Understanding Daily Cannabis Use in Canada

Health Canada
Executive Summary
January 2024

Prepared for:
Health Canada
Supplier name: Quorus Consulting Group Inc.
Contract award date: October 17, 2023
Delivery date: January 2024
Contract amount (incl. HST): $115,084.85
Contract #: CW2334333
POR number: 071-23

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

Understanding Daily Cannabis Use in Canada
Executive Summary
Prepared for Health Canada
Supplier name: Quorus Consulting Group Inc.
January 2024

This public opinion research report is based on 20 online focus groups that Quorus completed between December 4 and December 19, 2023. Focus groups spanned the country and consisted of adults who use cannabis daily, or almost daily. The sessions lasted approximately 90 minutes. All participants were informed the research was for the Government of Canada. A total of 140 individuals participated in this study.

Cette publication est aussi disponible en français sous le titre : Comprendre la consommation quotidienne de cannabis au Canada

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

Department of Health
200 Eglantine Driveway
A.L. 1915C
Ottawa, Ontario
K1A 0K9

Catalogue Number:
H14-598/2024E-PDF

International Standard Book Number (ISBN):
ISBN 978-0-660-71468-4

Related publications (registration number: POR 071-23):
Catalogue Number H14-598/2024F-PDF (Final Report, French)
ISBN 978-0-660-71469-1

^© His Majesty the King in Right of Canada, as represented by the Minister of Health, 2024

Political Neutrality Statement

I hereby certify as Senior Officer of Quorus Consulting Group 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 - Appendix C.

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:

January 17, 2024
Rick Nadeau, President
Quorus Consulting Group Inc.

Executive summary

Background and research objectives

Risks from cannabis use are greatest among those who use it frequently (i.e., daily or almost daily use; DADU) on a regular basis. Frequent and prolonged cannabis consumption has been associated with mental health problems including cannabis use disorder, anxiety and mood disorders, neurocognitive impairment, and further cardiovascular and respiratory diseases linked to cannabis smoking. In Canada, rates of DADU are high. As an example, the 2023 Canadian Cannabis Survey suggested that 25% of Canadians who reported using cannabis in the last year further reported DADU. The International Cannabis Policy Study estimated that 87% of all dried cannabis consumed in Canada is consumed by individuals engaged in DADU, and the illegal market is a key source for cannabis among this subgroup.

Minimal research has explored cannabis-related perspectives and behaviours among those using cannabis frequently. For instance, the perceived impacts of cannabis legalization and regulation on their use characteristics including patterns of use, specific reasons for DADU, access to and source of cannabis, and even polysubstance use (e.g., using daily cannabis with alcohol, tobacco, or other drugs) have not been well explored in the scientific evidence base. Further, less is known about this subgroup's knowledge of cannabis' risks, exposure to and understanding of risk-messaging, including perceived impact (e.g., message acceptability/believability), desired content and delivery of future public education. By contributing to the limited qualitative evidence available for this subgroup, this Public Opinion Research (POR) project aims to further explore the range of cannabis-related opinions, knowledge, and behaviours among frequent users across Canadian provinces and territories.

Research objectives

The objectives were to explore perspectives among Canadians who engage in daily or almost daily cannabis use on:

• Perspectives and experiences surrounding cannabis use (e.g., reasons for use, perceived benefits and risks, sourcing cannabis, polysubstance use)
• The impact of cannabis legalization and regulation on various cannabis indicators (e.g., changes in patterns of use, consumption methods, product preference and potency, access/source to cannabis, reasons for sourcing from the legal or illicit market cannabis impaired driving)
• Public education on cannabis use (e.g., exposure to, perceived impact, and desired scope/delivery of risk messaging)

Methodology

The research methodology consisted of 20 online focus groups with individuals in Canada who engage in daily or almost daily use of cannabis products. The focus groups were held between December 4 and December 19, 2023, and included individuals from across the country. Focus groups were segmented by region, age and gender. Each focus group session lasted approximately 90 minutes. Participants were informed upfront that the research was being conducted on behalf of Health Canada and they each received an honorarium of $125 for their participation. In total, 140 individuals participated in the research.

Research results

Understanding cannabis use patterns

When exploring the main reasons participants reported used cannabis for, the following themes were noted:

• Participants use cannabis for a mix of recreational (i.e., non-medical) and medical purposes.
• Recreational use typically referred to using cannabis products socially when spending time or having fun with friends. It is also used alone for relaxation, and to improve focus or enjoyment of other tasks. Many of the participants who use cannabis for recreational purposes also mentioned a therapeutic aspect to their use.
• Those who use for medical purposes are typically trying to relieve anxiety, chronic pain or improve sleep. The vast majority who report using cannabis for medical/therapeutic purposes are doing so without an authorization from a health care practitioner to use cannabis for medical purposes.
• Few participants started using cannabis products after legalization. Participants shared that legalization made cannabis products more readily accessible and instilled a sense that cannabis can be consumed safely. Participants also felt that legalization increased social acceptance of its use. Only a minority of participants explained that their shift to daily or almost daily use only occurred after legalization.
• Most participants tend to use cannabis once a day, usually near the end of their day, which allows them to relax, disconnect, address some of their health issues that arise throughout the day and/or leads to a good night sleep without impacting their focus and productivity during the day. The few who typically use cannabis multiple times a day explained that it helps alleviate certain symptoms throughout the day, such as pain or anxiety, or that they enjoy consuming cannabis recreationally throughout the day.
• While some participants use cannabis in combination with alcohol to supplement effects, most participants described using balance of both substances in order to avoid unpleasant outcomes. Several participants explained that they drink less alcohol because of their frequent use of cannabis. Participants rarely use cannabis in combination with other drugs.

Exploring cannabis product sources

• Most participants obtain their cannabis products from authorized sources. Authorized sources were seen as easily accessible, convenient, and for the most part, competitively priced. Those who used authorized retailers also felt that the products were safe and consistent, and the cannabinoid content was clearly indicated.
• Many participants also order cannabis online, however many admitted being less confident in determining whether the online retailer is authorized. When trying to access whether a website is authorized, participants typically consider whether the website is based in Canada, if it was recommended to them by people they know, whether the website looks professional, the product packaging looks reliable, and the vendor has been around for a while.
• A small number of participants also obtain their products from local growers or dealers that they know are unauthorized. This is generally due to price, quality, availability, convenience, or loyalty to a "dealer".
• Price tends to be the main driver to using illegal sources of cannabis products, especially when buying in large quantities. As well, quality was a factor in why some participants opted to use non-authorized sources, as they felt that the cannabis sold at authorized retailers lacked freshness. Some also wanted products with higher THC levels than what is sold at authorized stores. Additionally, some in rural areas did not have authorized sources in close proximity, and thus purchased cannabis from unauthorized sources due to convenience.

Drawbacks and concerns regarding cannabis

Very few participants had any major concerns or dislikes related to their frequent cannabis use. Of those who had concerns, they tended to be the following:

• Concerns about the impacts of smoking on lung health / overall health
• Short term impacts such as food cravings and indulgences, increased anxiety, and loss of productivity (particularly if cannabis is consumed early in the day)
• The cost of buying their cannabis products
• Perceived dependency on cannabis
• Risk perception concerning cannabis dependence is low. Many felt they were not dependent and felt that they could stop using cannabis at any point in time. Those who felt they were dependent did not have any concerns with their level of dependency, citing that the benefits of cannabis outweigh its risks, when particularly considering cannabis' therapeutic value in their lives.
  • For the most part, participants did not seem to think there was any risk or concern associated with cannabis use or with daily or almost daily use. Participants felt that insofar as they were "in control" (i.e., they knew they could stop or slow down at any time) and that their use did not interfere with their responsibilities (e.g., their job, their family, etc.) then there was no cause for concern. Many countered that if there were concerns, the benefits from using cannabis far outweighed them.
• There was widespread agreement that cannabis impaired driving is common among those in their social networks. There is also widespread agreement that it is more common than alcohol impaired driving. While driving impaired was not condoned, participants typically believed that cannabis does not have the same impact on the body as alcohol. As well, there was some reluctance to believe that cannabis use equates to cannabis impairment. Furthermore, many felt that tolerance levels and experience with cannabis can determine how use of cannabis can influence someone's ability to operate a vehicle – in other words, different cannabis products and strength will have different impacts on different people.

Public education

• Very few participants recall seeing within the past year or so any public education about the risks of using cannabis. Among the few who do remember seeing something, the messaging related to cannabis impaired driving or the impact of cannabis on developing brains. Very few felt these messages applied to them or had any impact on their behaviours. There was no awareness of Canada's Lower Risk Cannabis Use Guidelines.
• Perceived knowledge of risks appeared to be moderate.
• There was moderate interest in wanting to know more about the potential risks of using cannabis daily or almost daily. The most popular topics are whether it has any impact on mental functioning and whether there are any long-term impacts either from a physical or mental perspective. Given the range of cannabis product formats, some also questioned whether certain formats are safer or healthier than others.
• Participants were most interested in wanting to access or receive this type of information online. Many felt that they should be made aware via social media, often referring to advertising via Facebook, X/Twitter, Reddit, Instagram, YouTube and TikTok. There was also interest in seeing something in dispensaries such as posters, brochures or through QR codes on the packaging.

Qualitative research disclaimer

Qualitative research seeks to develop insight and direction rather than quantitatively projectable measures. The purpose is not to generate "statistics" but to hear the full range of opinions on a topic, understand the language participants use, gauge degrees of passion and engagement and to leverage the power of the group to inspire ideas. Participants are encouraged to voice their opinions, irrespective of whether or not that view is shared by others.

Due to the sample size, the special recruitment methods used, and the study objectives themselves, it is clearly understood that the work under discussion is exploratory in nature. The findings are not, nor were they intended to be, projectable to a larger population.

Specifically, it is inappropriate to suggest or to infer that few (or many) real world users would behave in one way simply because few (or many) participants behaved in this way during the sessions. This kind of projection is strictly the prerogative of quantitative research.

Supplier name: Quorus Consulting Group Inc.
Contract number: CW2334333
Contract award date: October 17, 2023
Contract amount (including HST): $115,084.85

For more information, please contact Health Canada at: hc.cpab.por-rop.dgcap.sc@canada.ca