Youth perspectives and experiences with cannabis since the start of legalization and through the COVID-19 pandemic

Executive Summary

Prepared for Health Canada

Prepared by Narrative Research
Call-Up Number: CW2236690
Requisition Reference Number: HT372-224492
Contracted Value: $105,666.30
Contract Date: 2022-08-05
Delivery Date: 2022-11-25
POR number: 019-22

For more information, please contact: cpab_por-rop_dgcap@hc-sc.gc.ca

Ce rapport est aussi disponible en français

Youth perspectives and experiences with cannabis since the start of legalization and through the COVID-19 pandemic

Executive Summary

Prepared for Health Canada
Supplier Name: Narrative Research
November 2022

This public opinion research report presents the results of 18 online focus groups with youth 15-17 years old in each of five regions (Atlantic, Quebec, Ontario, Prairies, BC), and six in-depth interviews in the North. Sessions were divided to include males, females, non-binary, and BIPOC audiences. Each group included a mix of age (within range), household situation, and ethnic background. The Quebec sessions were conducted in French while all other sessions were held in English. The fieldwork was conducted between October 13 and November 15, 2022.

Cette publication est aussi disponible en français sous le titre :
Points de vue et expériences des jeunes en lien avec le cannabis depuis le début de la légalisation et tout au long de la pandémie de COVID-19

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: cpab_por-rop_dgcap@hc-sc.gc.ca

Catalogue Number:
H14-435/2023E-PDF
International Standard Book Number (ISBN):
978-0-660-48193-7

Related publications (registration number: POR-019-22):
Catalogue Number H14-435/2023F-PDF (Final Report, French)
ISBN 978-0-660-48194-4

^©His Majesty the King in Right of Canada, as represented by the Minister of Health, 2022

Executive Summary

Narrative Research Inc.
Call-Up Number: CW2236690
Requisition Reference Number: HT372-224492
POR Registration Number: 019-22
Contract Award Date: 2022-08-05
Contracted Value: $105,666.30

Background and Research Methodology

Cannabis consumption among Canadian youth and young adults is one of the highest in the world and there is evidence that cannabis use poses a significant health risk during adolescence, in particular interfering with brain development and functioning. In the context of cannabis legalization and regulation, protecting the health and safety of youth is a top priority for the Government of Canada. Although quantitative data are available on youth cannabis consumption behaviours, there has been limited qualitative evidence on the perspectives and experiences of youth regarding cannabis, specifically within the intersecting context of federal legalization and regulation and the global COVID-19 pandemic. This includes potential changes among youth in cannabis-related attitudes and patterns of use, reasons for use, access to cannabis, inducements to use, knowledge of risks, and engagement with public education risk-messaging.

Health Canada was interested in the perspectives of Canadian youth (15-17 years old) on consumption behaviours and related cannabis outcomes, particularly in the context of cannabis legalization and regulation. Research findings may help inform and enhance the Cannabis Act's public health approach to protecting public health and public safety of Canadian youth, and help diverse stakeholders determine the target and scope of future educational initiatives.

More specifically, research objectives were to explore youth's perspectives on:

• The impact of cannabis legalization and the COVID-19 pandemic on cannabis use behaviours and attitudes, including potential changes in reasons for use, accessing cannabis, and inducements to use.
• The health risks associated with using cannabis in adolescence and young adulthood.
• The reach of cannabis public education (within and outside school-settings) including awareness of risk messaging, perceived impacts, desired knowledge and gaps, and strategies to help curb youth cannabis use.

To achieve these objectives, a qualitative research approach was undertaken with the fieldwork conducted from October 13th to November 15th, 2022. The research entailed a total of 18 online focus groups and six online or telephone in-depth interviews with youth 15-17 years old. Group discussions were held in five regions (Atlantic, Quebec, Ontario, Prairies, and BC) and in-depth interviews were conducted with youth from northern territories. Focus group participants were divided into four segments, namely males, females, those who do not identify as either male or female (non-binary), and BIPOC individuals. Each group included a mix of communities (within each region), ages (within range), household living situation, and ethnic background. Groups with the BIPOC audience also included a mix of gender. For the focus groups, all participants had access to a computer or tablet with high-speed internet to take part in the session. Parental/guardian consent was required for all participants. Across the northern territories, interviews also included a mix of gender, age, and locations.

From 146 recruited individuals, 125 took part across all sessions/interviews. Each group discussion lasted 90 minutes while individual interviews were each 60 minutes in length. All participants received an incentive of $100 in appreciation for their time. All discussions were held in English except in Quebec where the sessions were held in French. All participants were recruited per the recruitment specifications for the Government of Canada. Recruitment was conducted through qualitative panels stored on Canadian servers, with follow up calls to confirm the details provided and to ensure quotas were met.

This report presents the findings from the study. Caution must be exercised when interpreting the results from this study, as qualitative research is exploratory and cannot infer causality. Results cannot be attributed to the overall population under study, with any degree of confidence. Parental/Guardian consent was obtained prior to youth taking part in the study.

Political Neutrality Certification

I hereby certify as a Representative of Narrative Research that the deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Directive on the Management of Communications. 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
Margaret Brigley, CEO & Partner | Narrative Research
Date: November 25, 2022

Key Findings

The following provides key highlights from the research:

• Cannabis consumption among youth 15-17 years old is perceived to be widespread and common practice and is increasingly viewed as a normalized behaviour since legalization in Canada. Legalization has normalized and somewhat legitimized cannabis use, suggesting to youth that it may be less harmful than some other substances. Many youth equated cannabis to alcohol in terms of its normality. Legalization was also perceived to have increased accessibility of cannabis. By normalizing cannabis use and making it more accessible, aspects of legalization are considered to have contributed to inducing consumption among youth. Youth report that cannabis consumption begins as early as 13 or 14 years old. Introduction to cannabis is typically positioned as harmless and enjoyable, and considered a recreational activity. Peer pressure continues to be an important inducement factor. Cannabis is typically used in social settings, at school, and sometimes in isolation.
• Cannabis is considered easy to obtain by youth, notably through an adult whether it be an older sibling, friend or relative. Parents are also considered a source, especially in families where adults are using cannabis. Social media plays a vital role in youth's sourcing of cannabis outside of their social circle.
• Aside from its use for recreational purposes, cannabis is readily identified by youth 15-17 years old as a coping mechanism, predominately for mental health problems. These problems include anxiety, depression, stress, trauma, sleep disorders, or lack of appetite. Youth feel a lot of pressure from problematic relationships at home or with friends, schoolwork, social interactions, or in the case of Indigenous youth, generational trauma. Youth believe that a desire to address mental health issues has increasingly induced cannabis consumption in the last few years.
• There is mixed opinion as to what impact the COVID-19 pandemic has had on cannabis consumption among youth. Some believe there has been an increase in usage due to isolation, anxiety and uncertainty resulting from the pandemic, while others believe that consumption has dropped with lockdowns and school closures, given the resulting difficulties in accessing the product or an increased parental presence making it difficult to consume it at home.
• Youth identify a wide range of health-related benefits associated with cannabis usage. Most perceived benefits relate to positive health implications, notably dealing with anxiety and stress, coping with depression, helping to sleep or eat; assisting with social interaction; dealing with problems at home; coping with isolation; easing pain; providing an escape from undesirable realities; and among Indigenous youth, coping with generational trauma.
• The most common risks reported from cannabis use pertain to affecting brain development/functioning, addiction/dependence, lung issues, psychological effects, personality changes, and a negative impact on social interactions/relationships. Despite youth recognizing that using cannabis comes with risks, the health impacts are not clearly understood. The severity and duration of the health effects are not well known, and youth have little knowledge of what can be done to minimize those risks, other than reducing consumption amounts and frequency of use, the type of device chosen (e.g., edibles, vape pens) and using cannabis in a safe environment. While it is believed that some of the risks and health effects of cannabis consumption are more important for youth than they are for adults given that they are still physically and mentally developing, the exact nature of those differences is not well understood.
• Cannabis-related information is felt to be available and accessible, especially online, even though most youth have not looked for this information due to a lack of interest or because they believe they know what they need to know about the risks, harms and health effects of cannabis. Similarly, there is limited recall of information or advertisements about cannabis, including from school presentations or course material. Information presented at school is limited in scope and generally combined with information on drugs and alcohol, or addiction. The information is also shared in early high school years, with limited follow-up. Nonetheless, it was perceived that school provides a venue for interactive dialogue where youth can hear about lived experiences, ask questions, and participate in an open discussion on cannabis' potential therapeutic and harmful effects. Social media and transit (public transportation) should also be considered to convey cannabis-related information to youth. While the Internet provides youth with a wealth of information, people with lived experiences and trusted adults (e.g., parents) who hold an open-minded view of cannabis consumption are most trusted sources.
• Despite expressing limited interest in receiving information about cannabis, when prompted, youth showed some curiosity in better understanding the health risks of using cannabis. Topics of greatest interest include the consequences of addiction, if and how cannabis affects brain development or 'stunts growth', and how it might affect someone's mental health. In general, youth question the extent of cannabis' harm and are interested in understanding the scientific rationale of the drug's side-effects. Many also expressed interest in learning more about the types of cannabis, where to get cannabis, and why it is so accessible.
• Youth are most receptive to receiving balanced and evidenced-based information about using cannabis in a way they can relate to. They believe that an educational campaign needs to appreciate that they use cannabis to cope with mental health issues.Balanced information presenting the 'pros and cons' would elicit interest and contributes to its credibility. Further, the risks, harms and consequences of cannabis use need to be demonstrated to them, through real life experiences of people who can share their point of view, through a discussion of both the benefits or positive use of cannabis, and an understanding of the negative consequences. Youth believe that an educational campaign needs to appreciate that they use cannabis to cope with mental health issues. Increased resources and support should be provided to address the root of mental health issues to assist in the reduction of cannabis consumption.
• Exposure to promotional material about cannabis is limited and primarily seen online and through store signage. Although not memorable, social media messaging about cannabis that speak of the flavours and formats available, in addition to online videos showing usage and experiences from cannabis are most the most recalled forms of promotional materials. Outdoor ads and signage from local stores are also recalled in large urban centres.