The rate of cannabis legalization in the U.S. has increased rapidly in recent years. This has led to the proliferation of non-combustible cannabis products, like edibles (cannabis-infused food products), that do not involve inhaling toxic smoke, can be used with discretion, and have no smell. While popular in recreational states, these products pose unique public health challenges. Although edibles are packaged as appealing food products and are perceived to be less harmful than other cannabis products, there is an increased risk for the overconsumption of tetrahydrocannabinol (THC), the psychoactive component in cannabis. While smoking cannabis results in an immediate high, intoxication from consuming edibles can be delayed up to two hours or more and last up to 12 hours. This can lead to consuming more than the recommended serving, which can result in unexpected, stronger, and longer-lasting highs as well as severe intoxication, cardiovascular effects, and psychotic episodes. Since cannabis is regulated on a state-by-state basis, there is substantial variation in the regulation of product packaging and warnings that inform consumers. Furthermore, little research has been conducted on edibles, resulting in significant gaps in understanding how packaging and warnings impact product appeal, knowledge, harm perceptions and willingness to try edibles. This R01 will address these gaps by testing the impact of cannabis edibles product packaging and warnings using controlled, experimental designs. First, we will content analyze text and visual packaging elements of a sample of products marketed online. We will conduct two experiments to evaluate the impact of these elements on product appeal and harm perceptions (Aim 1). Next, we will convene an expert panel that will evaluate existing edibles warnings and develop an expanded warning to convey additional information about dosing and acute consequences. This warning will be paired with an icon to increase attention. Warnings will be tested in an experiment to evaluate their impact on communicating knowledge (Aim 2). Finally, in a combined experiment, we will test the impact of the edible warning developed in Aim 2 in the context of package marketing (identified in Aim 1) on appeal, knowledge, harm perceptions and willingness to try edibles in a nationally representative sample (Aim 3). Given the rapid pace of legalization, coupled with the responsibility of informing consumers about safe consumption and the risks of use, the scientific evidence generated from this study will be timely and is urgently needed by state policymakers as they develop informed regulations, including best practices for communicating knowledge to minimize harms. This application is directly responsive to NIDA’s research priority areas outlined in NOT-DA-19-065 (Public Health Research on Cannabis), including the impact of cannabis industry practices like marketing and warnings on cannabis use and outcomes.

R01DA053209

2022-04-15

2027-03-01