Availability of legalized cannabis reduces demand for illegal cannabis among Canadian cannabis users: evidence from a behavioural economic substitution paradigm

Rational Design, Synthesis, and Characterization of a Solid Δ9-Tetrahydrocannabinol Nanoformulation Suitable for "Microdosing" Applications

Background: This article highlights the formulation of a solid Δ9-tetrahydrocannabinol (THC)-loaded ingestible prepared from pure THC distillate. Methods: A THC-containing ethanol-assisted cannabinoid nanoemulsion (EACNE) was created using a solvent displacement technique. Subsequently, the EACNE was converted to a solid powdery material while still retaining its THC potency, a format uniquely suited for "microdosing" applications. Results: EACNE had an average lipid droplet size of ∼190 nm, with a polydispersity index of 0.15, and an average droplet ζ potential of -49±10 mV. The nanoemulsion (NE) was colloidally stable for at least 6 weeks, with no meaningful change in cannabinoid potency over the experimental period, as determined by high-performance liquid chromatography analysis. The EACNE remained stable when subjected to physical stresses such as heat, freeze/thaw cycles, carbonation, dilution to beverage concentrations, high sucrose concentrations, and a pH range between 5 and 8. The microencapsulated EACNE demonstrated limited free-flowing behavior but was freely redispersible in water without any visible phase separation. Conclusions: We report the design, creation, and characterization of a THC NE generated without the use of specialized equipment, such as a microfluidizer or a high-pressure homogenizer. This emulsion could readily be converted to a water-redispersible powder. This embodiment is particularly suited for THC "microdosing," a practice that might decouple the health benefits of THC from its psychotropic effects.

Exploring the suitability of cannabis use with next-day responsibilities: A behavioral-economic and qualitative study

Cannabis demand is sensitive to next-day responsibilities, such as job interviews; however, it is unclear how demand is affected by non-work-related responsibilities and how reported compatibility of cannabis use (i.e., how suitable one perceives cannabis use to be in a situation) influences demand. This study examined the effects of a range of responsibilities on cannabis demand in a crowdsourced sample of adults who smoked cannabis at least monthly (n = 177; 78% White; 47% women; mean age = 36.52). Participants completed hypothetical marijuana purchase tasks asking how much cannabis they would consume at escalating prices in the context of no responsibilities and next-day responsibilities spanning work, leisure, and caregiving. Cannabis demand was significantly reduced in all responsibility conditions (ps < .008; ds .28-.94), with the largest reductions for the job interview and caring-for-kids conditions. Higher ratings of suitability of cannabis use in each situation were correlated with higher demand. Finally, a qualitative thematic analysis characterized why cannabis use was considered suitable or unsuitable with each responsibility. These results suggest that demand is sensitive to next-day responsibilities. However, these effects are not uniform, and future research is needed to examine these individual differences and the timing of upcoming responsibilities.

Cannabis consumers' preferences for legal and illegal cannabis: evidence from a discrete choice experiment

BACKGROUND

In U.S. states that legalized and commercialized recreational cannabis, cannabis sales in illegal markets are still sizable or even larger than those in legal markets. This study aimed to assess cannabis consumers' preferences for purchasing cannabis from legal and illegal markets and estimate the trade-offs under various policy scenarios.

METHODS

963 adults were recruited, who used cannabis in the past year and lived in a state with recreational cannabis legalization. In a discrete choice experiment, participants chose purchasing cannabis from a legal dispensary or an illegal dealer with varying levels in product attributes including quality, safety, accessibility, potency, and price. Mixed logit models were used to analyze preferences.

RESULTS

The likelihood of choosing legal cannabis increased with a higher quality, the presence of lab test, a shorter distance to seller, a higher tetrahydrocannabinol level, and a lower price. The likelihood of choosing illegal cannabis increased with a higher quality, a shorter distance to seller, and a lower price. Among product attributes, quality and accessibility were perceived to be the most important for legal cannabis and price was perceived to be the most important for illegal cannabis. Policy simulations predicted that improving quality, ensuring safety, allowing delivery services, increasing dispensary density, and lowering prices/taxes of legal cannabis may reduce illegal cannabis market share.

CONCLUSIONS

In the U.S., cannabis consumers' preferences for illegal cannabis were associated with both legal and illegal cannabis product attributes. Policies regulating legal cannabis markets should consider potential spillover effects to illegal markets.

Utility of a brief measure of cannabis demand: Day-level associations with cannabis use

BACKGROUND

Cannabis demand (i.e., relative value) is usually assessed as a trait-level risk-factor for cannabis use and consequences. This study examined within-person variability in day-level intensity (i.e., amount consumed at zero cost) and Omax (i.e., maximum cannabis expenditure) and tested hypotheses that demand would be positively associated with day-level cannabis use.

METHODS

Young adults (n=85) reporting past-month simultaneous alcohol and cannabis use completed two daily surveys for 30 days. Morning surveys assessed prior-day cannabis use and evening surveys assessed day-level demand (i.e., intensity, Omax). Multilevel models tested day-level effects of intensity and Omax on any cannabis use and flower use frequency and quantity (i.e., grams).

RESULTS

Approximately 52 % and 46 % of variability in intensity and Omax, respectively, was due to within-person change. At the day-level, higher intensity and Omax were associated with higher likelihood of any cannabis use, regardless of formulation; Omax was associated with use of flower in particular; and intensity was associated with the highest quantity of use. At the person-level, only Omax was associated with flower use likelihood, and only intensity was associated with flower quantity across days.

CONCLUSIONS

Cannabis demand demonstrated day-to-day variability, conceivably in response to various internal states and external factors. Intensity and Omax were related to elevated likelihood of using any cannabis, particularly flower, at the day-level. Overall, these data illustrate the validity and utility of brief cannabis demand measures, which might be used to further understand cannabis' reinforcing value at a fine-grained level.

Lessons Learned in Developing a Behavioral Economic Measure of Cannabis Use Using a Predominantly White Sample

Behavioral economic approaches to measuring cannabis demand represent a well-validated, low-cost method of assessing risk for hazardous cannabis use. One widely used measure of cannabis demand is the Marijuana Purchase Task (MPT), which has shown good psychometric properties across multiple samples. However, preliminary data suggest that changes could improve task ecological validity and acceptability. Using a predominantly White convenience sample, this study aimed to develop a revised MPT that uses a modern dispensary scenario to better reflect national trends in cannabis use (e.g., multiple forms of cannabis consumption). Participant inattentiveness due to increased task length and difficulty estimating purchases for the next month may have impacted demand measures. Lessons learned are discussed to inform future efforts to assess cannabis demand in a manner that is more reflective of naturalistic use: including minimizing participant burden, setting higher price ceilings to increase task utility, and considering person-level factors that may influence demand.

Where Do Adults in the United States Obtain Cannabis? A Nationally Representative Study Examining the Relationships Between Sociodemographic Factors, Cannabis Use Characteristics and Sources of Cannabis

OBJECTIVE

Characterization of population subgroups based on where they acquire cannabis is unexplored. We examine relationships between sociodemographic characteristics, cannabis use modality, risky cannabis use, and source of cannabis.

METHOD

Analyzing a representative sample (unweighted n = 8,089) of U.S. adults living in medical cannabis-permitting states with past-year cannabis use from the 2021 National Survey on Drug Use and Health, we determined source of last cannabis used. Outcome groups were purchased from a dispensary, purchased from another source, or nonpurchased source. Incorporating the complex survey design, descriptive statistics and adjusted multinomial logistic regressions evaluated associations between sociodemographic, individual cannabis use characteristics, and source of cannabis. Secondary analyses described cannabis purchasing characteristics among the subsample who last purchased cannabis.

RESULTS

Purchasing from a dispensary was the most common source of cannabis (42.5%). Significant relationships between sociodemographic characteristics, cannabis use modality, risky cannabis use, and source of cannabis were found. Recent cannabis initiates and those with cannabis vaporizer use had an increased likelihood of purchasing cannabis from a dispensary. Purchasing from a nondispensary source was most likely among those with daily cannabis use, past-month blunt use, past-year driving under the influence, cannabis use disorder, and cannabis and alcohol co-use. Among those purchasing cannabis, joints and other forms of cannabis were more likely to be purchased from a dispensary than purchased from other sources.

CONCLUSIONS

We identified key sociodemographic and cannabis use characteristics that may influence where individuals obtain cannabis, which are important for cannabis behavior surveillance and cannabis use prevention and intervention strategies to consider.

Examining attributes of retailers that influence where cannabis is purchased: a discrete choice experiment

BACKGROUND

With the legalization of cannabis in Canada, consumers are presented with numerous purchase options. Licensed retailers are limited by the Cannabis Act and provincial regulations with respect to offering sales, advertising, location, maximum quantities, and information sharing in an effort to protect public health and safety. The degree these policies influence consumer purchase behavior will help inform regulatory refinement.

METHODS

A discrete choice experiment within a cross-sectional online survey was used to explore trade-offs consumers make when deciding where to purchase cannabis. Attributes included availability of sales/discounts, proximity, product information, customer service, product variety, and provincial regulation. Participants ≥ 19 years old who lived in Canada and purchased cannabis in the previous 12 months were recruited through an online market research survey panel. A multinomial logit (MNL) model was used for the base model, and latent class analysis was used to assess preference sub-groups. Key limitations included ordering effect, hypothetical bias, and framing effect.

RESULTS

The survey was completed by 1626 people, and the base model showed that customer service carried the most weight in purchase decisions, followed by proximity and availability of sales and discounts. There was considerable heterogeneity in preference patterns, with a five-group latent class model demonstrating best fit. Only one group (15% of sample) placed a high value on the store being provincially regulated, while three groups were willing to make a trade-off with regulation to access better customer service, product information, or closer proximity. One group preferred non-regulated sources (24% of sample); this group was also primarily driven by the availability of sales and discounts. Three groups (60.5% of sample) preferred online stores.

CONCLUSION

This study highlighted that there exists significant diversity with respect to the influence of consumer experiences on cannabis purchase behaviors. Modifications to cannabis retail regulations that focus on improving access to product information as well as reviewing limitations on sales and discounts could have the most impact for shifting customers to licensed retailers.

Behavioral economic analysis of legal and illegal cannabis demand in Spanish young adults with hazardous and non-hazardous cannabis use

BACKGROUND

In October 2021, a legal framework that regulates cannabis for recreational purposes in Spain was proposed, but research on its potential impacts on cannabis use is currently limited. This study examined the reliability and discriminant validity of two Marijuana Purchase Tasks (MPTs) for measuring hypothetical legal and illegal cannabis demand, and to examine differences in demand of both commodities in young adults at hazardous vs. non-hazardous cannabis use risk levels.

METHODS

A total of 171 Spanish young adults [Mage = 19.82 (SD = 1.81)] with past-month cannabis use participated in a cross-sectional study from September to November 2021. Two 27-item MPTs were used to estimate hypothetical demand for legal and illegal cannabis independently. The Cannabis Use Disorder Identification Test (CUDIT-R) was used to assess hazardous cannabis use and test for discriminant validity of the MPTs. Reliability analyses were conducted using Classical Test Theory (Cronbach's alpha) and Item Response Theory (Item Information Functions).

RESULTS

The MPT was reliable for measuring legal (α = 0.94) and illegal (α = 0.90) cannabis demand. Breakpoint (price at which demand ceases), and Pmax (price associated with maximum expenditure) were the most sensitive indicators to discriminate participants with different levels of the cannabis reinforcing trait. No significant differences between legal and illegal cannabis demand in the whole sample were observed, but hazardous vs. non-hazardous users showed higher legal and illegal demand, and decreased Breakpoint and Pmax if cannabis were legal vs illegal.

CONCLUSION

The MPT exhibits robust psychometric validity and may be useful to inform on cannabis regulatory science in Spain.

Perceptions and Attitudes Related to Driving after Cannabis Use in Canadian and US Adults

BACKGROUND

This study examined the risk perceptions related to driving after cannabis use (DACU) among Canadian and US adults who used cannabis in the past six months.

METHODS

Perceptions of danger, normative beliefs, perceived likelihood of negative consequences, and other driving-related variables were collected via online surveys in Canadian (n = 158; 50.0% female, 84.8% White, mean age = 32.73 years [SD = 10.61]) and US participants (n = 678; 50.9% female, 73.6% White, mean age = 33.85 years [SD = 10.12]). Driving cognitions and DACU quantity/frequency were compared between samples using univariate analyses of variance, and Spearman's (ρ) correlations were performed to examine associations between driving cognitions and DACU quantity/frequency.

RESULTS

The two samples did not significantly differ in self-reported level of cannabis use, lifetime quantity of DACU, or the number of times they drove within two hours of cannabis use in the past three months (Ps > .12). Compared to US participants, Canadians perceived driving within two hours of cannabis use as more dangerous (P < 0.001, ηp2 = 0.013) and reported more of their friends would disapprove of DACU (P = 0.03, ηp2 = 0.006). There were no differences in the number of friends who would refuse to ride with a driver who had used cannabis (P = 0.15) or the perceived likelihood of negative consequences (Ps > 0.07). More favorable perceptions were significantly correlated with greater lifetime DACU and driving within two hours of use (ρ = 0.25-0.53, Ps < 0.01).

CONCLUSIONS

These findings reveal differences in distal risk factors for DACU between Canada and the US and may inform prevention efforts focusing on perceptions of risk and social acceptance of DACU.

Exponentiated model of drug demand is preferred over exponential models in people with daily/near daily cannabis use

Cannabis use is a growing health concern emphasizing the need to better understand the complexities of drug choice in people with daily/near daily cannabis use. Hypothetical purchasing tasks provide a means to collect data on drug consumption behavior without requiring drug administration and have been used to isolate behavioral economic factors of choice, including facets of drug demand in substance using populations. Various models are used for analyzing hypothetical purchasing task data, but challenges exist in modeling data sets with consumption values of zero. Additionally, a single model or approach may not be best for all commodities and drug classes. This study compared two common demand models (exponential vs. exponentiated) applied to identical hypothetical purchasing task data from 21 (n = 21) individuals with daily/near daily cannabis use. The exponential model was fit using three common levels of replacement values for zero consumption (.1, .01, .001) and compared to the exponentiated model without replacement values. We found that the exponentiated model produced significantly better model fits for individual data, compared to all exponential models. Additionally, significant differences for model derived values of demand elasticity and intensity were found between the exponentiated model and different levels of the exponential model. We conclude that the exponentiated model is preferred over the exponential model for performing demand analysis on hypothetical purchasing task data from individuals with daily/near daily cannabis use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Cannabis demand and use among veterans: A prospective examination

OBJECTIVE

Cannabis demand (i.e., relative value), assessed cross-sectionally via a hypothetical marijuana purchase task (MPT), has been associated with use, problems, and dependence symptoms, among others. However, limited work exists on the prospective stability of the MPT. Furthermore, cannabis demand among veterans endorsing cannabis use, and the prospective cyclical relationship between demand and use over time, have yet to be investigated.

METHOD

Two waves of data from a veteran sample (N = 133) reporting current (past 6-month) cannabis use were analyzed to assess stability in cannabis demand over 6 months. Autoregressive cross-lagged panel models (CLPMs) assessed the longitudinal associations between demand indices (i.e., intensity, Omax, Pmax, breakpoint) and cannabis use.

RESULTS

Baseline cannabis use predicted greater intensity (β = .32, p < .001), Omax (β = .37, p < .001), breakpoint (β = .28, p < .001), and Pmax (β = .21, p = .017) at 6 months. Conversely, baseline intensity (β = .14, p = .028), breakpoint (β = .12, p = .038), and Pmax (β = .12, p = .043), but not Omax, predicted greater use at 6 months. Only intensity demonstrated acceptable prospective reliability.

CONCLUSIONS

Cannabis demand demonstrated stability over 6 months in CLPM models, varying along with natural changes in cannabis use. Importantly, intensity, Pmax, and breakpoint displayed bidirectional predictive associations with cannabis use, and the prospective pathway from use to demand was consistently stronger. Test-retest reliability ranged from good to poor across indices. Findings highlight the value of assessing cannabis demand longitudinally, particularly among clinical samples, to determine how demand fluctuates in response to experimental manipulation, intervention, and treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"That's Pot Culture Right There": Purchasing Behaviors of People Who Use Cannabis Without a Medical Cannabis Card

Introduction

The legal landscape surrounding purchasing cannabis without a medical cannabis card (i.e., without MCC) is changing rapidly, affecting consumer access and purchasing behaviors. Cannabis purchasing behaviors are related to subsequent use and experiencing greater cannabis-related negative consequences. However, purchasing behaviors of individuals who use cannabis without MCC are understudied.

Methods

The current study analyzed qualitative data from focus groups with adults who use cannabis without MCC (n = 5 groups; 6-7 participants/group; n = 31 total participants). Focus groups followed a semi-structured agenda, and were audio recorded and transcribed. Two coders applied thematic analysis to summarize topics pertaining to cannabis purchasing attitudes and behaviors. Focus groups occurred in 2015 and 2016 in Rhode Island, when purchasing and use of cannabis without MCC was decriminalized but still considered illegal.

Results

On average, participants (72% male) were 26 years old (SD = 7.2) and reported using cannabis 5 days per week (SD = 2.1). Thematic analysis revealed three key themes related to cannabis purchasing behaviors: (1) regular purchasing routines (i.e., frequency, schedule, amount of purchases), (2) economic factors (i.e., financial circumstances), and (3) contextual factors (i.e., quality of cannabis, convenience/availability) were perceived to influence purchasing decisions. Dealers' recommendations affected participants' purchases, who also reported minimal legal concerns. Participants reported saving money and using more cannabis when buying in bulk.

Discussion

Purchasing behaviors were found to vary and were perceived to be affected by individual-level (e.g., routines) and contextual factors (e.g., availability) that, in turn, may impact use patterns. Future research should consider how factors (e.g., availability) that differ across contexts (e.g., location) and demographic groups interact to affect purchasing behaviors.

Behavioral economic relationship between cannabis flower and concentrates: Evidence from simulated purchase tasks

Cannabis users use different forms of cannabis, which are associated with distinct public health concerns. Policies that aim to regulate one specific form may have unintended impacts on other forms. This study examined the behavioral economic relationship between flower and concentrates, the two most common forms of cannabis. We surveyed 605 adult cannabis users (21+) who lived in one of the U.S. states that had legalized recreational cannabis by the time of interview in 2019. The participants completed simulated purchase tasks, which asked how much cannabis flower and concentrates they would purchase in the next 30 days at escalating prices. We estimated (a) demand indices and own-price elasticities using nonlinear exponential demand models and (b) group- and individual-level cross-price elasticities using log-linear demand models. The estimated rate of change in demand elasticity (α) was 0.00066 for cannabis flower (SE = 0.00002, p < .001) and 0.00058 for cannabis concentrate (SE = 0.00002, p < .001). Group-level cross-price elasticity estimate (slope = -0.075, SE = 0.0135, p < .001) indicated that cannabis flower and concentrates were weak complements. Individual-level cross-price elasticity estimates showed that flower and concentrates were treated as independent by 76.2% of the users, as complements by 19.0% of the users, and as substitutes by 4.8% of the users. The findings suggested that cannabis flower and concentrates were overall weak complements and for most adult cannabis users were treated as independent of each other. Price and tax policies regulating either cannabis form may have minimal impacts on the other form. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reliability of an adaptive marijuana purchase task

Purchase tasks are used to measure the value, or demand, for various substances by assessing the amount of a substance individuals would purchase across a series of escalating prices. Marijuana purchase task (MPT) has been previously developed; however, cannabis can be consumed in various forms and measurements, thus raising questions about the applicability of the MPT across cannabis users. An adaptive MPT was developed to allow participants to select their preferred product (e.g., herbal, dabs) and division (e.g., hits, grams). Little research has been done to assess the temporal stability of these measures. Participants (N = 50, Mage = 35.3) who reported at least monthly cannabis use were recruited via Amazon's Mechanical Turk and completed a baseline and repeated original and adaptive MPT. Seventy-two percent (N = 36) of the sample reported the same preferred product and division. Results indicated that the baseline and repeated original MPT were significantly correlated across all indices (rrange = .37-.73), while the baseline and repeated adaptive MPT was significantly correlated with Pmax (r = .31, p = .029) and Omax (r = .57, p < .001). Permutation testing comparing the difference between the original and adaptive MPT on all indices demonstrated a difference for break point (rdifference = .52, p = .004) and elasticity (rdifference = .94, p = .005). Correlations were lower between participants who switched their preferences on the adaptive MPT. Only elasticity was significantly different (rdifference = .93, p = .012) between tasks among participants who did not switch their preferences. Results provide support that both the original and adaptive MPT are reliable across repeated measurement and demonstrate the importance of assessing cannabis product and division preferences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Concurrent validity of the marijuana purchase task: a meta-analysis of trait-level cannabis demand and cannabis involvement

BACKGROUND AND AIMS

The Marijuana Purchase Task (MPT) is increasingly used to measure cannabis reinforcing value and has potential use for cannabis etiological and regulatory research. This meta-analysis sought to evaluate for the first time the MPT's concurrent validity in relation to cannabis involvement.

METHODS

Electronic databases and pre-print repositories were searched for MPT studies that examined the cross-sectional relationship between frequency and quantity of cannabis use, problems, dependence, and five MPT indicators: intensity (i.e. unrestricted consumption), Omax (i.e. maximum consumption), Pmax (i.e. price at which demand becomes elastic), breakpoint (i.e. first price at which consumption ceases), and elasticity (i.e. sensitivity to rising costs). Random effects meta-analyses of cross-sectional effect sizes were conducted, with Q tests for examining differences by cannabis variables, meta-regression to test quantitative moderators, and publication bias assessment. Moderators included sex, number of MPT prices, variable transformations, and year of publication. Populations included community and clinical samples.

RESULTS

The searches yielded 14 studies (n = 4077, median % females: 44.8%: weighted average age = 29.08 [SD = 6.82]), published between 2015 and 2022. Intensity, Omax , and elasticity showed the most robust concurrent validity (|r's| = 0.147-325, ps < 0.014) with the largest significant effect sizes for quantity (|r| intensity = 0.325) and cannabis dependence (|r| Omax  = 0.320, |r| intensity = 0.305, |r| elasticity = 0.303). Higher proportion of males was associated with increased estimates for elasticity-quantity and Pmax -problems. Higher number of MPT prices significantly altered magnitude of effects sizes for Pmax and problems, suggesting biased estimations if excessively low prices are considered. Methodological quality was generally good, and minimal evidence of publication bias was observed.

CONCLUSIONS

The marijuana purchase task presents adequate concurrent validity to measure cannabis demand, most robustly for intensity, Omax , and elasticity. Moderating effects by sex suggest potentially meaningful sex differences in the reinforcing value of cannabis.

Substance-related cross-commodity purchase tasks: A systematic review

OBJECTIVE

In the context of behavioral economics, drug use is a choice to which an individual may allocate responding despite the presence of alternative response possibilities. To examine the demand for a drug in an environment in which other drugs or nondrug alternatives are present, researchers often use a cross-commodity purchase task. These tasks allow participants to make choices across several reinforcers at varied unit prices and may elucidate behavioral economic patterns of substitutability and complementarity. The objective of this study was to conduct a systematic review of cross-commodity purchase task studies with human participants.

METHOD

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we screened 46 full-text studies (from 456 total records obtained from PsycINFO and PubMed databases and reference list search), yielding a final sample of 35 studies.

RESULTS

The drug category with the largest number of studies assessed was tobacco and nicotine products. The most consistent economic relationships found were substitutability of traditional cigarettes by e-cigarettes and e-liquid, and both legal and illegal cannabis for the other; however, other substitutable and complementary relationships were observed (e.g., substitution of food for cigarettes, a complementary relationship between alcohol and cannabis).

CONCLUSIONS

We discuss the implications of the results of this review from a treatment and harm reduction standpoint, highlight areas for future research particularly among drug categories with few studies and evaluating ecological validity of hypothetical measures, and make best practice recommendations for future cross-commodity drug-related purchase task research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Behavioral economic relationship between cannabis and cigarettes: Evidence from hypothetical purchase tasks

BACKGROUND

In the United States (U.S), cannabis policies have been increasingly liberalized whereas tobacco policies have been increasingly stringent. Given the high prevalence of cannabis and tobacco dual use, there are concerns that a policy regulating one substance may unintendedly influence the other. This study examined the responsiveness of the demand for cannabis joints and cigarettes when price varied.

METHODS

The study included 338 adult participants (21+) who used both cannabis and tobacco and lived in one of the U.S. states with recreational cannabis legalized by the time of interview in 2019. They completed hypothetical purchase tasks to indicate the quantity desired of cannabis joints and cigarette packs 1) when only one substance was available with escalating prices and 2) when both substances were concurrently available with escalating prices of cannabis joints and a fixed price of cigarette packs. We estimated 1) the own-price elasticity of demand for each substance using nonlinear exponential demand model, and 2) the cross-price elasticity of demand at aggregate level using nonlinear exponential demand model and at individual level using log-linear demand model.

RESULTS

The estimates for the rate of change of own-price elasticity (α) were 0.0011 (SE = 0.000039, p < 0.001) for cannabis joints and 0.00095 (SE = 0.000037, p < 0.001) for cigarette packs. The aggregate-level estimates of cross-price elasticity (I = 13.032, SE = 0.34, p < 0.001; β = 0.0029, SE = 0.0021, p > 0.05) suggest an independent relationship between the two substances. At individual level, 78.70% of the participants treated the two substances as independent, 17.46% as complements, and 3.85% as substitutes.

CONCLUSIONS

For most adults who used both cannabis and tobacco in the U.S., cannabis joints and cigarettes had an independent relationship. Policies regulating the price of cannabis may not have large unintended consequences on cigarette use.

Developments and Changes in Primary Public Health Outcome Indicators Associated with the Legalization of Non-Medical Cannabis Use and Supply in Canada (2018): A Comprehensive Overview

Canada legalized non-medical cannabis use and supply for adults in 2018. We examined developments and changes associated with the legalization policy reform on key indicators for public health, namely cannabis (including frequent/problematic) use prevalence, cannabis-related hospitalizations, cannabis-impaired driving, and cannabis sourcing. We identified peer-reviewed and "grey" study data that featured population-level or other quasi-representative samples and comparable outcome data for pre- and post-legalization periods, including possible trends of changes over time. Cannabis use has increased in select population groups, with use modes shifting away from smoking. Evidence on cannabis-related hospitalizations (e.g., for mental health) is mixed. The prevalence of cannabis-impaired driving appears to be generally steady but THC exposure among crash-involved drivers may have increased. Increasing proportions of users obtain cannabis products from legal sources but some-especially regular-users continue to use illicit sources. Overall, data suggest a mixed and inconclusive picture on cannabis legalization's impacts on essential public health indicators, including select extensions in trends from pre-legalization.

How High-Frequency Users Embraced Cannabis Regulation in Uruguay

How cannabis legalization affects users’ behaviors? In this paper, we describe changes in the way users access cannabis in Uruguay before and after the implementation of cannabis regulation. We explore the differences between users that access through the legal, black, and gray markets. To do so, we rely on two face-to-face surveys of high-frequency users using the Respondent Driven Sample technique. The first survey was conducted at the beginning of the regulation implementation in 2014, and the second one in 2017. Results indicate that cannabis users gradually moved to the legal market, and most switched to the gray market. Furthermore, users kept acquiring cannabis from the black market even when using legal mechanisms. Considering these results, we argue that the strict regulations imposed in Uruguay may have operated as barriers for consumers to abandon the black market completely. These findings show that the specifics of each legalization policy matter.

Cannabis Use Disorder: A Behavioral Economic Perspective

Purpose of Review

To explore relations between behavioral economic demand for cannabis and cannabis use disorder (CUD). Prior reviews have focused on drug demand in relation to use outcomes more generally. Complementing and enhancing prior work synthesizing research on cannabis demand, the present review endeavors to determine whether specific demand indices derived from the marijuana purchase task are most reliably related to CUD. Additionally, sociodemographic characteristics of participants in these studies were reviewed to identify whether certain populations were underrepresented in behavioral economic cannabis research.

Recent Findings

Behavioral economic demand is related to CUD; intensity and elasticity of cannabis demand were consistently associated with CUD diagnosis and severity. However, frequently, only select demand indices were assessed or reported, precluding the ability to confirm which indices are superior for denoting CUD risk. Further, most studies enrolled samples that were predominately young adults, Caucasian, and male.

Summary

As CUD becomes more prevalent in the wake of cannabis legalization, identification of robust predictors of CUD risk is paramount. Cannabis demand is consistently associated with CUD; however, individual indices of import in this relationship remain ambiguous. Subsequent research is needed to confirm index-specific markers of disordered cannabis use, and whether links between demand and CUD generalize across diverse populations.

Cannabis flower prices and transitions to legal sources after legalization in Canada, 2019-2020

BACKGROUND

The post-tax price of legal cannabis has the potential to influence whether consumers transition from the illegal to legal cannabis market. The aims of the study were to: 1) estimate the percentage who report purchasing dried flower at different sources; 2) estimate the unit price of dried flower; and 3) examine the association between price and legality of purchase source.

METHODS

Repeat cross-sectional survey data come from Canadian respondents from the International Cannabis Policy Study conducted in 2019 and 2020. Respondents were recruited through online commercial panels, of legal age to purchase cannabis (up to 65 years), and purchased dried flower in the past 12-months (n = 4923). Weighted binary logistic regression models examined the association between price and legality of source.

RESULTS

The proportion of consumers last purchasing dried flower from legal sources increased from 2019 to 2020 (45.7% vs 58.1%) and in the past 12-months, the average percent of dried flower consumers reported purchasing from legal sources increased from 2019 to 2020 (55.7% vs 67.5%). The mean price of legal dried flower decreased in 2020 ($12.63 vs $11.16; p < 0.001), but remained more expensive than illegal dried flower in both years ($12.63 vs $9.04 in 2019; p < 0.001, $11.16 vs $9.41 in 2020; p < 0.001).

CONCLUSIONS

Two years after legalization in Canada, the price of dried flower from legal sources decreased, along with a greater percentage of consumers purchasing from legal sources than after one year. Price and retail policies must continue to encourage the transition to the legal market in Canada.

Characteristics that influence purchase choice for cannabis products: a systematic review

Introduction

When non-medical cannabis use became legal, government regulators implemented policies to encourage safer consumption through access to a regulated market. While this market is growing, sales still occur through unregulated channels. This systematic review identifies factors influencing cannabis purchasing to help policymakers understand why consumers still purchase illicit market cannabis (registered with PROSPERO CRD42020176079).

Methods

A comprehensive search strategy included databases in health, business, and social science fields (inception to June 2020). Studies were eligible for inclusion if they were conducted with persons who purchase cannabis and examine at least one attribute that would influence purchase choice and were published in the English language. Studies could be of any methodological design. Two independent reviewers completed two levels of screening, and all extraction was verified by a second reviewer. A qualitative synthesis of the findings was completed. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool.

Results

Of the 4839 citations screened, 96 were eligible for full-text review and 35 were included in the final synthesis. Aspects of price were the most common factors (27 studies). Twenty studies measured price elasticity; most studies found that demand was price inelastic. Many other attributes were identified (e.g., product quality, route of administration, product recommendations, packaging), but none were explored in depth. Eleven studies addressed aspects of product quality including demand elasticity based on quality, potency, and aroma. Studies also explored consumer-perceived “quality” but provided no definition; differences in quality appeared to impact consumer choice. Smoking cannabis appeared to be the preferred route of administration but was only examined in three studies. There was insufficient data to understand in the impact of other attributes on choice. There appeared to be preference heterogeneity for different attributes based on the consumer’s experience, reason for use, and gender.

Conclusion

While price influences choices, demand is relatively inelastic. This suggests that consumers may be seeking lowest-cost, unregulated cannabis to avoid reducing consumption. Beyond price, there is a significant gap in our understanding of consumer choices. Perceived quality does appear to impact choice; however, more research is needed due to the lack of a recognized definition for cannabis quality.

Supplementary Information

The online version contains supplementary material available at 10.1186/s42238-022-00117-0.

Legalization of recreational cannabis: Facilitators and barriers to switching from an illegal to a legal source

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Limiting surveillance, quantity limits, and preserving anonymity is a facilitator.

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Competitive pricing from the illicit market and heavy regulation are barriers.

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Loyalty to current illicit suppliers is a barrier to switching to a licit market.

Illicit markets persist in places where recreational cannabis has been legalized. This study aimed to identify perceived facilitators/barriers of switching from an illicit to a licit cannabis source. Using a cross-sectional qualitative approach, 529 students, from one New Zealand university, completed a survey investigating the facilitators/barriers to switching through two open-ended questions. Perceived facilitators for switching included: safety (63.1%); price (42.7%); legal, no risk of convictions (35.3%); increased accessibility (32.3%); product diversity (14.2%). Perceived barriers included: price (66.4%); judgement (36%); regulation (28.9%); loyalty to current supplier (27.2%); reduced accessibility (13.2%). The findings provide recommendations for policies aimed at tipping people in favor of a licit over an illicit source. Avoiding arrest/convictions, and easier access, were not primary facilitators for switching. Thus, providing a licit market might be insufficient in the absence of other competitive factors, such as communicating improved product safety. Competitive pricing and regulation (tetrahydrocannabinol strength/quantity limits) were also barriers. Given legal markets aimed at minimizing harm are constrained with competing in these areas, it is significant that our findings identified other barriers which could be overcome, including limiting surveillance and quantity limits and positioning stores to preserve anonymity. The findings also highlight that loyalty to current illicit suppliers will be a significant barrier.

A systematic review and meta-analysis of delay discounting and cannabis use

Delay discounting reflects the systematic reduction in the value of a consequence by delay to delivery. Theoretical and empirical work suggests that delay discounting is a key behavioral mechanism underlying substance use disorder. Existing work on cannabis use, however, is mixed with many studies reporting null results. The purpose of this review was to provide an in-depth assessment of the association between delay discounting and cannabis use. We conducted metaregression analyses to determine the omnibus correlation between delay discounting and cannabis use, and to evaluate task-based and sample-based moderators. Studies included evaluated an association between delay discounting and cannabis quantity-frequency or severity measures in human participants (27 studies, 61 effect sizes, 24,782 participants). A robust variance estimation method was used to account for dependence among effect sizes. A significant, but small, omnibus effect was observed (r = .082) in which greater cannabis use frequency or severity was associated with greater discounting. Incentive structure and outcome type were each significant moderators in a multiple moderator model such that incentivized tasks correlated with severity measures showed stronger associations (r = .234) than hypothetical tasks correlated with quantity-frequency measures (r = .029). Comparisons to historic effect size data supported the hypothesis that, at present, the relationship between cannabis use and delay discounting appears empirically smaller than for other substances. Future work should explore theoretical rationales explaining this modest relationship involving cannabis use and delay discounting, such as reflecting the smaller magnitude of perceived long-term clinical outcomes associated with cannabis compared to other substances. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The effect of next day responsibilities and an adaptive purchase task on cannabis demand

BACKGROUND

The marijuana purchase task (MPT) is a commonly used behavioral economic measure of relative cannabis value (i.e. demand) that presents specific methodological concerns due to non-standardized measurement, variability in modality of use, and evolving legalization policies. Refinement of the task is critical to improve task ecological validity and accurate measurement of cannabis demand. The present study examined the construct validity of an adaptive MPT that allowed for participant selection of their preferred cannabis-based product and unit of measurement and the effect of next-day responsibilities on demand.

METHODS

Participants reporting at least monthly cannabis use (N = 186, 40.3 % women, Mage = 33.59) were recruited via Amazon Mechanical Turk and completed the original MPT and our adaptive form with 2 next-day responsibilities scenarios (no responsibilities vs. morning job interview) for each MPT. Cannabis use motives, problems, and risk for cannabis use disorder were also assessed.

RESULTS

Cannabis demand was sensitive to next-day responsibility, with higher hypothetical consumption observed in the no responsibilities condition. Responsibility-related decreases in Omax (F(1,185) = 4.83, p = .029, η2p = .03) were significantly greater on the adaptive MPT than the original MPT. Demand indices derived from the adaptive MPT were significantly correlated with cannabis problems (rbreakpoint = .19, rPmax = 0.18, relasticity=-0.18) and motives (rrange=-.32-.25), and demand metrics from the original MPT.

CONCLUSIONS

Results provide preliminary support for the construct validity of an adaptive MPT and suggest that early-morning work responsibilities may reduce cannabis demand. Continued research is needed to further refine this task and determine implications for cannabis use disorder intervention and prevention approaches.

Implications of marijuana purchase task based demand functions for optimal legal pricing of cannabis

BACKGROUND

Legalization of recreational cannabis use in Canada has prompted a wide array of new policy decisions to be made at all levels of government. Policies had to be designed and implemented to cover everything from the structure of production, distribution, and retail markets to zoning requirements governing the location of storefronts. Policies concerning price have proven particularly challenging due to a lack of observation data on price sensitivity of cannabis demand and the degree to which users are willing to substitute legal cannabis for illicit cannabis and other drugs.

METHOD

The most rigorous estimates of demand elasticity to date are derived from a sample of 289 cannabis users in Ontario who completed a hypothetical marijuana purchase task (Amlung & MacKillop, 2019). We calculate the optimal price of legal cannabis given a fixed illicit price based on this demand system for a range of parameters around the point estimates provided.

RESULTS

Our results clearly show a dichotomy between minimizing social harms and maximizing government revenue from legal cannabis net of production costs and social harm. In all cases the social harm minimizing legal price was below the illicit price while the net-revenue-maximizing price was above the illicit price.

CONCLUSIONS

The existence of the illicit market must be considered when designing legal cannabis pricing policies as it limits the effectiveness of price increases in controlling demand. Legal cannabis prices in Canada have so far been more consistent with revenue maximization than with minimizing social harms.

No evidence of differences in smoking levels, nicotine dependence, carbon monoxide or motivational indices between cigarette smokers and cigarette + e-cigarette dual users in two samples

Concurrent use of electronic cigarettes (e-cigarettes) as an alternative source of nicotine may lead to lower smoke exposure, tobacco addiction and reinforcing value of conventional combustible cigarettes. In two different cohorts, we characterized smokers, dual cigarette/e-cigarette users, and e-cigarette-only users in terms of sociodemographic, motives and patterns of e-cigarette use. Differences in smoking-related characteristics and reinforcing value of cigarettes between smokers and e-cigarette dual users were also examined. Two cohorts comprising 339 community adults [Sample 1; aged 18-65] and 293 young adult binge drinkers [Sample 2; aged 19-24] were recruited in Hamilton, Ontario. All participants provided expired carbon monoxide (CO) samples and completed an assessment battery including the Fagerström Test of Nicotine Dependence (FTND), the Wisconsin Inventory of Smoking Dependence Motives (WISDM), and the Cigarette Purchase Task (CPT). In both samples, smoking rate, CO level, FTND, WISDM, and CPT responses did not significantly differ between smokers and dual users. Compared to e-cigarette-only individuals, dual users from the two cohorts reported a greater use of e-cigarettes for quitting smoking, but dual product consumers exhibited no significant differences in motivation for change relative to combustible-only smokers. Relative to smokers, e-cigarette dual users did not show lower levels of smoking, lower severity of cigarette addiction and reinforcing value of cigarettes in these samples. These findings suggest that concurrent e-cigarette use does not affect combustible tobacco use or motivation, or reduce its harms.

Facing the option for the legalisation of cannabis use and supply in New Zealand: An overview of relevant evidence, concepts and considerations

ISSUES

Non-medical cannabis policies are changing, including towards legalisation-with-regulation frameworks. New Zealand will hold a public referendum on cannabis legalisation in 2020. We reviewed data on cannabis use and health/social harms; policy reform options; experiences with and outcomes of reforms elsewhere; and other relevant considerations towards informing policy choices in the upcoming referendum.

APPROACH

Relevant epidemiological, health, social, criminal justice and policy studies and data were identified and comprehensively reviewed.

KEY FINDINGS

Cannabis use is common (including in New Zealand) and associated with risks for health and social harms, mainly concentrated in young users; key harms are attributable to criminalisation. 'Decriminalisation' reforms have produced ambivalent results. Existing cannabis legalisation frameworks vary considerably in main parameters. Legalisation offers some distinct advantages, for example regulated use, products and user education, yet outcomes depend on essential regulation parameters, including commercialisation, and policy ecologies. While major changes in use are not observed, legalisation experiences are inconclusive to date, including mixed health and social outcomes, with select harms increasing and resilient illegal markets. It is unclear whether legalisation reduces cannabis exposure or social harms (e.g. from enforcement) for youth.

IMPLICATIONS/CONCLUSIONS

No conclusive overall evidence on the outcomes of legalisation elsewhere exists, nor is evidence easily transferable to other settings. Legalisation offers direct social justice benefits for adults, yet overall public health impacts are uncertain. Legalisation may not categorically improve health or social outcomes for youth. Legalisation remains a well-intended, while experimental policy option towards more measured and sensible cannabis control and overall greater policy coherence, requiring close monitoring and possible adjustments depending on setting-specific outcomes.

Assessing Cannabis Demand: A Comprehensive Review of the Marijuana Purchase Task

The marijuana purchase task (MPT) is a behavioral economic measure of individualized cannabis value (i.e., demand). The MPT follows purchase tasks for other substances (e.g., alcohol, tobacco), though presents with unique caveats due to its mixed illicit status, non-uniform units of purchase and use, and substantial within substance variability in strain, potency, and quality. As the regulatory climate surrounding purchase and use of cannabis continues to evolve in the USA and globally, rigorous assessment of cannabis use and value are of the utmost importance. This study represents the first comprehensive review of investigations utilizing the MPT. Searches through PubMed and Web of Science databases by two independent coders identified 15 empirical articles referencing the use of an MPT and were published through the year 2019. Articles were coded for demographic and procedural characteristics, structural characteristics of the MPT itself, data analytic characteristics, and relationships with cannabis-related outcomes. Rigorous assessment of demand for cannabis is essential with respect to the broad public health issues surrounding cannabis legalization. We have synthesized the research presented herein and comment on vital considerations for subsequent MPT work, including recommendations for a unified approach to using the MPT in subsequent research.