Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United States

Abstract Background Most states with legalized cannabis require warnings, but current cannabis warnings are unnoticed, difficult to read, and confusing. There is limited cannabis-specific research on which warning characteristics (e.g., size, content) effectively communicate the risks of cannabis us...

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Main Authors: Leah M. Ranney, Sonia A. Clark, Caroline J. Meek, Kristen L. Jarman, Sarah D. Kowitt
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23518-1
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author Leah M. Ranney
Sonia A. Clark
Caroline J. Meek
Kristen L. Jarman
Sarah D. Kowitt
author_facet Leah M. Ranney
Sonia A. Clark
Caroline J. Meek
Kristen L. Jarman
Sarah D. Kowitt
author_sort Leah M. Ranney
collection DOAJ
description Abstract Background Most states with legalized cannabis require warnings, but current cannabis warnings are unnoticed, difficult to read, and confusing. There is limited cannabis-specific research on which warning characteristics (e.g., size, content) effectively communicate the risks of cannabis use. This research explores perceptions of cannabis warning labels from a qualitative perspective. Methods We conducted six virtual focus groups (n = 36 participants) in March and April 2023 with U.S. adults (21+) who reported using cannabis in the past 30 days and resided in a state with legalized recreational cannabis. After exploring risk perceptions of cannabis products, participants were shown existing warnings on cannabis packages from states that have legalized cannabis and novel warnings on cannabis packages created by the study team and asked about cognitive and affective reactions. The resulting audio recordings were transcribed, and ATLAS.ti was used to perform thematic data analysis. Results Half of the participants identified as White, 22% as Black or African American, and 28% as another race. Participants’ mean age was 30.5 years, and, on average, participants reported using cannabis 3.7 of the past 7 days. Themes that emerged from the data were that participants perceived the purpose of warnings as accurately educating or promoting safe use: “I would say to inform people of the health risk so they can make an educated decision.” Participants did not notice existing warnings and wanted warnings to capture attention: “I’ve never noticed one […]” and “I would want some kind of a warning icon or symbol […].” Finally, participants were aware of both the benefits and risks of using cannabis: “I smoke for my anxiety” and “[…] I’ll get some sort of like paranoia.” Conclusions Our findings highlight areas for cannabis warning improvement, particularly with the warning content, design, and placement. Cannabis warnings that inform, educate, and guide less risky use may be well-received by people who use cannabis. More research is needed on the health effects of cannabis use to aid in the development of evidence-based cannabis warnings, particularly around mental health concerns.
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spelling doaj-art-115dcaef18a643e7b682c53870494ac12025-08-20T03:04:07ZengBMCBMC Public Health1471-24582025-07-0125111110.1186/s12889-025-23518-1Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United StatesLeah M. Ranney0Sonia A. Clark1Caroline J. Meek2Kristen L. Jarman3Sarah D. Kowitt4Department of Family Medicine, University of North Carolina at Chapel HillLineberger Comprehensive Cancer Center, University of North Carolina at Chapel HillDepartment of Health Behavior, University of North Carolina at Chapel HillDepartment of Family Medicine, University of North Carolina at Chapel HillDepartment of Family Medicine, University of North Carolina at Chapel HillAbstract Background Most states with legalized cannabis require warnings, but current cannabis warnings are unnoticed, difficult to read, and confusing. There is limited cannabis-specific research on which warning characteristics (e.g., size, content) effectively communicate the risks of cannabis use. This research explores perceptions of cannabis warning labels from a qualitative perspective. Methods We conducted six virtual focus groups (n = 36 participants) in March and April 2023 with U.S. adults (21+) who reported using cannabis in the past 30 days and resided in a state with legalized recreational cannabis. After exploring risk perceptions of cannabis products, participants were shown existing warnings on cannabis packages from states that have legalized cannabis and novel warnings on cannabis packages created by the study team and asked about cognitive and affective reactions. The resulting audio recordings were transcribed, and ATLAS.ti was used to perform thematic data analysis. Results Half of the participants identified as White, 22% as Black or African American, and 28% as another race. Participants’ mean age was 30.5 years, and, on average, participants reported using cannabis 3.7 of the past 7 days. Themes that emerged from the data were that participants perceived the purpose of warnings as accurately educating or promoting safe use: “I would say to inform people of the health risk so they can make an educated decision.” Participants did not notice existing warnings and wanted warnings to capture attention: “I’ve never noticed one […]” and “I would want some kind of a warning icon or symbol […].” Finally, participants were aware of both the benefits and risks of using cannabis: “I smoke for my anxiety” and “[…] I’ll get some sort of like paranoia.” Conclusions Our findings highlight areas for cannabis warning improvement, particularly with the warning content, design, and placement. Cannabis warnings that inform, educate, and guide less risky use may be well-received by people who use cannabis. More research is needed on the health effects of cannabis use to aid in the development of evidence-based cannabis warnings, particularly around mental health concerns.https://doi.org/10.1186/s12889-025-23518-1Cannabis warningsAdultsQualitative researchHealth warning labels
spellingShingle Leah M. Ranney
Sonia A. Clark
Caroline J. Meek
Kristen L. Jarman
Sarah D. Kowitt
Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United States
BMC Public Health
Cannabis warnings
Adults
Qualitative research
Health warning labels
title Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United States
title_full Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United States
title_fullStr Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United States
title_full_unstemmed Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United States
title_short Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United States
title_sort perceptions of cannabis warnings and recommendations for improvement a qualitative study with people who use cannabis from the united states
topic Cannabis warnings
Adults
Qualitative research
Health warning labels
url https://doi.org/10.1186/s12889-025-23518-1
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