The intent of this research was not to provide a definitive description of how and how often Canadian adolescents are exposed to cannabis marketing, but to provide and test a tool that could facilitate such future research. With this tool, we also aim to provide preliminary data demonstrating the existence and potential impacts of cannabis advertising on youth. Data collection occurred between March 2020 and February 2021. We recruited participants through print and digital advertising including Facebook, Instagram and other social media sites. Recruitment materials contained no information about cannabis; prospective participants responded to advertisements with a general goal of using cell phones to study advertising. Research assistants screened individuals over email or Facebook messenger to determine eligibility. Eligible individuals attended a virtual baseline session with a parent or legal guardian where they provided written informed consent and assent if they were under the age of 18. Participants who were 18 years of age provided written informed consent. All adolescents completed a baseline questionnaire assessing demographics, social determinants of cannabis use, and cannabis use history . Parents/guardians were informed that they would not have access to their child’s study data. Participants were trained to download and use the Expiwell app to photograph/screenshot and describe each individual cannabis advertising exposure that occurred during the 9-day study period through a brief questionnaire. The questionnaire assessed advertising channel ,grow tent complete kit message, and context , followed by participants’ real-time ratings of cannabis use expectancies and intentions.
Participants also responded to two daily randomly issued prompts, which also included questions about cannabis use expectancies and future cannabis use risk. Participants who completed the study received $75 or 5 hours towards 40 hours of volunteer service required for a high school diploma in Ontario. Participants received full compensation if they completed at least 70% of the device-issued random prompts within 5 min of the notification; those who completed <70% of random prompts within the 5-minute window received $50 or 3.5 hours of high school volunteer time. All procedures were reviewed and approved by Lakehead University’s Research Ethics Board. Historical research on other legalized, recreational drugs suggests that Canadian youth are likely cannabis marketing targets, but to date, almost no data exists regarding the scope and impact of cannabis marketing on Canadian youth in a post legalization context . This study presents some of the very first data that demonstrate that cannabis marketing to youth is actively occurring in Canada, and that researchers and policymakers must begin to take action on the issue in order to protect youth and public health. To our knowledge, this is the very first study to use EMA to capture adolescent cannabis marketing exposures, in Canada or elsewhere. A particular strength of the EMA approach is that it enables detailed data collection about each exposure , and its immediate impacts, that are otherwise obscured or blurred in retrospective self-report. . Thus, the current study provides novel evidence for a powerful tool that researchers and policymakers can use to obtain detailed information about cannabis marketing exposure characteristics , and strategies for assessing their subsequent effect on adolescents’ cannabis-related expectancies and intentions. We recognize that EMA methods overall are not new, and that Shiffman and others have been advancing the science of EMA for more than 30 years.
The newness of cannabis legalization in Canada and the associated taboo of cannabis in some communities , however, necessitated this extensive pilot work, not only to demonstrate the concept of the work , but also that our recruitment procedures, messaging, and protections were acceptable to adolescents and their guardians, as all of these components of the study are essential to effectively conduct the research. Overall, our results show that the protocol is feasible. Although overall rates of compliance were slightly lower than previous EMA studies of adolescents, rates among the participants whose app was working well were directly in-line with other work . Unexpectedly, a major task of this pilot research was to resolve software compatibility issues between the Expiwell app and older versions of Android platforms, including identifying device setting issues such as “do not disturb” or “battery saver” mode on individuals’ phones that interfered with participants receiving notifications from the study app. Participant compliance rates were much better among those with newer phones whose platforms were more compatible with the app. Researchers replicating or extending this research will need to consider the pros and cons of allowing participants to use their own devices for data capture as compared to using a study-issued device. Despite it’s feasibility design, this study also provides new, albeit very preliminary knowledge regarding the quantity and characteristics of cannabis marketing currently reaching Canadian adolescents; information that has previously only been described in aggregate, retrospectively, and by self-report. Overall, data showed that nearly all participating adolescents had cannabis marketing exposures during the study period. This included an average of about two cannabis-related marketing exposures per week, substantiating previous research . This finding demonstrates cannabis companies’ success in skirting current cannabis-related marketing laws which categorically prohibit marketing of cannabis products to youth.
Our data also showed that most cannabis-related exposures occurred through promotion by public figures and through ads on the internet. This finding is likely influenced by the COVID-19 context in which data were collected, and it is consistent with a significant increase among youth in the use of social media, streaming services, gaming sites and apps . At the same time, previous research has demonstrated that cannabis has an established and sophisticated presence specific to the internet based on creative advertisements designed for social media platforms , regardless of legality or media company policies . Indeed, while alcohol and tobacco industries developed their original marketing campaigns decades ago using traditional media channels , Canada’s sale and legalization of cannabis began in the digital age, and as a result, cannabis companies rely mostly on social media to market their products . Information shared through social media and the internet may also be viewed as more relevant or persuasive to youth, with the social endorsement by trusted celebrities or peers . This is concerning, as an increase in social media use and novel potential for social engagement and peer network integration could increase youth vulnerability to cannabis marketing through social medical channels . Youth exposure to online cannabis marketing is especially concerning when it is accompanied by dispensary practices facilitating easy access to cannabis. Altogether, if replicated in a larger, more representative sample and during less unusual times, data showing that most exposures occur through online formats may suggest the need to better describe and reinforce online cannabis-related marketing to mitigate harms to youth. We also found that the timing and social context for cannabis-related marketing exposures occurred consistently throughout the week, mostly in the afternoon and the evening, while youth were alone and at home. This finding makes sense given that the majority of exposures occurred through the internet or public figures while youth were browsing social media online.
As the majority of exposures also occurred through the internet or public figures, it is possible that cannabis advertisements influenced adolescents’ view of injunctive norms by suggesting high levels of peer approval of cannabis use and/or demonstrating or reinforcing positive outcome expectations related to cannabis use; this is particularly alarming because exposures generally occurred in the absence of family member who could buffer these effects . Research that identifies clusters in the context of cannabis-related marketing exposures is also important as it can inform cannabis marketing regulations, such as the need for tighter restrictions on marketing channels that frequently reach youth, especially in vulnerable contexts . We also found that youth described cannabis marketing as relatively visually engaging. This is consistent with research demonstrating that companies marketing age-restricted substances create designs that likely appeal to youth, including bright colours, cheerful messages, cartoon and/or animal characters, and other features explicitly prohibited by legislation . Unfortunately, we do not have sufficient data to conclude whether the vividness of ads impact adolescents’ cannabis expectancies or intentions to use cannabis. Policymakers and public health officials will likely benefit from larger and more detailed analyses of the features and content of cannabis ads that put them at the greatest risk for future cannabis use. Limitations of this feasibility study include its small sample size and its geographically unique sample of convenience. In Northern Ontario, adolescent cannabis use rates are high compared to major centres of the province . This smartphone owning sample may have been more willing or able to utilize EMA effectively than youth in the general population, although data now show that more than 85% of Canadian youth own and operate a smartphone . Second, information related to youths’ exposure to educational cannabis-related information and anti-cannabis information, and its subsequent effect on cannabis-related cognitions and cannabis use was not collected as part of this protocol, although it could be in the future. Lastly, this small sample size did not support meaningful statistical comparisons of random prompt and exposure occurrences,grow tent kit and assessment of differences according to demographic or SES factors.
Larger studies, conducted beyond the immediate impacts of the COVID-19 pandemic, are needed to verify the type and impact on cognitions and cannabis use for cannabis-related marketing exposures. In conclusion, to our knowledge, we have provided the first example of an EMA protocol that adolescents can use to systematically demonstrate whether Canadian cannabis marketing regulatory efforts are comprehensive, effective, and the extent to which Canadian adolescents are exposed to cannabis marketing. Policymakers, educators, families and communities need to know the nature and extent of Canadian adolescents’ exposure to cannabis marketing and its impact on their attitudes, beliefs, and ultimately their decisions to use cannabis. With data from larger, more diverse samples, this information could be used to hold companies accountable, to validate and enhance current regulations, and to minimize public harm of early cannabis use among youth. Cannabis sativa L. is one of the earliest known cultivated plants since agricultural farming started around 10,000 years ago . It is a multi-purpose crop plant with diverse agricultural and industrial applications ranging from the production of paper, wood, and fiber, to potential use in the medicinal and pharmaceutical industries. The first-ever report to reveal the prospects of C. sativa L. as a medicinal plant was already published in 1843 and described the use of plant extracts to treat patients suffering from tetanus, hydrophobia, and cholera . However, the first chemical constituent identified was oxy-cannabis , isolated cannabinoid , and fully identified in 1940 was cannabidiol followed by tetrahydrocannabinol and cannabigerol in 1964, and cannabichromene in 1966 . identification of THC later led to an understanding of the endocannabinoid system followed by the discovery of the first cannabinoid receptor in 1988 . CB1 receptor acts as a homeostatic regulator of neurotransmitters for pain relief mechanisms, but the same mode of action was responsible for intoxicating effects from cannabinoids’ excessive use. Thus, the understanding of mode of action of CB1 receptor raised concerns about the adverse effects of cannabis use. Consequently, the plant was removed from the medicinal category and recategorized exclusively to the category of drug-type plants. Cultivation and use of cannabis plants for recreational, medical, and industrial use were strictly banned and severely limited the scientific research in the field.
Owing to strict legal regulations, the plant remained unexplored for its incredible potential in drug discovery for an extended period until it was legalized for medical use first in California and later in many countries around the globe. Extensive research followed legalization to explore the chemodiversity of cannabinoids for potential clinical value. In total, more than one thousand compounds—278 cannabinoids, 174 terpenes, 221 terpenoids, 19 flavonoids, 63 flavonoid glycosides, 46 polyphenols, 92 steroids—have been identified . Nearly 278 of these compounds are cannabinoids and classified as phytocannabinoids to distinguish them from endocannabinoids . Cannabimimetic drugs binding to CB1-receptors in the endocannabinoid system can also be found in algae, bryophytes, and monilophytes. The major cannabinoids in cannabis include THC, CBD, and CBC, their precursor CBG and cannabinol. To date, 10 CBN-type, 17 CBG-type, 8 CBD-type, and 18 THC-type cannabinoids have been isolated . Cannabigerolic acid , a CBG-type cannabinoid, is the central precursor for the biosynthesis of psychoactive THC, non-psychoactive CBD, and CBC .