Study on Cannabis
Health Warning Messages Focus Groups
Executive Summary

Contents

Executive Summary

Executive Summary

Earnscliffe Strategy Group (Earnscliffe) is pleased to present this report to Health Canada summarizing the results of the Cannabis Warning Message Testing focus groups.

The Government of Canada has committed to legalize, strictly regulate and restrict access to cannabis. On June 21, 2018, Bill C-45, an Act respecting cannabis and to amend the Controlled Drugs and Substances Act, the Criminal Code and other Acts (the Cannabis Act) received Royal Assent. To support implementation of the Act, regulations will need to be enacted in a range of areas, including the packaging and labelling of cannabis, to ensure that the risks and harms of cannabis are appropriately addressed under the legal framework.

As part of the regulations that will support the coming into force of the Cannabis Act, the Government of Canada is requiring that mandatory health warning messages be included on the package of all cannabis products. The purpose of the health warning messages is to warn people of the potential health effects of using cannabis.

Focus groups were required to explore the views of the general population, with a special attention to youth, on the effectiveness of health warning messages. Feedback from the research will enable Health Canada to develop appropriate messages that meet packaging and labelling requirements. The total cost to conduct this research was $113,971.80 including HST.

To meet these objectives, Earnscliffe conducted a comprehensive wave of qualitative research. In total, there were twenty qualitative sessions with four different segments of the Canadian population: young adults (18-24); youth (13-15); youth (16-17); and, adults (25+).

The research took place in Toronto, ON (May 28); Quebec City, QC (May 29), Saskatoon (May 29), Vancouver (May 30) and St. John's (June 5). The focus groups in Quebec City were conducted in French. The sessions were all one hour in length.

The research explored the effectiveness of the health warning messages. More specifically, it sought to determine whether the messages stand out from the 'noise' of other information on the label, such as brand elements, whether they are large enough to read, and are easy to understand. The research also tested the effectiveness of the plain packaging requirements (restrictions on the use of branding, logos, colour and other features) in reducing the appeal of the products to youth and others in increasing the effectiveness of the health warning messages and other mandatory labelling elements.

For the purposes of this report, it is important to note that qualitative research is a form of scientific, social, policy and public opinion research. Focus group and interview research is not designed to help a group reach a consensus or to make decisions, but rather to elicit the full range of ideas, attitudes, experiences and opinions of a selected sample of participants on a defined topic. Because of the small numbers involved the participants cannot be expected to be thoroughly representative in a statistical sense of the larger population from which they are drawn and findings cannot reliably be generalized beyond their number.

Reactions to Health Warning Messages

• Overall reaction to the messages was mixed. For the most part, reaction related to participants' views of cannabis. Participants were generally either pre-disposed to fearing cannabis (and by default, receptive to most/all warnings) or pre-disposed to being comfortable with it (and presented a range of different reactions depending on experience, knowledge and desire/intention).
• In terms of the language used, it was generally felt to be clear and understandable although there were a few terms that were not well understood by all youth (mainly those 13-15): THC, psychosis, and schizophrenia.
• Participants who were more comfortable with cannabis argued that messaging would be much more credible if it were supported with facts and referenced appropriately. They felt that several of these messages employed a fear-mongering approach which, if accepted as truth, begged questions about the government's decision to legalize cannabis.
  • For these participants, simply stating facts (statistics) was not all that persuasive or credible. They called for evidence of harms or risks to be referenced to have any credibility.
• With respect to the message that cannabis smoke is harmful, most agreed that any smoke is bad and most understood this statement to mean that cannabis smoke is particularly bad.
  • Highlighting the relativity to tobacco seems to make this message more effective, particularly for those aware of mixing tobacco with cannabis.
  • There were a few who interpreted this as being about the effect of the drug, rather than about the inhaling of smoke. For these people, the primary message meant simply "cannabis is harmful."
  • Some participants understood it to mean that the choice to smoke cannabis involved risks associated with smoking, but pointed out that there are ways of using cannabis that do not involve smoking and therefore, the context of the message would bear an impact on the perceived relevance of it.
• While most accepted the premise that it is not sensible to drive after using cannabis, there were some, often in the youth groups (13-17) who argued cannabis can have a calming effect on some drivers. However, when pressed, most tended not to want to be the passenger in a vehicle being driven by someone who is high. 
  • Youth, in particular, found the second sentence pertaining to the number of deaths and injuries related to driving under the influence was persuasive, but others felt the statistics were rather low compared to deaths related to drunk driving.
• Participants did not immediately agree with the statement that cannabis is addictive. Some argued that there is no active ingredient in cannabis that causes addiction and described it more as a mental dependence on the routine of getting high. The statistics in the three secondary messages were not all that persuasive.
• When it came to the message that regular use of cannabis can increase the risk of psychosis and schizophrenia, participants tended to fall into one of two camps: those that had heard or accept this as fact already and find it a powerful message; and, those that are skeptical or not yet convinced but for whom "if that really is true" the warning has the potential to be powerful. This was one of the messages that would most motivate participants (of all ages) to do something (i.e., look for more information about this online).

Reactions to Proposed Packaging

• The packaging was met with generally favourable, though at times quizzical, reaction. Participants described the overall look as somewhat understated, neutral, sleek, and, in some groups, cool (particularly among young adults). In large part, this was attributed to the black background although many remarked that the lack of brand elements was interesting. When asked, most tended to feel that that was appropriate; so as not to entice the wrong people (i.e., children).
• The more quizzical reactions tended to revolve around the size, shape and material of the package. Many participants did not believe it was an intuitive design and questioned the use of paper stock (carton) as opposed to a re-sealable bag. They assumed that there would be a re-sealable bag inside with the cannabis to protect it, but also to reduce the odour and potential of cannabis waste.
• The other thing that was a little surprising for most was that the contents of the package were not clearly marked. Many expected the box to be a green colour which would more readily suggest a package of cannabis or that it would have a large symbol (i.e., a cannabis leaf), prominently on the package.
• Most felt the symbol should be larger - it was not the most attention-grabbing element on the package. In fact, many in most groups did not notice the symbol until asked.
• The most attention-grabbing element of the package was the health warning message in the yellow box. The yellow box on the black package was noticeable although many argued that the placement could be a little more prominent and that the font could be larger.
• One of the most consistent comments offered was that the instruction to "keep out of reach of children" was not given the prominence that it deserves. Even bold lettering would be an improvement for a message that is universally accepted as important.
• There were also some suggestions of adding more warning messages to the blank sides of the package. Some complained that the example provided (i.e., do not use if pregnant or breastfeeding) was too narrow and did not speak to all who may be potential consumers of cannabis. Others argued that if there were too many warning messages on the package, consumers would become immune. They felt that one message that changed regularly would be more impactful.

Research Firm:

Earnscliffe Strategy Group Inc. (Earnscliffe)
Contract Number: HT372-174600/001/CY

Contract award date: April 17, 2018

I hereby certify as a Representative of Earnscliffe Strategy Group that the final deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Communications Policy of the Government of Canada and Procedures for Planning and Contracting Public Opinion Research. Specifically, the deliverables do not include information on electoral voting intentions, political party preferences, standings with the electorate or ratings of the performance of a political party or its leaders.

Date: October 9, 2018

Signed:

Stephanie Constable
Principal, Earnscliffe