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Highlights

  • We conducted an experiment to examine the co-marketing of cannabis and cigars on packages.
  • Participants were US youth aged between 15 and 20 who smoked cigars or were susceptible.
  • Co-marketing has led many youth to believe that tobacco and nicotine are not in the products.
  • Co-marketing increased the likelihood of using the product displayed.

Abstract

Significance

Some cigars are marketed with references to cannabis because they are used for smoking blunts, which are cannabis rolled up in cigar paper without or with tobacco. There is little research on the impact of co-marketing cannabis on cigar perceptions.

Methods

Participants were 506 US youth (ages 15-20) recruited through Qualtrics between April and June 2023 who reported using little cigars (LCCs), using LCCs in the past 30 days, or being susceptible to using LCCs. We then conducted an experiment between subjects, randomly assigning youth to one of two packages for cigarillos: 1) a package that included cannabis comarketing (i.e. the package contained a cannabis-related flavour descriptor, and the word “blunt’ appeared in the product label and brand name) or 2) a packaging without cannabis comarketing. We evaluated the packaging’s effects on perceptions of the product ingredients, addictiveness, harm perceptions, product attraction, susceptibility of using the product shown and purchase intentions.

Results

Packages with cannabis comarketing were perceived to be more likely to contain marijuana (ORIt is less likely to contain any tobacco (CI 95 %: 3.73, 8,27)ORNicotine (CI: 0.25 to 0.70, 95 %, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.41, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.44, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.42, 0.40, 0.42, 0.42 :OR: 0.57, 95 % CI: 0.40, 0.82). Cannabis co-marketing led to a higher susceptibility for using the product shown.B.: 0.21, p = 0.02). We found no evidence that co-marketing cannabis changed harm perceptions and purchase intentions.

Conclusions

The co-marketing of cannabis on cigar packages could change the perception of product ingredients, and increase susceptibility towards using such products. This could lead to the introduction of cigars and marijuana.

Introduction

In 2023, around 280,000 high-school students reported past 30-day cigar usage (Birdsey 2023). In a study conducted on high school students, two-thirds reported that they used cigars, and nearly half of them modified the cigars into blunts. In a qualitative study conducted with high school students, more youth reported that they modified cigarillos in order to smoke blunts, as opposed to using unmodified ones (Kong et. al., 2017). Many young people report that cigarillos were made specifically to be used as a blunt (Giovenco, Miller Lo, Lewis, & Delnevo, 2017, for example). Importantly, many people who use blunts do not consider themselves “cigar smokers” (C.D Delnevo Bover-Manderski & Hrywna 2011). Some estimates of blunt usage may be underestimated if only those reporting cigar use are asked.

Due to the fact that blunts are smoked by users, they are likely to have similar health risks as other combustible tobacco and cannabis products. The harms of cannabis-tobacco co-use remain largely unknown due to the difficulty in measuring co-use, and disentangling tobacco-tobacco health effects. Despite this, blunts may still expose users to nicotine, even if the tobacco filler has been removed (Peters, Schauer, Rosenberry, & Pickworth, 2016,) as the wrapper may contain tobacco. As a result, blunt use has been linked to both nicotine and marijuana dependence (Schauer Rosenberry & Peters 2017). For youth in particular, blunt use is also associated with subsequent use of cigars (Audrain McGovern, Rodriguez Alexander, Pianin & Sterling, 2019,) and other tobacco products (e.g. cigarettes) (Fairman et. al. 2023, Mayer et. al. 2020).

Cigars can be co-marketed in various ways with cannabis, including product names and descriptors that connote cannabis-related flavors, such as Swisher Sweets, or product descriptors like Kush, Purple Haze, or Cali Green. In a study of tobacco stores near middle and high school in California, approximately 62 % sold cigars that featured at least one form cannabis co-marketing. (Henriksen, Ababseh, Johnson, & Fortmann, 2018, for example). In particular, 26.0% of stores sold blunt wraps or cigarillos with a cannabis flavor, and 27.2% sold cigarillos marketed with a brand name (e.g. Swisher Sweets Blunt). In a study based on 2016 sales, it was found that almost 30 million cigars, and 56 million wraps, sold in 2016, had cannabis co-marketing as the flavor or brand name. (Representing 4.3 % of the dollar share and 4.9% of unit share, respectively.) And most of those with cannabis-related flavors used cannabis terminology within the brand name. (Delnevo Giovenco Kurti & Al-Shujairi 2020). Both studies showed disparities in the way and where cannabis comarketing is displayed. Cannabis co-marketing is more prevalent in areas with lower median household incomes (Henriksen, et. al., 2018), while cannabis-flavored cigars are cheaper on average than cigars that do not have cannabis flavors (Delnevo, et. al.,2020).

Cigars with co-marketing cannabis can be advertised anywhere in America and are not limited to states where cannabis is legal. Cigarillos, which can be used to make blunts, and often contain cannabis comarketing, are the most common cigars purchased at convenience stores or gas station (Edwards, et. al., 2012). Cannabis retailers are often prohibited from selling tobacco products such as cigars and cigar wraps, even in states where cannabis use is legal. Washington (Washington State Liquor and Cannabis Board 2023) and California Public Health Law Center 2023) prohibit cannabis retailers to sell tobacco products and tobacco retailer from selling cannabis. In the US, blunts are not often commercially available but cigars still carry references to cannabis. As a result, cigars that have cannabis co-marketing must adhere to the regulations of the Center for Tobacco Products, which is the regulatory authority for tobacco products in the US.

Despite the fact that research has shown that co-use of cannabis and cigars is common, we are unaware of any research testing the impact on packaging among youth. This study aimed to examine the relationship between cigar and cannabis comarketing on packaging and product perceptions. We hypothesized cigar and cannabis comarketing would decrease perceptions about product harm, increase perceptions about the cigars containing cannabis, increase appeal, susceptibility for using the product shown and purchase intentions. We hypothesized that there would be significant interactions between comarketing and blunt usage, with the strongest effects being among youth reporting blunt use.

Section snippets

Participants

This study was a part of a larger parent study that examined the impact of larger, picture-based warning labels on perceived effectiveness of warnings. We conducted this experiment at the end of the parent research to examine the impact of cannabis comarketing on cigar packaging. Participants were recruited from Qualtrics, a sample of US youth aged between 15 and 20 years old. A total of Then, you can ask for help.The final sample consisted of 506 youths, and the survey was completed in a median time of 14 minutes. Eligible participants

Participant characteristics

The average age of participants was 17,6 (SD: 1,6) and about half of them (48.6%) reported being male or female (Table 1). Majority of youths reported being white (54%) followed by Black or African American (18.2%). Additionally, 26.7 % reported being Hispanic/Latino. In terms of LCC use, 32 % of youth reported using LCCs in the last 30 days. In terms of blunt usage

Discussion

In our study, we found that the co-marketing of cannabis on cigar packages reduced youths’ perceptions that cigars contain nicotine or tobacco. Co-marketing increased youths’ susceptibility to use the product shown. This was especially true for youths who were curious about blunts, but had never used blunts. This is the first study that has experimentally examined how cannabis comarketing on cigars might influence product perceptions. Our findings

Conclusions

Our study of a sample of US teens found that cannabis advertising on cigar packages can change perceptions about product ingredients and increase susceptibility for using the product shown. This is especially true among youth who have an interest in blunts.

Funding

The National Cancer Institute of the National Institutes of Health and Food and Drug Administration Center for Tobacco Products supported the research reported in this publication under Award Number R01CA260822. The content is the sole responsibility of the authors and may not represent the official views of either the National Institutes of Health, or the Food and Drug Administration. The National Institute of Environmental Health Sciences supported MJ’s research on this paper.

CRediT authorship contribution statement

Sarah D. Kowitt Writing – review & editing, Writing – original draft, Visualization, Methodology, Investigation, Formal analysis, Conceptualization. Sonia A. Clark: . Olivia Glaser Writing – review and editing, Writing the original draft. Michael Jetsupphasuk Writing – review & editing, Visualization. Kristen L. Jarman: Writing – review & editing, Project administration, Methodology, Investigation, Conceptualization. Adam O. Goldstein: Writing – review and editing. James F. Thrasher Writing –

Declaration of Competing Interest

The authors declare they have no competing financial interests which could have appeared to have influenced the work reported in this article.

References (25)

Full Paper at https://www.sciencedirect.com/science/article/abs/pii/S0306460324001758

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