A Multi-Method Investigation of Cannabis Messaging: Characterizing Source, Content, and Associations with Cannabis Consumption

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With the majority of US states having adopted legislation to medically and/or recreationally legalize cannabis, public perception of the drug is now overwhelmingly favorable. Increased access and prevalence of use are accompanied by perceptions of low health risk and/or of therapeutic benefits associated with cannabis use. Aside from evidence for symptom relief in certain medical conditions, evidence regarding therapeutic effects of cannabis for many conditions remains elusive, leaving the decision regarding when and how to use cannabis to the user. Both therapeutic and recreational reasons (motives) for CU are largely shaped through exposure to messages about the effects of cannabis, yet little is known about the source of messaging, how it is transmitted to users, how it shapes their thinking, and ultimately its association with CU patterns. The proposed study will gather critical information about message sources, cannabis-promoting content, and risk warnings being disseminated to cannabis users as well as the messages being received, their effects on CU motives, and subsequent CU. The mixed-methods design will include two phases. Phase 1 involves semi-structured interviews conducted with 1) cannabis users, as well as with message sources, including 2) cannabis dispensary and retail outlet staff (budtenders), 3) growers, and 4) health care providers who discuss cannabis with patients. Additionally, extraction and coding of messaging content will be conducted across internet and social media messaging platforms. Observational coding of recreational/medical cannabis outlets will be conducted using validated surveillance tools. Together, these data permit characterization of cannabis messaging content across various types of sources and platforms (Aim 1) that will in turn inform Phase 2 methods. Phase 2 consists of a three-burst 4-week ecological momentary assessment (EMA) study with a sample (N=300) of weekly 18-74 year-old cannabis users. Participants will complete brief smartphone-based measures of exposure to messaging (source and content), cannabis motives, and use patterns in the natural environment. With these quantitative data, this will be the first study to examine prospective associations between a user’s exposure to cannabis messaging and motives and other cognitions (Aim 2). Further, we will test whether cannabis motives are a mechanism underlying the association between cannabis messaging and CU at both the between-person and within-person levels (Aim 3). Finally, we will explore user characteristics and message source characteristics as potential moderators of the effects of cannabis messaging and CU (Aim 4). This combination of complementary and highly rigorous data collection approaches will provide the most nuanced understanding of the messages being disseminated about the effects of cannabis to the cannabis user. Findings will arm policy makers and cannabis regulatory science with evidence-based information about the impact of cannabis messaging that can ultimately reduce potential harms from misuse.