Canadians' Views and Use of Natural Health Products, Non-Prescription Drugs and Health Products Containing Cannabidiol

Executive Summary

Prepared for Health Canada
Supplier: EKOS RESEARCH ASSOCIATES INC.
Contract Number: CW2333896
Contract Value: $80,704.60
Award Date: August 16, 2023
Delivery Date: February 27, 2024

Registration Number: HC POR 023-03
For more information on this report, please contact Health Canada at: hc.cpab.por-rop.dgcap.sc@canada.ca

Ce rapport est aussi disponible en français

Canadians' Views and Use of Natural Health Products, Non-prescription Drugs and Health Products Containing Cannabidiol

Executive Summary

Prepared for Health Canada
Supplier name: EKOS RESEARCH ASSOCIATES INC.
Date: February 2024

This public opinion research report presents the results of an online survey conducted by EKOS Research Associates Inc. on behalf of Health Canada. The research study was conducted with 2,575 Canadians in December 2023.

Cette publication est aussi disponible en français sous le titre : Points de vue de Canadiens et utilisations de produits de santé naturels, de médicaments sans ordonnance et de produits de santé contenant du cannabidiol.

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-rop.dgcap.sc@canada.ca or at:

Health Canada, CPAB
200 Eglantine Driveway, Tunney's Pasture
Jeanne Mance Building, AL 1915C
Ottawa, Ontario K1A 0K9

Catalogue Number: H14-599/2024E-PDF
International Standard Book Number (ISBN): 978-0-660-71470-7

Related publications (registration number: POR 023-03

Catalogue Number: H14-599/2024F-PDF (French Report)
International Standard Book Number (ISBN): 978-0-660-71471-4

^©His Majesty the King in Right of Canada, as represented by the Minister of Public Works and Government Services, 2024

Executive Summary

EXECUTIVE SUMMARY

A. BACKGROUND AND OBJECTIVES

Health Canada's Natural and Non-prescription Health Products Directorate (NNHPD) commissioned this online survey with Canadian consumers to assess the knowledge, attitudes, awareness, and behaviours concerning self-care products; specifically, natural health products (NHPs), non-prescription drugs (NPDs), and health products containing cannabidiol (HPCCs).

There is a plethora of self-care products marketed to Canadians which are available independent of the guidance of a health care practitioner or a prescription. Although some NHPs and NPDs have similar risk profiles, they are regulated differently, and consumers may view their risk differently.

As part of the Self-Care Framework, Health Canada is currently reviewing and updating the approach to regulating self-care products. Health Canada is working towards a risk-based approach to regulatory oversight of all self-care products and the current research will support future policy and regulatory approaches with respect to NHPs and NPDs.

The 2018 Cannabis Act allowed for the sale of cannabis for recreational purposes while maintaining access to cannabis for medical purposes and prescription drugs containing cannabis. Currently, the only legitimate route to market for a HPCC is as a prescription drug. However, illicit non-prescription HPCCs are available in stores and online, resulting in Canadians acquiring these unregulated products to treat ailments. A proposed regulatory approach for HPCCs will be informed by the recommendations provided by the Science Advisory Committee on Health Products Containing Cannabis, and would enable access to safe, effective and high quality HPCCs without a prescription.

The objectives of this research are to gather data on Canadian consumers' current level of knowledge, attitudes, awareness, and behaviours with respect to self-care products and to use the data to inform policy and regulatory approaches with respect to NHPs, NPDs and HPCCs.

B. METHODOLOGY

The survey was conducted between December 5 and 19, 2023. The survey included 2,575 Canadians aged 18 and over. This randomly recruited probability sample carries with it a margin of error of +/-1.9%. The margin of error for key segments within each sample is between +/-5% and +/-10%. The sample source is an in-house Probit panel of randomly recruited Canadians and therefore results can be extrapolated to the population of Canadians who are 18 years of age or older. The survey instrument was delivered online (85%) as well as by telephone (15%) and available in both official languages. The average length of the survey was 13 minutes online and 18 minutes by telephone. The overall response rate for the survey was 12%. Appendix A presents further details on the methodology for the survey.

C. KEY FINDINGS

Use of NHPs and NPDs

Once presented with a definition, 73% and 65% of survey respondents indicated use of NHPs and NPDs, respectively. Use is slightly higher among women than it is among men.
Among users of NHPs, 57% reported daily use, compared to 31% of NPD users who reported daily use. For both types of products, the frequency of use is higher among product users over the age of 55.
Just over half of Canadians (and 65% of product users) feel they have the information they need about NPDs in terms of the benefits and risks. On the other hand, 36% of Canadians (and 43% of product users) feel they have the information they need on the benefits and risks when it comes to NHPs.
In terms of where consumers most commonly purchase these products, 73% of survey respondents reported that pharmacies are the most likely location for NPDs purchases, as well as for NHPs (49%). Grocery stores and departments stores are also common locations for one in three Canadians for NHPs and NPDs. Health food or natural health specialty stores are used by 27% to purchase NHPs.

Perceptions about Safety of NHPs

Three in four Canadians (73%) feel that NHP manufacturers are responsible for the safety of the product. Just over half (53%) feel that Health Canada is responsible for the safety of NHPs.
One-third (34%) believe that product claims must be true if on the label, although 43% disagree with this statement. Only one in five (19%) agree that a natural product is safer because they are made with natural ingredients, while half of Canadians (49%) disagree.
While 31% of Canadians indicated confidence in NHPs, 26% rated their confidence as low (and 40% said they are moderately confident). Confidence is higher among those who use these products (37%).

Product Labels of NHPs and NPDs

Most Canadians look at NHP or NPD product labels for directions of use including dosage (82%). Purpose and health claims as well as warnings about the product are also sought by two in three (68% to 69%). Medicinal and non-medicinal ingredients are also of interest to 61% and 47%, respectively, while other information such as storage information is looked for by 42%.
Among the 84% of Canadians with access to data on a mobile device, 25% said that they would be likely to use a QR code to access product label information in-store before making a purchase. Another 23% said they would be moderately likely to do so, however half said they would be unlikely to do so, rising to 61% among those 65 or older.
The most often cited reason for not being likely to use a QR code in-store is that it is too time consuming (42% of those unwilling) or that they do not want to use their phone in the store (20%), while another three in ten said either looking at information online is too complicated (17%) or they do not know how to use a QR code (13%).

Adverse Reactions to NHPs and NPDs

Just under one in ten Canadians report that they have had an adverse reaction to an NPD (9%) or NHP (8%). Among those who have, just over half said that they did not report it (53% of those experiencing a reaction to a NPD and 60% of those with a reaction to a NHP). Healthcare practitioners are the most likely contact for Canadians to report an adverse reaction to (35% of those with a reaction to a NPD and 20% of those with a reaction to a NHP).

Health Products Containing Cannabidiol (CBD)

If available without a prescription, half of Canadians (49%) would be likely (29%) or moderately likely (20%) to purchase a health product containing CBD. Another 46% said they would be unlikely to purchase a health product containing CBD.
The preferred location for purchasing health products containing CBD are pharmacies (82%), followed by authorized cannabis retailers (50%). About one in three would prefer to purchase them at a health food store (36%) or grocery/department stores (31%).

D. NOTE TO READERS

Detailed findings are presented in the sections that follow. Overall results are presented in the main portion of the narrative and are typically supported by graphic or tabular presentation of results. Bulleted text is also used to point out any statistically and substantively significant differences between sub-groups of respondents. If differences are not noted in the report, it can be assumed that they are either not statistically significant¹ in their variation from the overall result or that the difference was deemed to be substantively too small to be noteworthy.

Results for the proportion of respondents in the sample who either said "don't know" or did not provide a response may not be indicated in the graphic representation of the results in all cases, particularly where they are not sizable (e.g., 10% or less). Results may also not total to 100% due to rounding. The programmed survey instrument can be found in Appendix B.

A number of definitions were provided to survey respondents. These included:

Natural Health Products (NHPs): Are made from naturally occurring ingredients that are used to restore or maintain health and can be purchased without a prescription in Canada. Examples of natural health products are vitamins, minerals, probiotics, herbal remedies, homeopathic products, and traditional medicines such as Traditional Chinese Medicine, Ayurvedic Medicine and Traditional Herbal Medicine. In addition, some toothpastes and hand sanitizers can also be classified as NHPs.

Non-prescription drugs (NPDs): Are also called over-the-counter drugs. These are health products that can be bought without a doctor's prescription. For example, certain pain relief medicine (oral or topical), cough and cold medicine, and allergy medicine.

Homeopathic products: A type of natural health product based on homeopathy which is a practice based on the principle that a disease and its symptoms can be cured by a product known to produce similar symptoms. For example, an ingredient such as Allium cepa (the common onion) would be indicated, after being prepared homeopathically, to relieve symptoms such as watering eyes and sneezing, since it can cause these symptoms in its unprocessed form. Homeopathic products are made of substances that come from plants, minerals, and animals and come in many forms such as pellets, oral droplets, syrups, creams and ointments.

Traditional medicine: Includes Traditional Chinese Medicine, Ayurvedic Medicine and Traditional Herbal Medicine. Traditional medicine refers to the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, used in the maintenance of health, as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.

Health Products Containing Cannabidiol: Refers to products containing cannabidiol (CBD) that would be marketed with health claims and would be intended to treat minor ailments similar to other natural health products and non-prescription drugs. These products would not require a prescription.

Other definitions can be found in the questionnaire in Appendix A.

E. Political Neutrality Certification

I hereby certify as Senior Officer of EKOS Research Associates Inc. that the deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Policy on Communications and Federal Identity and 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 by:

Susan Galley (Vice President)

FOOTNOTES

Chi-square and standard t-tests were applied as applicable. Differences noted were significant at the 95% level.