standardised cannabis surveys

Survey highlights the need for standardised cannabis use surveys to improve familiarity with cannabis product terms

Medical cannabis has become more widely available globally in response to growing evidence of its benefits and harms. Consequently, the medical cannabis industry has developed a broad array of different products to allow medical cannabis to be administer in the most appropriate manner for a patient’s needs. This includes oils, tinctures, ointments, flower (flos), capsules, and lozenges amongst others.

However, it has been noted that doctors and patients may use different terms to refer to these medical cannabis products. By using different terms which either party may not understand this can cause confusion, or at worse impair the safety of prescribing. As an example, until recently ‘marijuana’ was largely used by both cannabis consumers and scientists (particularly in North America) to describe cannabis flower – as it was the main cannabis preparation available. However, researchers are now
more likely to use the terms ‘buds’ or ‘flower’ to differentiate between herbal cannabis and other preparations of the plant, such as edibles and concentrates. Yet, it remains unknown whether these are terms that are familiar to cannabis consumers.

In order to gauge product familiarity among cannabis users, researchers conducted a survey of a sample of college students from a large southwestern university in the US. Participants were asked to complete a survey in the Spring of 2020 – the results of which were assessed in a recent publication.

About the Survey

The researchers designed a 30-item questionnaire which was embedded within a larger screening survey administered to the participant pool. Participants were first asked about their familiarity with different cannabis product terms by use of a written list of terms generated from sources including Weedmaps’ cannabis dictionary, published research articles and interviews conducted with young people. Participants were asked to indicate whether they had ever heard of or seen (in real life or in pictures) a
range of “forms of marijuana”.

The list included the following product terms: “buds or flowers,” “wax pen or THC oil,” “shatter,” “rosin,” “budder or badder,” “crumble,” “hash,” “diamonds, THCa crystals, or crystalline,” and “butane hash oil (BHO), CO2 oil, Rick Simpson oil, or honey oil.” Response options were: 1 – never heard of it or seen it; 2 – heard of it but haven’t seen it in real life or in pictures; 3 – have seen it in real life or in pictures.

Participants were then shown pictures of different cannabis products and asked to match them with the previously listed terms that best fit what they thought most people would call that cannabis product. They were then shown pictures of different cannabis products and were asked to “select the picture or pictures that represent what you mean when you use the term ‘marijuana’.” Finally, participants were asked whether they had used various cannabis products using sample pictures of each product.

Results of the Survey

Among the full participant sample, the most familiar term was “wax pen or THC oil”, with 85.0% of participants reporting they had heard of (13.8%) or had seen (71.2%) this product. On the other hand, only 71.2% of participants reported that they were familiar with the term “marijuana buds or flowers”.

This was a significant finding considering that the prevalence of “marijuana flower” use and “wax pen/THC oil” use in the sample was about the same, based on participants responses to pictures of the cannabis products they had used (38.2% and 37.6%, respectively). This may suggest that studies that assess the prevalence of “marijuana flower” use may underestimate such use, due to unfamiliarity with this term.

Of participants who had used a “wax pen/THC oil” (based on selecting pictures of the products they had used, n = 324), 99.4% (n = 322) reported having seen a “wax pen or THC oil”.

Furthermore, participants differed in terms of which cannabis products they included in their definition of “marijuana”.  Over 90% of participants selected pictures of “marijuana flower”, in comparison to around half who selected pictures of “wax pens/THC oil” and “edibles”. The data also revealed that more experienced users generally included more cannabis products in their definition of “marijuana”.

The variation in individual meanings of the term “marijuana” demonstrates that caution should be practiced when using this term in survey research, or, in the least, care should be taken to inform participants that the term includes edibles and other non-flower forms of cannabis.

Conclusions

The researchers note that the results of this study should also be considered in the context of its limitations. Namely, that the study sample comprised of college students from a single state in the US in which medical, but not recreational, cannabis was legalised. Furthermore, participants were mostly white and from middle- to upper-class families. As such, the results of this study should be considered with some caution as there may be cultural and regional variations in cannabis product terminology that
may limit the generalisation of these results.

Nonetheless, these results led the researchers to conclude that there is a need for standardised surveys of cannabis use. Furthermore, surveys that use pictures of different cannabis products could potentially address some of the existing issues related to cannabis product terminology.