Testing Warning Labels for Retail Cannabis Products Using a Discrete Choice Experiment

The DCE will be conducted via a self-administered online questionnaire, with inclusion criteria assessed before assignment to choice set conditions. Participants will be residents of legal-retail cannabis use states, able to legally purchase cannabis (21 or older), who have used cannabis in the past 30 days (i.e., current use). Frequency of cannabis use (i.e., monthly, weekly, daily), mode (e.g., flower, vape, etc.), and dose (i.e., THC level) will be measured through self-report. Inclusion criteria are reported using cannabis (any mode) in the past 30 days. Consented participants will be presented with descriptions of cannabis packaging attributes and an example choice set to become familiar with DCE tasks. Participants will be asked to imagine the cannabis products in the DCE as the only choices they have available to them "in the near future" and to evaluate images within this scenario. Participants will be randomly assigned to view 16 choice sets. To optimize the evaluation of preferences and reduce respondent burden, we will assign contrasting labels to "choice sets," each of which will include 4 images of products in such a way that each attribute level appears an equal number of times in combination with all other attribute levels. Presentation order of the 16 choice sets will be randomized within and across choice sets to minimize ordering effects. Participants will view each choice set for as long as they wish. After evaluating choice sets, participants will complete a recall task to assess retention of health warning information and will be provided a debrief page with information about substance use and resources for seeking help with substance use.

• Discrete choice experiment (DCE) survey-experiment (Behavioral): A discrete choice experiment (DCE) consisting of 16 distinct choice sets. Each choice set presents combinations of the following attributes: 1) Cannabis package style: 1) "Standardized" plain package, 2) plain package with brand logo and fonts, 3) brand color background with brand logo and fonts, and 4) fully branded with brand imagery, brand logo, and brand descriptors and fonts. Branding type: 1) Adventure brand vs. 2) Earthy brand. Health warning size: 1) Small (20% of packaging surface) - health warnings use currently mandated warning language from multiple jurisdictions vs. 2) Large (40% of packaging surface) - health warnings use currently mandated warning language from multiple jurisdictions. Product THC content: 1) Low THC vs. 2) High THC. Product type: 1) Joints, 2) Vape, 3) Edibles, and 4) Drinks. Participants will rate all combinations of product attributes.

Primary outcomes

• Risk perceptions about cannabis products [At the time of survey completion (approximately 15 minutes)]: Binary measure using best-worst scaling. For each question, participants will also have the option of indicating none of the above/opt-out as a response. For each choice set, the statement selected as the best option will be coded using a value of 1, and the worst will be coded as -1. The remaining statements in that set will be coded as 0. If the participant selects none of the above, all statements in that choice set will be assigned a value of 0.
• Cannabis product use intentions [At the time of survey completion (approximately 15 minutes)]: Binary measure using best-worst scaling. For each question, participants will also have the option of indicating none of the above/opt-out as a response. For each choice set, the statement selected as the best option will be coded using a value of 1, and the worst will be coded as -1. The remaining statements in that set will be coded as 0. If the participant selects none of the above, all statements in that choice set will be assigned a value of 0.

Sex: All, ages: 21 Years to any

Eligibility for participation includes: 1) being 21 years of age or older, 2) being able to speak and understand English, 3) self-reported having consumed cannabis in the last 30 days (any mode, e.g., flower, vape, edible, etc.), and 4) residing in a U.S. state or jurisdiction where retail (i.e., non-medical) cannabis use is legal.

• Zachary Massey, PhD, Principal investigator, University of Oklahoma

NIH grants: K01DA057395