreased. Socio-demographic characteristics such as visible minority status, household income, and education level of the most vulnerable dissemination areas provide insights into health equity implications from these changes.

Conclusion:
The changes observed in accessibility to alcohol, cannabis, and vape retailers indicate a broad societal shift in access to controlled substances. Comprehensive representative population-level survey data is needed to evaluate if consumption patterns and related health outcomes have changed in relation to the observed changes in spatial accessibility to these substances. These changes are an emerging policy, practice, and research issue that requires more monitoring to inform potential interventions.