Cannabis is an open access peer-reviewed journal dedicated to the scientific study of marijuana/cannabis from a multidisciplinary perspective. Consistent with the mission of the Research Society on Marijuana (RSMj), the journal publishes empirical research of the determinants, correlates, consequences, contexts, and assessment of marijuana use as well as the treatment of problematic marijuana use, including cannabis use disorder. The journal covers research across the human spectrum (note that we currently do not accept animal model research).
Clinical Experience and Student Support for Medical Cannabis Use: A Secondary Analysis
Objective: As medical cannabis (MC) legalization expands across the United States, understanding the factors shaping healthcare students’ support for its use is essential to informing educational practices and reducing stigma in clinical care. Method: This secondary analysis examined factors associated with students’ support for medical cannabis use (SFMCU), including clinical experience, personal cannabis use, demographic characteristics, and variation across patient vignettes. Participants (N = 349) were recruited from sciences and healthcare majors at multiple higher education institutions. SFMCU was measured using four clinical vignettes, and linear mixed-effects modeling was employed to account for both within- and between-subject variability. Results: Students with clinical experience demonstrated significantly lower SFMCU compared to those without such experience (p < .001). Personal cannabis use was also associated with higher SFMCU, with users reporting greater support than non-users (p < .001). Older age and male gender predicted higher SFMCU (p < .05). Support varied by vignette type, with participants reporting greater SFMCU for post-traumatic stress disorder and insomnia compared to depression (p < .001). Conclusions: Findings indicate that clinical experience, personal cannabis use, and demographic factors each influence students’ attitudes toward MC. Students with healthcare experience exhibited lower support, possibly reflecting exposure to traditional medical norms or institutional stigma. These results underscore the need to integrate evidence-based MC education into healthcare curricula to enhance student knowledge, address misconceptions, and prepare future professionals to engage in informed, stigma-free patient care.
Copyright (c) 2026 Andrew W. Tong, Chloe J. DuBoux, Rebecca H. Seuferer, Francis W. Siu, Bryan Magana, Joshua M. Gold, Thomas A. Clobes, Julia Bensing-Ruiz http://creativecommons.org/licenses/by-nc-nd/4.0
Abstracts from the 2025 Scientific Meeting of the Research Society on Marijuana July 18-20, 2025
Copyright (c) 2025 Lauren Micalizzi, Kyra Farrelly, Stephanie Penta http://creativecommons.org/licenses/by-nc-nd/4.0
Sleep Motives and Expectancies for Cannabis Use in Pregnancy
Objective: Sleep difficulties are a common motive for cannabis use during pregnancy. However, evidence supporting cannabis use as an effective sleep aid is limited, while substantial research demonstrates the efficacy of cognitive behavioral treatments. This study characterized the sleep complaints of adults using cannabis during pregnancy to inform prevention and intervention efforts. Method: Pregnant adults reporting cannabis use (a) in the month prior to or (b) after becoming pregnant were recruited from across the United States between May and August of 2025. Participants completed a cross-sectional research survey, and those who passed all fraudulent responding criteria were included in data analysis. Descriptive statistics, chi-square, and t-tests compared the demographic and clinical characteristics of pregnant adults who did and did not report using cannabis to help their sleep. Results: Of the 210 valid respondents (100% assigned female at birth, 93% cisgender; age M = 29.3 years; 53% White, 38% Black; 58% in second trimester), 185 persisted in cannabis use during pregnancy and 119 reported using “mostly” or “almost always” to help their sleep. Those using cannabis for sleep reported greater insomnia severity, earlier bedtimes, and more wake after sleep onset than those using cannabis for other reasons, but they were less likely to report taking >30 minutes to fall asleep, consistent with expectancies that cannabis would help their sleep. Three out of four using cannabis for sleep (78%) expressed interest in alternative sleep treatments. Conclusions:Sleep is a common reason for cannabis use during pregnancy that appears to be a promising target for prevention and intervention efforts.
Copyright (c) 2026 Mary Beth Miller, Margaret Lloyd Sieger, Katie R. Moskal, Emily Marut, Shikha Gupta, Andrea M. Wycoff http://creativecommons.org/licenses/by-nc-nd/4.0
Perceived Ethnic Discrimination and Negative Emotional Reactivity to Minority Stress: Association with Cannabis Use Processes Among United States Hispanic/Latinx Adults
Objective: Cannabis use has been increasing among the Hispanic/Latinx population in the United States (US). Little research has expressly focused on culturally relevant factors related to cannabis use processes and problems among this group. The present investigation sought to help bridge this gap and test the main and interactive effects of perceived ethnic discrimination and negative emotional reactivity to minority stress in terms of cannabis use processes, including perceived barriers for cannabis reduction, cannabis use problems, and cannabis use motives, among Hispanic/Latinx adults in the US. Method: Participants were recruited through Qualtrics Panels and included 521 adults who engaged in current (past month) cannabis use (Mage = 36.52 years, SD = 10.26; 55.1% male). Results: In adjusted models, for perceived barriers for cannabis reduction and cessation as well as cannabis use problems, both perceived ethnic discrimination and negative emotional reactivity to minority stress were independently associated with higher odds of endorsement. For cannabis use motives, negative emotional reactivity to minority stress was positively associated with enhancement, social, coping, and expansion motives, whereas perceived ethnic discrimination was a contributor to conformity motives; effects ranged from small to medium. No interactive effects emerged as statistically significant. Conclusions: The current findings suggest that among the U.S. Hispanic/Latinx population, screening and intervening upon perceived ethnic discrimination and negative emotional reactivity to minority stress may help mitigate challenges with the continued use of cannabis.
Copyright (c) 2025 Michael J. Zvolensky, Bryce K. Clausen, Ava A. Jones, Rodrigo Castillo-Avilés, Jessica M. Thai, Justin M. Shepherd, Lucas Bogiaizian, Brooke Y. Redmond, Lorra Garey http://creativecommons.org/licenses/by-nc-nd/4.0
Current and Projected Cannabis Demand Predict Future Consumption in Young Adults Who Use Cannabis
Objective: Cannabis demand, as measured by the Marijuana Purchase Task (MPT), holds associations with concurrent cannabis consumption and associated risks (e.g., cannabis use disorder [CUD]). As few studies have examined prospective associations between cannabis demand and future cannabis use, the current study examined this association in young adults who use cannabis. In addition, the present study explored the novel construct of projected future cannabis demand and its associations with future cannabis use. Method: Participants first completed a current Time1 (T1) MPT, projected future Time2 (T2) MPT (i.e., “three months from now”), and measures of past-month cannabis use frequency and CUD symptoms during an initial session. They returned three months later (T2) to complete a current T2 MPT and measures of cannabis use and CUD symptoms. Results: Measures across the three MPTs (observed T1, projected future T2, and observed T2) indicate relatively stability of demand across time and accuracy in projecting future demand. Prospective associations between T1 demand measures and cannabis use were observed, with both observed T1 and projected future T2 demand measures associated with T2 cannabis use frequency. Conclusions: Results of the current study highlight the potential of current and projected future cannabis demand measures to better understand the trajectory of cannabis use in this high-risk population.
Copyright (c) 2025 Rebecca Kurnellas, Cassandra A. Sutton, Daiil Jun, Hailey Taylor, Aaron P. Smith, Ricarda Foxx, Ali M. Yurasek, Richard Yi http://creativecommons.org/licenses/by-nc-nd/4.0
Intentions and Motives for Cannabis Use in Pregnancy and Postpartum: Preliminary Daily Diary Findings on Planned and Unplanned Use
Objective: Perinatal cannabis use is a significant public health concern linked to adverse maternal and neonatal outcomes. Despite growing evidence of prenatal cannabis use (PCU) risks, many individuals use it to manage symptoms such as nausea, anxiety, or pain. The Theory of Planned Behavior (TPB) identifies intentions as key predictors of substance use. While intentions and use patterns have been well studied in non-pregnant populations, research on prenatal intentions for cannabis use is limited. This pilot ecological momentary assessment (EMA) study examines: (a) cannabis use and non-use days in terms of intentions and use; (b) associations between daily intentions and use across prenatal and postpartum; and (c) motives linked to planned versus unplanned use. Method: Pregnant participants (N = 20; Mage = 30.15) reporting current prenatal CU completed two 14-day EMA bursts (in pregnancy and at 6-weeks postpartum) tracking daily CU, motives, and intentions. Planned use days were coded based on morning endorsement of intention to use, followed by reported use; unplanned use days were coded based on no morning intention, followed by reported use. Results: Planned use was most common both in pregnancy and postpartum, followed by planned nonuse, unplanned use, and foregoing plans to use. Intentions strongly predicted daily cannabis use (OR = 5.78, p < .001), with no significant difference between pregnancy and postpartum. Common motives across both planned and unplanned days included relaxation, pain relief, and sleep improvement. Some motives, including appetite increase and anxiety reduction, were more frequent on planned days, while enhancement motives were more common on unplanned days. Conclusions: Findings support TPB’s relevance to perinatal cannabis use, highlighting distinct motives for planned versus unplanned use. Larger samples are needed to expand these insights.
Copyright (c) 2026 Lindy K. Howe, Lauren Micalizzi, Sara E. Simmons, Jane Metrik, Cynthia L. Battle, Rachel L. Gunn http://creativecommons.org/licenses/by-nc-nd/4.0
Mediating the Impact of Prenatal Cannabis Exposure on Neurobehavioral Disinhibition: The Role of Delayed Developmental Milestone Attainment
Objective: Environmental perturbations such as prenatal cannabis exposure (PCE) during critical periods may lead to disruptions in biological systems that have downstream consequences on behavior and development. Developmental milestones have served as a measure of normative development that allows providers and parents to identify areas for intervention. However, little is known about the direct impacts of PCE on development milestone attainment and whether failures to attain development milestones mediate later disruptions in executive functioning and behavioral disinhibition. Method: Data from the Adolescent Brain Cognitive Development (ABCD) study were used to examine prenatal cannabis effects on development while using a propensity score approach to control for familial and environmental characteristics. Results: PCE was not significantly associated with any delays in gross motor or language attainment; however, after accounting for confounders via propensity score for PCE (pPCE), PCE was significantly associated with delays in ‘saying his/her first word’ (Odds Ratio = 1.51, 95% Confidence Interval: [1.08, 2.10]). Upon examining the mediating effects, there were no significant total direct or total indirect effects on executive functioning. However, pPCE was associated with behavioral disinhibition and a significant mediation of PCE on behavioral disinhibition via delays in saying his/her first word were observed. Conclusions: This study suggests that delays in saying his/her first word serves as a risk factor for later behavioral disinhibition/externalizing problems. Importantly, the current study didn’t examine language development, rather delays in saying his/her first word can provide insight into the possible impacts prenatal cannabis exposure has on developmental milestone attainment.
Copyright (c) 2026 Ami S. Ikeda, Manjushri Karthikeyan, H.M. Sean Lee, Valerie S. Knopik , Rohan H.C. Palmer http://creativecommons.org/licenses/by-nc-nd/4.0
Prenatal Cannabis Use and Child Diagnoses of Depressive and Anxiety Disorders
Objective: Prenatal cannabis use is associated with adverse pregnancy and neonatal outcomes, but research on its association with child anxiety and depressive disorders is limited. This study aimed to test the hypothesis that prenatal cannabis use is associated with child anxiety or depressive disorder diagnoses. Methods: Population-based retrospective birth cohort study of children (N=115,553) born between 1/1/2011-12/31-2017 to pregnant individuals (N= 97,376) universally screened for prenatal cannabis use. Cox proportional hazards regression models examined associations between cannabis use during early pregnancy (at ~8-10 weeks gestation based on self-reported use or a positive urine toxicology test for delta-9-tetrahydrocannabinol [THC]) and child anxiety and depressive disorders from ages 6 to 13 years based on diagnosis codes, adjusting for maternal sociodemographic and clinical characteristics. Results: The median (IQR) age at pregnancy onset was 31 (6) years. Most pregnancies (61.4%) were to non-White individuals; 4.4% screened positive for any cannabis use; 3.7% had a positive toxicology test and 1.9% self-reported use. Overall, 9,230 children were diagnosed with an anxiety disorder at (median (IQR)) age of 8 (3) years and 1,224 with depressive disorder at median (IQR) age of 9 (3) years. Prenatal cannabis use was associated with lower risk of child anxiety disorders (aHR:0.84:95%CI: 0.75-0.95) which remained significant when defined by a toxicology test but not when defined by self-report. Maternal prenatal cannabis use was not associated with child depressive disorders (aHR:1.15:95%CI: 0.85-1.54). Conclusions: Prenatal cannabis use during early pregnancy was not associated with an increased risk of offspring anxiety or depressive disorders.
Copyright (c) 2026 Kelly C. Young-Wolff, Mahlet Shenkute, Nina Oberman, Stacey E. Alexeeff, Lisa A. Croen, Jamie O. Lo, Deborah Ansley, Carley Castellanos, Kathryn K. Ridout, Matthew E. Hirschtritt, Lyndsay A. Avalos http://creativecommons.org/licenses/by-nc-nd/4.0
Provider Perspectives of Conversations and Practices Surrounding Perinatal Cannabis Use
Objective: To explore practices and perspectives of perinatal providers related to cannabis use during pregnancy and postpartum. Method: A mixed methods approach was employed using data collected from 18 perinatal providers practicing in the United States.Results: Most (72%) providers surveyed conduct universal evidence-based screening for perinatal cannabis use. Providers report these conversations are important and relevant, but only 55% report comfort with the topic. Four higher-order themes and five sub-themes emerged to further describe providers experiences of these conversations, including barriers and beliefs. Conclusions: Providers believe conversations about peripartum cannabis use are important, but describe needing additional support navigating up-to-date information, legal statues, and patient perceptions.
Copyright (c) 2026 Marie A. Hayes, Sara M. Witcraft, Emily Johnson, Kathleen Brady, Constance Guille http://creativecommons.org/licenses/by-nc-nd/4.0
Cannabis Dispensary Staff ("Budtender") Perspectives on Trustworthiness of Social Media Information: A Qualitative Study
Objective: Scientific and medical sources continue to be outpaced by the burgeoning cannabis marketplace regarding emerging forms of cannabis, leaving consumers with a great deal of uncertainty about safety and efficacy that may be addressed in cannabis dispensary and online settings. The present study examines how cannabis dispensary staff (“budtenders”) use and evaluate the trustworthiness of online information about cannabis, especially social media content. Method: Qualitative semi-structured interviews were conducted with San Francisco Bay Area budtenders (n = 18) and analyzed thematically. Results: Social media was not viewed as a reliable information source for dispensary-based social interactions. Budtenders were skeptical of most commercially-oriented social media content and frustrated with inconsistent content moderation practices of social media platforms. Budtenders instead preferred offline information sources and relationships, as well as information derived from first and secondhand experiences with cannabis products. When evaluating information on social media, online settings promoting privacy, community moderation, and accountability were seen as features of trustworthy environments. Budtenders also expressed a range of confidence in medical, natural healing, and personal experience frameworks of health and cannabis knowledge production; concordance of social media content with these frameworks was an additional signal of trustworthy information. Conclusions: This research highlights the role of budtenders in evaluating and triangulating emerging online cannabis information sources for consumers and the varied features and signals that cue budtenders to consider some online information as more trustworthy and credible for cannabis consumers.
Copyright (c) 2025 Meredith C. Meacham, Maha N. Mian, Danielle Schell, Coye Cheshire http://creativecommons.org/licenses/by-nc-nd/4.0
A Factor Analysis of the Marijuana Motives Measure in an Anxiety and Related Disorders Sample
Objective: Motivational models of cannabis use, amongst other substances, suggest that individuals are driven to use it to achieve variable personally important outcomes. Understanding individuals’ personal motivations for cannabis use is essential to screen for problematic use and intervene where appropriate. Importantly, more research is needed to understand how individuals transition from recreational to problematic use, as well as maintenance factors. As such, the use of psychometrically sound measures of motives for cannabis use is necessary, particularly in populations of individuals with anxiety and related disorders (ARDs), where there is a high rate of cannabis use. Method: We examined the factor structure of the Marijuana Motives Measure (MMM) to confirm its structural validity in a clinical sample. Treatment-seeking adults from an outpatient anxiety clinic in Canada (N = 253) completed the MMM and several symptom questionnaires. Results: Confirmatory factor analysis exhibited strong fit indices and good internal consistency across subscales ranging from .88-.93. Significant positive correlations were observed amongst most subscale pairs, the highest between expansion and coping (cor = 0.78). Scores on a measure of cannabis use disorder symptoms showed the strongest association with the coping subscale (tau = 0.54). Conclusions: The MMM demonstrated structural and convergent validity in this sample, adding evidence supporting its use in an adult, treatment-seeking population with ARDs.
Copyright (c) 2026 Yash M. Joshi, Spencer Metcalfe, Arij Alarachi, Andrew M. Scott, Mélise J. Ouellette, Karen Rowa http://creativecommons.org/licenses/by-nc-nd/4.0
Analysis of Novel Cannabis Products Labeled as Containing THC-JD
Objective: THC-JD (tetrahydrocannabioctyl) is a semi-synthetic cannabinoid with an eight-carbon C3 side chain, present in only trace amounts in hemp, requiring synthesis for commercial use. It has been promoted as potentially 19 times more potent than delta-9-THC, consistent with enhanced CB1 receptor affinities for cannabinoids with 7-8 carbon C3 side chains. While one peer-reviewed report identified THC-JD (tetrahydrocannabioctyl) in Japanese online products, an anecdotal report from the U.S. suggests mislabeling. Method: To inform regulatory efforts and consumer awareness and to address these discrepancies, this study chemically analyzed five U.S. commercial cannabis vape products marketed as containing THC-JD. Results: Utilizing GC-MS analysis with a delta-8-THC-JD reference standard, no THC-JD was detected in any of the five commercial samples. Instead, the most prevalent compound in four of the five samples was delta-8-THC. Conclusions: The absence of THC-JD in these products raises critical concerns for consumer safety, regulatory compliance, and industry integrity, as consumers risk unknowingly ingesting uncharacterized or mislabeled substances. The lack of standardization in THC-JD products raises critical concerns for regulatory compliance and industry integrity. Further studies are needed to characterize THC-JD products and evaluate their potential health risk to consumers.
Copyright (c) 2026 Kaelas R. Munger, Carlton C. B. Bone, Killian M. Anreise, Robert M. Strongin http://creativecommons.org/licenses/by-nc-nd/4.0
Dispensing Medical Advice: San Francisco Bay Area Budtender Recommendations for Pain and Sleep Relief
Objective: Evidence regarding the efficacy of various forms of cannabis and cannabinoid concentrations is limited, and cannabis industry regulatory infrastructure is still in development. Meanwhile, most US states have legalized medical or adult use cannabis. This study aimed to understand what advice cannabis budtenders in the San Francisco Bay Area were providing to customers for pain and sleep trouble – two of the conditions most cited as reasons for using cannabis medicinally. Method: We visited 35 of 42 cannabis dispensaries in Alameda and San Francisco Counties in California, and using a “secret shopper” approach, asked the budtenders for recommendations on products, dosage, and strains to best alleviate pain and sleep trouble. Results: For pain relief, budtenders showed a strong preference for topicals (77.1%), while edibles were most indicated for sleep trouble (60.0%). Reasons provided included budtender personal experience and product effectiveness. Cannabidiol (CBD) was endorsed most often for pain relief in high CBD:THC ratios (28.6%), 1:1 ratios (28.6%), and CBD alone (22.9%). For sleep relief, tetrahydrocannabidiol (THC) alone was most recommended (34.3%). When asked about cannabis strains for pain, 85.7% of budtenders did not express a preference, but for sleep, 57.1% of budtenders selected indica. Conclusions: This study illustrates that budtenders in the Bay Area have specific ideas about cannabis uses, including types, concentrations, and strains, despite a lack of evidence for most recommendations. Future research should prioritize study of topical preparations of cannabis for pain, edibles for sleep, and tinctures for both, which budtenders regularly recommended to customers.
Copyright (c) 2025 Pamela M. Ling, Christine Hoang, Louisa M. Holmes http://creativecommons.org/licenses/by-nc-nd/4.0
Trends in and Factors Associated with Current Cannabis Vaping Among U.S. Adolescents, 2022-2024
Objective: Electronic vapor products are widely used by adolescents and are increasingly used to vape cannabis, posing ongoing health risks. This study aimed to examine trends in and factors associated with current (past 30-day) cannabis vaping among U.S. adolescents. Method: Using pooled adolescent data from the 2022-2024 National Survey on Drug Use and Health (n = 34,875), we calculated the prevalence of current cannabis vaping overall and by sociodemographic, policy, and other substance use characteristics for each year. Employing multivariable logistic regression, we examined linear trends in cannabis vaping and associations with each covariate. Subgroup-specific trends were estimated from models that included interactions between survey year and participant characteristics, with linear combinations of coefficients used to derive subgroup estimates. Results: Current cannabis vaping increased from 2022-2024 (3.5% to 4.2%, p = .001) and among older (aged 16-17; 6.6% to 7.6%, p = .01), male (2.9% to 3.7%, p = .01), non-Hispanic White (3.8% to 4.7%, p = .01), and wealthier ($75,000+ annual household income; 3.2% to 3.8%, p = .02) adolescents, as well as adolescents covered by state medical cannabis laws (3.5% to 4.1%, p = .004). In pooled analyses, current cannabis vaping between 2022-2024 was associated with older age, compared to younger age (e.g., AOR: 4.61, 95% CI: 2.93-7.26 for 16-17 vs. 12-13-year-olds), and nicotine vaping (AOR: 24.00, 95% CI: 17.44, 32.96). Conclusions: Cannabis vaping may be rising among certain U.S. adolescent subgroups. Further research is needed to monitor trends in cannabis vaping over time, particularly among at-risk groups such as adolescents engaging in polysubstance use, among whom use has increased.
Copyright (c) 2026 Delvon T. Mattingly, Bethany Shorey Fennell, Meman Diaby, Osayande Agbonlahor, Joy Hart http://creativecommons.org/licenses/by-nc-nd/4.0
Understanding the Relationships between ADHD Symptoms and Cannabis-Related Consequences among Young Adults
Objective: The link between attention-deficit/hyperactivity disorder (ADHD) and cannabis-related problems is well documented, though research has primarily focused on cannabis use disorder (CUD) or cannabis consequences in aggregate. This study examined how inattentive (IN) versus hyperactive/impulsive (HI) ADHD symptoms relate to CUD symptoms as well as distinct domains of cannabis consequences (social-interpersonal consequences, impaired control, negative self-perception, self-care, risk behaviors, academic/occupational consequences, physical dependence, and blackout use) in young adults. Total amount of cannabis flower used over the past 90 days was explored as a potential mediator of these associations. Â Method: Young adults (N = 160; 41% male; ages 19-25, M = 22, SD = 2.06) with a history of regular cannabis use completed self-report measures of ADHD symptoms and cannabis consequences. Participants also completed a 90-day Timeline Follow Back assessing grams of cannabis flower consumed each day, along with a structured clinical interview for CUD. Results: IN symptoms were directly associated with cannabis-related occupational/academic consequences, self-care consequences, and blackouts/memory impairment, independent of quantity of cannabis consumption. HI symptoms showed positive indirect associations with physical dependence, impaired control, and CUD through greater amount of cannabis used. Conversely, IN symptoms had negative indirect associations with these outcomes, mediated by amount of cannabis used. Conclusions: Findings reveal distinct pathways through which IN and HI ADHD symptoms relate to cannabis problems in young adults. Findings highlight the need to consider ADHD symptom domains separately when assessing specific cannabis-related risks, which may have implications for tailoring interventions.
Copyright (c) 2025 Claire Minister, Christian S. Hendershot, Matthew T. Keough, Jeffrey D. Wardell http://creativecommons.org/licenses/by-nc-nd/4.0
Examining the Reliability and Utility of MouseView.js as a Method to Measure Attentional Bias for Cannabis Use
Objective: Current methods of assessing cannabis-related attentional bias such as modified Stroop tasks are characterized by several limitations, including low reliability. The goal of the present study was to explore the reliability and utility of a novel methodological tool that is a proxy for eye-tracking—MouseView.js—to examine cannabis-related attentional bias. Method: Canadian postsecondary students (N = 580) freely viewed 30 image pairs of neutral and cannabis stimuli using MouseView.js. Participants also completed self-report measures of cannabis use, including problematic cannabis use. Reliability coefficients (Cronbach’s alpha and split-half) were calculated to estimate the internal consistency of cannabis images, neutral images, and dwell difference scores. A hierarchical testing strategy was used to examine whether image (neutral vs. cannabis) and cannabis use status (non-use, recreational use, problematic use), as well as the interaction between image and cannabis use status, explain variation in dwell times. Results: A total of 368 participants (64.4%) did not use cannabis, 138 (23.8%) used cannabis recreationally, and 74 (12.8%) used cannabis at problematic levels. The reliability estimates for cannabis images, neutral images, and attentional bias scores ranged from acceptable to excellent. There was a main effect of image, such that all participants spent more time viewing cannabis relative to neutral images, indicative of an attentional bias. The main effects for cannabis use status and interactions between cannabis use status and image type were not statistically significant. Conclusions: Taken together, the present findings suggest MouseView.js may be a reliable method to assess cannabis-related attentional biases.
Copyright (c) 2026 Jana Milicevic, Samantha J. Dawson, Jenna L. Vieira, Maya C. Thulin, Nassim Tabri, Carson Pun, Hyoun S. Kim http://creativecommons.org/licenses/by-nc-nd/4.0
Associations of Disability and Social Support with Cannabis Use Among Adults with Anxiety and Depressive Symptoms
Objective: People with (versus without) disabilities may be more likely to use cannabis medicinally, especially if they lack social support to cope with symptoms. However, associations of social support and disability with cannabis use remain largely unexplored. Method: Adults with clinically significant anxiety and/or depressive symptoms participating in a clinical trial completed a baseline survey assessing past-month medical and recreational cannabis use, self-perceived disability (yes/no), perceived social support, and sociodemographics. Regression models examined the association between disability and social support, and the main and interactive effects of disability and social support on past-month medical and recreational cannabis use, adjusting for race and ethnicity, gender, age, and income. Results: The sample (N = 822) was 25.3% American Indian, 25.1% Black, 25.1% White, and 24.6% Latinx (64.6% female; Mage = 38.3 [SD = 12.8]). Half (51.1%) self-reported a health condition that limited activities (i.e., disability); 24.9% reported past-month medical cannabis use, and 25.4% reported past-month recreational cannabis use. Participants with a self-reported disability reported lower average social support than those without (p = .031). A significant (p = .045) disability X social support interaction indicated that social support was associated with lower odds of medical cannabis use among those without (p = .038), but not with (p = .525), disability. Disability and social support were not significantly associated with recreational cannabis use (p-values > .05). Conclusions: Individuals with disabilities had elevated odds of using medical cannabis, regardless of social support. Social support is imperative for well-being, and cannabis use may alleviate some symptoms; however, more accessible, comprehensive healthcare may be needed to support individuals with disabilities.
Copyright (c) 2025 Erin A. Vogel, Katelyn F. Romm, DJ McMaughan, Michael J. Zvolensky, Lorra Garey, Michael S. Businelle http://creativecommons.org/licenses/by-nc-nd/4.0
“If You Need to Light Up … You Gotta Do What You Gotta Do”: A Qualitative Study of Adolescent Attitudes Towards Cannabis Use and Comparison with Alcohol Attitudes
Objective: Cannabis and alcohol are among the substances most frequently used by adolescents. Adolescents also frequently co-use these substances, with use of alcohol predicting subsequent initiation of cannabis use, and vice-versa. Minimal research has explored adolescents’ attitudes towards cannabis use qualitatively, and how these attitudes may directly/indirectly relate to attitudes towards alcohol use and vice versa. Method: Forty U.S. adolescents (MAge = 16.68, SD = 0.86) who had recently completed a study reporting their in-vivo exposure to substance use content in media completed follow-up interviews focused on substance depictions in media and attitudes towards substance use. Interviews were individual, semi-structured, and approximately one hour long. A priori codes were derived from the interview agenda. Interviews were transcribed and qualitatively coded by a team of three graduate students. Percent agreement across coders was 80%, suggesting substantial agreement. Results: Several themes emerged from analysis. Most adolescents reported that their approval/disapproval of cannabis use was contingent on several factors including legality, age, degree of use/problematic use, and purpose (i.e., medicinal/recreational). Participants more commonly endorsed cannabis use as more acceptable than alcohol. Common reasons for this comparative approval included perceived social and health impacts (e.g., alcohol poisoning, liver disease), perceived addictive potential, and different effects of intoxication. Conclusions: Results of the present study provide rich context to recent trends in adolescent cannabis and alcohol use and perceptions, as well as co-use and abstention. Understanding teens’ attitudes towards substance use may be beneficial in developing appropriate substance prevention and intervention strategies (e.g., effectively communicating health risks of cannabis use).
Copyright (c) 2025 Alex Clement, Erin Corcoran, Kristina M. Jackson, Joy Gabrielli http://creativecommons.org/licenses/by-nc-nd/4.0
The Impact of Adult Cannabis Use Legalization in California: A Qualitative Review of Subject Matter Expert Opinions on Proposition 64
Objective: California Â legalized adult cannabis use in 2016 with the passing of Proposition 64: The Adult Use Marijuana Act (Prop 64). This qualitative study aimed to explore the impact of legalization on various stakeholders and institutions within California, especially as it relates to public policy, health, and safety. Method: Twenty-two semi-structured interviews were conducted from January to March 2022 with stakeholders that included Subject Matter Experts (SME) from the following categories: clinicians (primary care, pain management, addiction medicine, cannabis clinicians), researchers, advocates, dispensary owners/personnel, legal professionals, and cannabis consumers. Nine interview guides were constructed to assess participants' perceptions of Prop 64 and its impact on their given sector/industry as it relates to the use, production, distribution, and access to medicinal and adult cannabis use. Thematic analysis was conducted to identify salient themes from the interviews. Results: The three primary themes and subthemes included: (1) Successes of Prop 64 (quality control, justice reform, stigma reduction), (2) Shortcomings of Prop 64 (high cost, licensing, bureaucracy, social inequity), and (3) Recommendations for improvement of Prop 64 (need for research, policy change, the transformation of business model). Conclusions: The implementation of cannabis legalization in California had a broad impact on many key stakeholders. While demonstrating some success, SME described key areas for improvement of Prop 64. A multidisciplinary approach with support from government, state, and local municipalities is necessary to facilitate proper regulation, provide timely support, and reduce social injustice, harm, and unforeseen consequences of use. Updating federal regulations (e.g., Schedule I status) might be an important step to allow for improving regulation and operations (e.g. banking) within the cannabis industry, further research and education, and greater cross-state consistency regarding law enforcement/regulation of cannabis. Public Health Implications: The information gathered will help inform public policy, as well as help health professionals design new health education campaigns for the general public.
Copyright (c) 2025 Daniel Ageze, Renee Dell'Acqua, Thomas D. Marcotte, Jesus Garcia, Jill Rybar, Linda Hill http://creativecommons.org/licenses/by-nc-nd/4.0
Abstracts from the 2025 Research Society on Marijuana and Society for Research on Nicotine and Tobacco Post- Conference Workshop March 15, 2025
Copyright (c) 2025 Jamie E. Parnes http://creativecommons.org/licenses/by-nc-nd/4.0
Marketing Management and Policymaking for Medical Cannabis: Overcoming Barriers and Shaping Strategies
Objective: Medical cannabis has emerged as a promising therapeutic option, but its market acceptance faces significant regulatory, societal, and scientific challenges. This study explores pharmaceutical business managers’ perspectives on marketing strategies, brand architecture, and the value proposition of medical cannabis, aiming to identify approaches to overcome these barriers and guide policymaking. Method: Semi-structured interviews were conducted with 12 pharmaceutical managers to explore key challenges and strategies. Results: Key themes included the need for extensive scientific research, targeted communication to address stigma, effective marketing tactics, and long-term sustainability. Participants stressed the importance of rigorous, disease-specific research to establish medical cannabis’ therapeutic efficacy and build trust with healthcare providers and patients. Societal stigma was identified as a major barrier, with participants advocating for communication strategies that distinguish medical cannabis from recreational use and educate stakeholders. Marketing strategies focused on creating a unique value proposition, strong brand identity, and adaptive approaches to meet the diverse needs of healthcare professionals, regulators, and patients. Additionally, phased market entry strategies, beginning with pilot programs in regions with progressive regulatory environments, were recommended to pave the way for broader market expansion. Conclusions: This study offers valuable insights into the marketing management and policymaking necessary for integrating medical cannabis into the pharmaceutical market. By addressing regulatory uncertainties, societal stigma, and scientific gaps, pharmaceutical companies can unlock the full potential of medical cannabis as a credible therapeutic product. These findings lay the groundwork for future research and policymaking to promote sustainable growth in the emerging medical cannabis market.
Copyright (c) 2025 Christos Ntais, Nikolaos Kontodimopoulos, Yioula Melanthiou http://creativecommons.org/licenses/by-nc-nd/4.0
Cannabis Products and Use Patterns Associated with Cannabis Use Disorder Symptoms Among Youth in Southern California
Objective: Cannabis use is common among adolescents. Limited research has examined how specific cannabis use behaviors may differentially increase cannabis use disorder (CUD) risk. Method: Data were from two waves of a prospective cohort of Southern California adolescents who used cannabis in the past six months (N = 420; Fall 2022, Spring 2023). Multivariable logistic regression models were used to examine the association of each cannabis use behavior at baseline (number of modes of cannabis administration used, product type used first and most often, cannabinoid formulation used most often, past 30-day frequency, quantity) with probable CUD at a six-month follow-up (measured using the Cannabis Abuse Screening Test), adjusting for sociodemographic factors, other substance use, and probable CUD at baseline. Results: Most adolescents (69.8%) used >1 mode of cannabis in the past six-months; concentrates (vaped or dabbed) were the product type used most often (37.5%). Greater odds of CUD were observed for each additional cannabis product used in the past 6 months (vs. only one; adjusted odds ratio [AOR] range = 2.83-4.13; ps < .05), and for frequent past 30-day cannabis use (10+ days/month vs. 1-2 days/month; AOR = 2.87, 95%CI = [1.31,6.27]). No other cannabis behaviors or characteristics were associated with CUD in adjusted models. Conclusions: Frequent past-month cannabis use and using multiple modes of administration were predictors of probable CUD. In addition to monitoring the overall presence of adolescent cannabis use, these results demonstrate the importance of raising awareness about specific use behaviors associated with CUD risk among youth, particularly in regions with well-developed cannabis markets.
Copyright (c) 2025 Claire A. Walsh, Nikki Jafarzadeh, Reid Whaley, Dae-Hee Han, Adam Leventhal, Eric Pedersen, Jessica Barrington-Trimis, Alyssa Harlow http://creativecommons.org/licenses/by-nc-nd/4.0
Cannabis Use for Medical or Non-Medical Purposes in a Sample of Young Adult Cancer Survivors in the United States
Objective. This study examined cannabis use and motives (i.e., medical, non-medical [‘recreational’]) for first use and current use among young adult cancer survivors (ages 18-39). Methods. We analyzed 2024 baseline survey data from 155 young adult cancer survivors (Mage=32.89 [SD=4.89], 87.7% female, 81.9% White, M=1.34 [SD=1.04] years post-treatment) regarding cannabis use, use motives (i.e., medical, non-medical), use characteristics (e.g., frequency/mode), and quality of life (PROMIS). Analyses characterized participants by lifetime use, past-month use, and first use for medical or non-medical purposes; multivariable binary logistic regression assessed correlates of past-month cannabis use among all participants and among those reporting lifetime use, respectively. Objective: This study examined cannabis use and motives (i.e., medical, non-medical [‘recreational’]) for first use and current use among young adult cancer survivors (ages 18-39). Method: We analyzed 2024 baseline survey data from 155 young adult cancer survivors (Mage = 32.89 [SD = 4.89], 87.7% female, 81.9% White, M = 1.34 [SD = 1.04] years post-treatment) regarding cannabis use, use motives (i.e., medical, non-medical), use characteristics (e.g., frequency/mode), and quality of life (PROMIS). Analyses characterized participants by lifetime use, past-month use, and first use for medical or non-medical purposes; multivariable binary logistic regression assessed correlates of past-month cannabis use among all participants and among those reporting lifetime use, respectively. Results: Of those reporting lifetime use (n = 68, 43.9%), 48 (70.6%) first used for non-medical purposes and 18 (26.5%) for medical. Among those reporting past-month use (n = 41, 26.5%), 4 (9.8%) used for only medical purposes, 12 (29.3%) primarily medical but some non-medical, 6 (14.6%) equally medical/non-medical, 6 (14.6%) primarily non-medical but some medical, and 4 (9.8%) only non-medical. Common reasons for first and current medical use included pain, insomnia, anxiety, and nausea. Past-month use among all participants was associated with less advanced cancer stage, treatment involving chemotherapy, and greater anxiety symptoms. Among those reporting lifetime use, past-month use was also associated with first using for non-medical purposes. Conclusions: A large proportion of young adult survivors first used cannabis for non-medical purposes but also reported medical use. It is crucial to understand use motives and trajectories over time to identify those who may benefit from medical use or face use-related harms.
Copyright (c) 2025 Darcey M. McCready, Laura C. Schubel, Hannah Arem, Cassidy R. LoParco, Afrah Howlader, Sheena Shajan, Palash Bhanot, Carla Berg http://creativecommons.org/licenses/by-nc-nd/4.0
Developing a Mock Retail Cannabis Shop for Research: A Description of The CANNEX
Objective: Cannabis retail dispensaries have proliferated in the United States in recent years, making it an important time for conducting research. Research is needed to learn more about consumer purchasing behaviors, including the impact of product marketing both inside and outside of retail spaces, and studies are needed to explore how both consumers and retail staff interpret the health benefits and potential risks associated with cannabis products within these environments. Current research on cannabis dispensaries often involves surveys or interviews with customers and dispensary staff outside of dispensary environments, but much can be learned through observational and experimental methods within dispensaries themselves. However, researchers have traditionally relied on surveillance methods, where researchers visit dispensaries to gain a deeper understanding of real-world encounters in these environments. Although these methods provide helpful insights into purchasing and selling behavior, as well as regulatory compliance, these studies are conducted in an uncontrolled environment, as products, messaging, and interactions are specific to the dispensaries in which the research is conducted. Method: We therefore created a mock cannabis dispensary to offer participants a retail experience that can be controlled and manipulated (e.g., adjustable cannabis product prices, placement of health and risk information in the dispensary, scripted interactions with dispensary staff) to help balance ecological and internal validity and answer questions about purchasing and selling behavior beyond what current methods allow. Results: We describe the process of developing and stocking the first known mock cannabis dispensary for research purposes, the Cannabis Annex (“The CANNEXâ€), including interior design, product selection, feedback solicitation from 20 cannabis industry workers, and plans for future research studies within the environment. Conclusions: By describing our process, we hope to aid researchers in developing their own similar mock dispensaries to continue learning about the health benefits, risks from use, and policy implications of cannabis in an increasingly legal recreational atmosphere.
Copyright (c) 2025 Eric Pedersen, Mark A. Prince, Ireland M. Shute, Megan E. Brown, Bethany Gray, Keegan D. Buch, John Monterosso http://creativecommons.org/licenses/by-nc-nd/4.0
Same Story, Different Seller: Teaching the Public How Cannabis Models Driven by Profit Create the Same Injustices as Prohibition
Objective: U.S. cannabis policy has been shaped by racism and produced racist outcomes. The legalization of cannabis for adult use represents an opportunity to end harmful policies and repair some of the damage caused by the War on Drugs. However, this opportunity may be slipping away. Large corporations with histories of exploitation are steering cannabis policy to maximize profits. Parabola Center for Law and Policy created a media campaign to educate the public about these issues and promote cannabis policies that benefit regular people. We conducted an experiment in the context of an online survey to determine whether six videos from the campaign would resonate with U.S. adults and influence beliefs about cannabis policy. Method: In September 2023, we conducted an online survey of 404 U.S. adults. Participants were randomized to view six Parabola Campaign videos featuring cannabis policy experts before or after responding to survey questions. Results: Participants who saw the Parabola Campaign videos had greater agreement that cannabis legalization should not benefit the tobacco industry, the pharmaceutical industry, and alcohol companies (all p < .05). They also had greater agreement that legalization should create space for small businesses, create a sharing community, and benefit people from communities that have been harmed by the Drug War (all p < .05). Â Conclusions: Public education can be a powerful tool to promote equity-focused cannabis policy, by raising awareness of corporate influence, promoting community-centered regulatory models, and building support for an equitable approach to federal legalization.
Copyright (c) 2025 Jane Appleyard Allen, Shaleen Title, Brian Bradfield http://creativecommons.org/licenses/by-nc-nd/4.0
Cannabis Use and Perceptions of Cannabis Safety, Effectiveness, and Stigma amongst older Canadians: A Cross-Sectional Survey
Objective: Since legalization in 2018, older Canadians’ use of cannabis has increased steadily, yet little is known about their perceptions of cannabis. We aimed to determine cannabis usage, and characterize perceptions of safety, effectiveness and stigma in community dwelling older Canadians. Method: Canadians aged 50 years and older were invited to participate in an electronic survey of their experience with cannabis and perceptions of cannabis safety, effectiveness, and stigma. Data were categorized as participants reporting current use, non-use, prior use, and considering use. Perceptions were assessed with a 5-point Likert scale and open text box questions. Logistic regression models were used to assess how age, sex, cannabis usage, and education influenced perceptions. Results: One thousand six hundred fifteen participants completed the survey. Current cannabis use was reported by 44% of respondents, followed by non-use (33.2%), prior use (16.5%) and considering use (6.1%). Almost half (49.2%) perceived the risks of using cannabis to be low or very low. The greatest concerns regarding cannabis use were effects on cognition/mental health (40.8%), physical health (19.1%), and available product information (18.0%). Participants somewhat or strongly agreed that there is not enough information on cannabis safety (60.4%) and effectiveness (63.8%), and 34.7% perceived there to be a negative stigma amongst family and friends. Cannabis perceptions were influenced by age, sex, cannabis usage, and education. Conclusions:Generational and sex-based differences exist in cannabis usage and perceptions amongst older Canadians. These differences require consideration by health practitioners and public health workers to meet the educational needs of older adults.
Copyright (c) 2025 Jennifer Bolt, Jacob Movold, Melanie Fenton, Megan Behm, Jill Williamson, Jennifer M. Jakobi http://creativecommons.org/licenses/by-nc-nd/4.0
Cannabis Use Characteristics and Reasons for Product Choices Among Patients Accessing Treatment for Substance Use Disorders: A Mixed-Methods Study
Objective: The diversity and potency of cannabis products have increased in recent years, underscoring the importance of understanding which products are being used and why. Patients with substance use disorders (SUDs) use have a high prevalence of risky cannabis use, making it especially important to understand use patterns in this group. We aimed to first describe cannabis product characteristics and then explore reasons for choosing products in our sample. Method: In this mixed-methods study, 472 adults who self-reported accessing SUD treatment and lifetime cannabis use completed an online survey. A subset of 22 participants completed in-depth interviews. Quantitative results focused on describing cannabis use characteristics (e.g., product types) among participants reporting past-year cannabis use (current use group) or lifetime cannabis use but no use in past year (past use group), while qualitative descriptive analysis was used to describe reasons for choosing products among participants who were currently using cannabis. Results: Â Across medical and non-medical use of cannabis, dried flower and smoked cannabis formulations were most used (e.g., 89% of the current use group reported smoking cannabis for non-medical purposes), followed by edibles (e.g., 53% of the current use group used edible formulations of cannabis for non-medical purposes), though there was considerable use of higher-potency products such as concentrates and dabs (e.g., 11% of the current use group had used dabs for non-medical purposes). Our qualitative analysis found that almost all participants were motivated by THC content when purchasing products, yet sometimes perceived medical benefits or harm reduction were reasons for using certain products (especially CBD-dominant products), while sometimes other factors (e.g., convenience, familiarity) were influential. Conclusions: Cannabis use characteristics (including motives for choosing products) are complex and nuanced in patients accessing SUD treatment. More work is needed to understand longitudinal relationships between use of different cannabis products and both harms and potential benefits.
Copyright (c) 2025 Justin Matheson, Harseerat Saini, Rebecca Haines-Saah, Marcos Sanches, Matthew Sloan, Adam Zaweel, Ahmed Hassan, Leslie Buckley, Amy Porath, James MacKillop, Christian Hendershot, Stefan Kloiber, Bernard Le Foll http://creativecommons.org/licenses/by-nc-nd/4.0
Cannabis Use Patterns and Co-Use of Alcohol and Nicotine in Adults Over 50 by Demographic Factors and Medical Cannabis Use
Objective: Cannabis use among adults over age 50 is increasing, but data on specific products, co-use, and cannabis-related problems in this age group are lacking. The current study assessed differences in cannabis use patterns and alcohol and nicotine co-use by select demographic factors and medical cannabis status, as well as associations with problem cannabis use, among adults over 50. Method: Adults over age 50 who used cannabis use in the past 30 days were recruited from a healthcare system and invited to complete an online survey. Results: Participants (N = 367) were 43% female, with an average age of 65.9 (SD = 8.6), and predominantly White (67.9%), Native Hawaiian or Pacific Islander (NHPI; 12.3%), or Asian (9.3%). Mean frequency of cannabis use within the past 30 days was 18.7 days (SD = 11.5), and 27% reported use of non-medical cannabis-only. Co-use of cannabis with other substances was common, especially alcohol. Although group comparisons showed several differences by age, sex, and medical cannabis status, greater differences were found by race/ethnicity. White participants were more likely than others to have a state medical cannabis card, source their cannabis solely from medical dispensaries, and report alcohol co-use. NHPI participants were most likely to smoke cannabis and use tobacco. Smoking, as compared to consuming edibles and “otherâ€ methods, and greater cannabis frequency, were associated with problem cannabis use. Conclusions: Findings illustrate patterns of cannabis and other substance use, with important demographic differences. Future research among older adults should include development of targeted interventions to address cannabis use problems and polysubstance use.
Copyright (c) 2025 Kristina T. Phillips, Kathy Pedula, Kara Tsuzaki, Catherine Erickson, Jonathan Lai, Vanessa Simiola, Samantha Wong, Pallav Pokhrel, Derek D. Satre http://creativecommons.org/licenses/by-nc-nd/4.0
Budtender Perceptions and Knowledge of Cannabis and Mental Health: A Preliminary Study
Objective: Legal cannabis dispensary employees (“Budtendersâ€) are a significant resource for cannabis users. Current research indicates that cannabis use may adversely impact mental health. Public perception, however, is often inconsistent with this evidence, leading to increased use and disproportionate harm towards individuals with mental health disorders. This underscores the need for a deeper understanding of how Budtenders may influence these perceptions. This preliminary cross-sectional survey assessed Budtender perceptions and knowledge of cannabis use and its implications for mental health. Method: Researchers recruited Budtenders (N = 46) from legal cannabis dispensaries (Ontario Cannabis Stores) across the Greater Toronto (Canada) Area to participate in a 15-minute online survey. The survey collected non-identifying demographic data and responses about perceptions, education and customer interactions surrounding cannabis and mental health. Results: We found that Budtender perceptions (N = 46) of cannabis’ influence on mental health vary significantly based on symptomatology assessed, and often diverge from evidence-based knowledge. Notably, 54.6% of Budtenders rated cannabis as having a beneficial effect across the outcomes assessed, with sleep and depression most frequently perceived as beneficial. Customers inquired about the mental health effects of cannabis at 21% of cannabis store visits. There was considerable variability in the sources from which Budtenders derived their knowledge. Conclusions: This study underscores significant gaps between Budtender perceptions and scientific evidence regarding cannabis use and mental health. Determining the impact of these perceptions is crucial for developing targeted, evidence-based educational interventions to mitigate the risks associated with recreational cannabis use.
Copyright (c) 2025 Darby J. E. Lowe, Cindy Wang, Sergio Rueda, Tony P. George http://creativecommons.org/licenses/by-nc-nd/4.0
Special Section Editor: Abstracts from the 2024 Scientific Meeting of the Research Society on Marijuana July 19th -21st, 2024
Copyright (c) 2024 Ireland Shute http://creativecommons.org/licenses/by-nc-nd/4.0