POR-024-20

Contract # HT372-202923/001/CY

Contract Date: 2020-08-21

Contract Value: $99,920.25

Executive Summary

Understanding Youth and Young Adults’ Interest in, and Usage of, Flavoured Cannabis Vaping Products

Prepared for

Health Canada

HC.cpab.por-rop.dgcap.SC@canada.ca

December 8, 2020

Prepared by

The Strategic Counsel

15 Delisle Avenue, 3^rd Floor

Toronto, Ontario M4V 1S8

Tel: (416) 975-4465 Fax: (416) 975-1883

Email: info@thestrategiccounsel.com

Website: www.thestrategiccounsel.com

Ce rapport est aussi disponible en français sur demande.

Understanding Youth and Young Adults’ Interest in, and Usage of, Flavoured Cannabis Vaping Products

Executive Summary

Prepared for: Health Canada

Supplier Name: The Strategic Counsel

December 2020

This public opinion research report presents the results of an online survey conducted by The Strategic Counsel on behalf of Health Canada. The research study was conducted with 1,501 youth and young adults in October and November 2020.

Cette publication est aussi disponible en français sous le titre: Les produits de vapotage de cannabis aromatisés : intérêt et consommation chez les jeunes et les jeunes adultes.

This publication may be reproduced for non-commercial purposes only. Prior written permission must be obtained from Health Canada. For more information on this report, please contact Health Canada at: HC.cpab.por-op.dgcap.SC@canada.ca or at:

Communications Branch and Public Affairs Branch

Health Canada

1576 Jeanne Mance Building

200 Eglantine Driveway

Ottawa, ON K1A 0K9

Catalogue Number: H14-361/2021E-PDF

International Standard Book Number (ISBN): 978-0-660-38405-4

Related publications (registration number: POR 024-20)

H14-361/2021F-PDF (Final Report, French)

978-0-660-38406-1

© Her Majesty the Queen in Right of Canada, as represented by the Minister of Health Canada 2021

I. Executive Summary

A. Background and Objectives

The Cannabis Act and Cannabis Regulations came into force in Canada on October 17, 2018, creating a new legal framework for the control, production, distribution, sale and possession of cannabis in Canada. While the legal framework provides adults with access to a quality-controlled supply of cannabis, the Act prohibits the sale of cannabis to youth and any products, promotion, packaging or labelling that could be appealing to young people. On June 26, 2019, Health Canada published the Regulations Amending the Cannabis Regulations (New Classes of Cannabis) setting out the rules governing the legal production and sale of three new classes of cannabis, including cannabis extracts (e.g., cannabis vapes). Regulatory controls aim to mitigate public health and public safety risks associated with these products, including their potential appeal to youth. Control measures include restrictions on product ingredients, limits on the amount of tetrahydrocannabinol (THC) permitted in a product, and restrictions on the promotion of certain flavours, among other measures. Although cannabis extracts are permitted to include flavouring agents as ingredients, it is prohibited to promote a cannabis extract in a manner that could cause a person to believe it has the following flavours: confectionary, dessert, soft drink or energy drink. However, other flavours such as fruit and menthol are permitted.

The amended Cannabis Regulations came into force on October 17, 2019. As such, new products –including cannabis vapes – began to become available for adult consumers in licensed retail stores in some provinces as of mid-December 2019. Some provinces have taken action to prevent the sale of cannabis vape products or flavoured cannabis vape products thus, the presence of these products in the legal market is still relatively new and varies considerably across Canada. This provides a unique opportunity for Health Canada to explore the usage and appeal of cannabis vape products among certain populations as they enter the legal market.

Vaping, in particular, has become an increasingly popular way for youth and young adults to consume cannabis, according to results from the 2018-19 Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS)^{Footnote 1} and the Canadian Cannabis Survey 2019 (CCS).^{Footnote 2} The CCS study highlighted that vaping cannabis with portable devices (e.g. vapes) and dabbing – a process which also uses cannabis extracts intended for inhalation, such as wax – is more popular with 16 to 19 and 20 to 24 year olds than it is with those aged 25 and older.

Previous research conducted by Health Canada in 2018 on nicotine vape products indicated that flavours are a key factor influencing youth experimentation and use of these products. Flavour was cited as the second most popular reason by youth aged 13 to 19 when asked about the reasons why they had started vaping nicotine products.^{Footnote 3}However, to date, there has been less research on the impact that flavour has on youth and young adults who are interested in vaping cannabis and the role that flavours play with respect to their attitudes on, or usage of, cannabis vape products.

The primary objective of this research was to address this gap by gathering information from youth and young adults (aged 15 to 24, who are vaping cannabis extracts intended for inhalation) about their attitudes and behaviours towards these products, as well as the role that products with a flavour other than cannabis flavour play in their usage. Although it is also possible to use a vaporizer to vape dried cannabis flower (sometimes also referred to as vaping cannabis), this research focused solely on vaping cannabis extracts intended for inhalation. Specifically, this research aimed to provide insights into various aspects of the use and appeal of cannabis vaping products, including:

• Frequency of use of products with a flavour other than cannabis flavour, when vaping cannabis;
• Whether they were the first cannabis products tried or secondary to trying other kinds of cannabis products and whether they were using any other vaping products such as nicotine-based vaping products, including flavoured varieties;
• Motivators, influencers and factors that led to their interest and use of these products, including their decision to start using, or to continue using, cannabis vape products;
• Use and appeal of specific flavours as well as the extent to which certain information such as the ingredient list, terpene profile, or name of the product can evoke a sense of flavour;
• Where they source flavoured cannabis vape products from, including both the legal and illegal markets;
• The impact that restrictions on the sale of flavoured cannabis vape products would have on their intention to continue using cannabis products; and
• Whether there are any differences in the behaviours or attitudes expressed by participants depending on a variety of identity factors (e.g. self-identified sex, gender, sexual orientation, age, geography, ethnicity, or education).

B. Methodology

This research was undertaken between October 19^th and November 3 ^rd, 2020 among 1,501 Canadian youth, aged 15 to 17 (n=750), and young adults, aged 18 to 24 (n=751). Respondents were profiled, selected and screened through the use of a nationally representative online panel.

Since the survey was intended to target such a narrow sub-group of the population, only age was set as a hard quota. Through setting soft quotas, the research design also aimed to get a reasonable cross-section of respondents by gender, region and language as per the latest Statistics Canada data. These variables were monitored throughout the period this survey was in field.

More information about the youth and young adults who participated in the survey in terms of standard demographics including the participant’s sex at birth, gender, sexual orientation, region, language, ethnicity, education, household income, living situation and community makeup can be found in Section IX - Respondent Profile.

In addition to totals, throughout the report breakouts by the following key subgroups are shown on the right side of the tables:

• Gender: male, female (for the purposes of this report, the terms “male” and “female” refer to participants’ gender identity, unless otherwise noted);
• Age: 15-17 years old, 18-24 years old; and
• Cannabis vaping status: frequent vapers (who vape cannabis at least one day a week or more), regular vapers (who vape cannabis one to three days per month), occasional vapers (who vape cannabis less than one day per month, but who have vaped cannabis within the last year) or infrequent vapers (who have not vaped cannabis in the last 12 months).

Conducting the survey online was deemed to be the most appropriate approach for a range of reasons, including: the sensitivity of the topic, the need to include detailed explanations and descriptions within the survey to enhance clarity for respondents, and to avoid any misinterpretation which could adversely affect the validity of the data, and the low incidence of the target group within the population.

A series of screening questions were employed to specifically target those who had vaped cannabis in the past (see Section X for the full list of survey questions). In accordance with Government of Canada and Health Canada standards for conducting public opinion research, consent was obtained from a parent or guardian specifically for the 15-year old respondents. The survey was about 15 minutes in length, but ran anywhere between 8 and 39 minutes in length depending on individual respondent’s use of various products and their experience using flavoured cannabis vape products.

All sub-group differences noted in the report are considered significant based on T-Test for Means and Z-Test for percentages.

More information about the survey methodology can be found in Section VIII.

C. Key Findings

Among youth and young adults who are vaping cannabis, many are doing so frequently and in a variety of settings, primarily social. Frequency of use correlates with other key attitudes and behaviours related to cannabis use, in particular having begun vaping cannabis at a relatively early age.

Just under two-thirds of respondents are frequent cannabis vapers (61%), which for the purposes of this research was defined as vaping cannabis at least 1 day per week or more within the last 12 months. Another one-in-five (19%) vape cannabis between 1 to 3 days a month.

• A higher proportion of frequent cannabis vapers are found among the younger cohort, aged 15 to 17 (69%) compared to those aged 18 to 24 (52%); and, among males (75%) compared to females (47%).
• The age at which respondents first began vaping cannabis varies, although one-in-five (20%) frequent vapers began vaping cannabis when they were younger than 13 years of age.
• Half (50%) say they were also using other cannabis products when they first began vaping cannabis.
• Over one-third (38%) did indicate these were the first cannabis products they started using, while just over one-quarter (29%) reported that they were also using non-cannabis vapes at the time they started vaping cannabis.

Cannabis vaping occurs in a variety of situations, including in both social and individual settings. Many youth and young adults report that they usually vape cannabis with friends (65%) or at parties/social events (42%). At the same time, a large proportion vape cannabis when they are alone (47%), and this tendency is more common among frequent vapers (57%) relative to those who vape less often.

• Vaping cannabis while driving occurs fairly rarely (only 6% of all respondents reported this behaviour), although a slightly higher proportion of frequent vapers (9%) report doing so.

The motivators which prompted initial interest in cannabis vaping are wide-ranging – general curiosity is foremost among them (81% say it was a somewhat/very important factor). Peer influence also ranks highly (68%) as does the perception that vaping is a safer alternative to smoking (66%). However, the taste and smell of the product (72%) as well as the ability to get products with a flavour that is different from cannabis (e.g., melon, citrus, grape) (65%) are firmly situated within the top 5 motivating factors, ranked by perceived importance.

There is some variability by gender, age and frequency of use in the degree to which each of these motivators is viewed as important, although each of the above-noted factors consistently ranks within the top 5 (out of 8 factors tested) across all sub-groups.

• The ability to get products with a flavour that is different from cannabis has particular appeal among frequent vapers (74%), males (71% vs. 61% for females) and the younger age group (69% for 15 to 17 year olds; 61% for 18 to 24 year olds).
• Flavour is also cited as a key reason why respondents choose to vape cannabis versus using it in other ways, by about two-in-five respondents (42%), although the primary motivator, mentioned by almost half (47%) is convenience. Another one-third (33%) mentioned that they like that they can get flavoured products that do not taste like cannabis.
• And, while price is a key factor for almost half of survey respondents when selecting which vape products (46%) to use, flavour is the next most cited consideration (38%). Flavour is also a stronger purchase driver among youth (44%), compared to young adults (31%).

Flavoured cannabis products are highly popular among respondents– especially fruit and candy-flavoured products. Just over half (51%) of the respondents state they use flavoured products regularly – either very often (33%) or always (18%). Moreover, most respondents, including those aged 15 to 17, find these products are easily obtained regardless of where they live in Canada. Respondents are also able to readily ascertain whether a vape product is flavoured or not by the product name or description in addition to other indicators such as the strain name, information obtained online, from a family member or by a salesperson at a retail outlet, as well as the ingredient list and the packaging.

Regular use (those who reported always or very often using a flavoured cannabis product) of flavoured cannabis products when vaping is higher among the younger cohort, aged 15-17 (58% say they use them very often or always) compared to those aged 18-24 (44%). In addition, almost 9 out of 10 in the younger age group (88%) say that these products are somewhat or very easy to obtain.

• Just over half of respondents say they source these products only through legal channels (51%), but a sizeable proportion say they are sourcing through a mix of legal and illegal channels (28%) or illegal channels only (13%).

Preferences for different types of flavours vary, but a majority (57%) have tried fruit-flavoured products and significant numbers of cannabis vapers have also tried candy-flavoured (40%) and mint or menthol (34%). Somewhat fewer have tried dessert-flavoured (25%), soft drink (20%) or energy drink-flavoured (17%) products.

• There are clear gender differences when it comes to the use of and preference for flavours. Females are more likely to have tried and prefer fruit, candy and dessert-flavoured products.

When asked to imagine what they would do if flavoured products were no longer available through a legal retailer, most respondents say they think they would continue to either vape cannabis (44%) or that they would stop vaping cannabis, but use other cannabis products (36%). A smaller percentage say they would stop vaping cannabis and switch to other flavoured vape products, such as nicotine vapes (17%). Very few think they would stop using cannabis altogether and would not use other vape products (9%).

Among the 44% of respondents who said they would continue to vape cannabis if restrictions were to be placed on flavoured cannabis vape products, a large proportion (66%) said they would do so by vaping non-flavoured cannabis products, while just under half (45%) said they would purchase flavoured cannabis products from an illegal source. However, it is not clear what percentage of those who said they would purchase these products illegally may have been doing so previously.

A short series of attitudinal statements was included in the survey to assess respondents’ general views towards cannabis use and cannabis vaping, specifically focusing on benefits and risks associated with use and the environmental context in which it is used. The findings showed that the vast majority of respondents associate specific recreational and social benefits of using cannabis and health benefits with vaping cannabis, particularly when compared to smoking cannabis (e.g., 70% agree vaping is safer). At the same time, there is a relatively high level of understanding of the risks related to cannabis use such as addiction and dependency, problems with memory, learning and decision-making (e.g., 74% agree using cannabis may result in these issues).

Advanced statistical analysis was undertaken to better understand the profile of respondents according to their usage of cannabis vape products and flavoured vape products and their attitudes regarding three specific attitudinal statements regarding the risks associated with cannabis. This produced three broad segments or categories of respondents: Higher Usage (representing 33% of respondents), Medium Usage (44%) and Lower Usage (23%).

The Higher Usage segment is predominantly heterosexual, male, younger (aged 15-17), from households with annual incomes of $60,000 to just under $100,000 and resides in larger centres and urban areas. Of note, this group is more likely, relative to the other two segments, to have begun vaping at an earlier age, report that vaping cannabis was the first cannabis product they started using and to cite taste and smell as well as an ability to get products with a flavour that is different from cannabis as influencing factors.

• Relative to the other two groups, the Higher Usage group is also more inclined to indicate that a primary reason for choosing to vape cannabis rather than use cannabis in other ways is that it gets them more ‘high’ (i.e. produces a stronger psychoactive effect). This group is also notable in that they demonstrate markedly higher awareness of advertising for cannabis and for use of cannabis in social settings.

A sex- and gender-based analysis plus (SGBA+) was also undertaken to permit Health Canada to explore any differences in behaviours or attitudes of respondents based on the intersection of gender and a variety of other identity factors such as sexual orientation, age, education and community size. A detailed analysis is provided in Section VII. The analysis did demonstrate some variability in usage and behaviours.

• Those who identify as male and who are in the younger cohort, aged 15 to 17, were generally more likely to be frequent cannabis vapers, regularly use flavoured cannabis vape products and more inclined to be influenced by flavours other than cannabis as well as the taste and smell of the product. The same pattern holds true, generally speaking, for the group which identifies as heterosexual females, compared to females overall.
• While there was some variability by community size and educational attainment, there was no consistent pattern.

D. Conclusions

The use of flavoured products is popular among youth, aged 15 to 17, and young adults, aged 18 to 24, who vape cannabis. Flavoured cannabis vape products are regularly being used and obtaining these products is reportedly easy for the majority of respondents. Among youth and young adults who identified as frequent vapers of cannabis, it was found that their experimentation with these products was more likely to have begun at a fairly young age. The findings also show that young people are commonly introduced to cannabis vaping by their peers, although general curiosity about these products also plays a significant role in their initial interest. At the same time, it is also clear from the results of this study that the sensory experience is a key factor motivating initial use, specifically the taste, smell and flavour of cannabis vape products.

E. Limitations

More information about some of the limitations of the study including the online methodology, composition of the final sample, and the target audience can be found in Section VIII – Methodology.

Note to Reader

Unless otherwise noted, results shown in this report are expressed as percentages and may not add up to 100% due to rounding and/or multiple responses to a given question.

Statement of Political Neutrality

I hereby certify as a Senior Officer of The Strategic Counsel that the 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.

Signed: ___________________________________