Marijuana Use in Canada: Patterns of Use Among Medical Marijuana Users

Research evidence supports the use of marijuana for the purpose of relieving medical symptoms and, therefore, the Canadian courts granted Canadians legal access to marijuana for medical purposes. More than 40,000 Canadians are currently approved to use medical marijuana, with an additional 400,000 Canadians reporting use of marijuana for medical purposes. During the study period, Marihuana for Medical Purposes Regulations (MMPR) was the medical marijuana regulation in effect in Canada, which allowed patients with a medical document from a physician to purchase dried marijuana from a Health Canada licensed producer. Medical marijuana regulations infer how medical marijuana is to be accessed and used. The mode of delivery—whether marijuana is smoked, vapourized, or consumed—may have important implications for potential therapeutic efficacy, as well as health risks. Anecdotal evidence suggests that the use of alternative and innovative modes of delivery is on the rise; however, there is very little evidence on current patterns of use among Canadian medical marijuana users, particularly with respect to modes of delivery. The primary objective of the current research was to examine patterns of use among Canadians using marijuana for medical purposes. The study had five specific aims: 1) To estimate the prevalence of different modes of delivery, 2) To examine perceptions and importance of various factors for different modes of delivery, 3) To estimate the prevalence of different forms of marijuana, 4) To examine the reasons for using different forms of marijuana, and 5) To assess prevalence and perceptions of different sources for obtaining medical marijuana. An overall sample of 364 approved adult Canadian medical marijuana users completed an online cross-sectional survey between April 29 and June 8, 2015. Participants were recruited through a convenience sample from Health Canada licensed producers. Nine Health Canada licensed producers from across Canada helped recruit participants mainly through email. The results showed that using a vapourizer was the most popular mode of delivery currently used (53%), even more so than smoking a joint (47%), indicating a possible increase in the use of vapourizers among approved medical users since the introduction of the MMPR. The main reason participants reported using a vapourizer was to reduce negative health consequences associated with smoking. Furthermore, current use of a vapourizer was associated with fewer respiratory symptoms (OR=1.28, 95%CI: 1.05-1.56, p=0.01) supporting that the use of vapourizers may be less harmful than smoking. Overall, 75% of participants reported using dried herb due to it’s easy accessibility, as it was the only legal form of marijuana available for purchase from licensed producers. It is important to note that accessibility of the forms of marijuana may change due to the recent revision to the MMPR allowing alternative forms of marijuana, in addition to dried herb, to be sold by licensed producers. Licensed producers, as the only legal source for obtaining medical marijuana at the time, was preferred by most approved users (44%). However, the city of Vancouver did not agree that licensed producers were a sufficient source for obtaining medical marijuana, thus, against federal medical marijuana law, decided to allow dispensaries and clubs to sell marijuana. Monitoring implications of such current and future changes to medical marijuana regulations may be beneficial to policymakers. Specifically, continuing to monitor and track medical marijuana use trends in terms of modes, forms, and sources in light of the present data. Overall, the current study addressed an important evidence gap on patterns of medical marijuana use in Canada following the introduction of the MMPR as it is critical to understand the population of medical users in order to inform marijuana policy

Medical cannabis use in Canada: vapourization and modes of delivery

Abstract Background The mode of medical cannabis delivery—whether cannabis is smoked, vapourized, or consumed orally—may have important implications for its therapeutic efficacy and health risks. However, there is very little evidence on current patterns of use among Canadian medical cannabis users, particularly with respect to modes of delivery. The current study examined modes of medical cannabis delivery following regulatory changes in 2014 governing how Canadians access medical cannabis. Methods A total of 364 approved adult Canadian medical cannabis users completed an online cross-sectional survey between April and June 2015. The survey examined patterns of medical cannabis use, modes of delivery used, and reasons for use. Participants were recruited through a convenience sample from nine Health Canada licensed producers. Results Using a vapourizer was the most popular mode of delivery for medical cannabis (53 %), followed by smoking a joint (47 %). The main reason for using a vapourizer was to reduce negative health consequences associated with smoking. A majority of current vapourizer users reported using a portable vapourizer (67.2 %), followed by a stationary vapourizer (41.7 %), and an e-cigarette or vape pen (19.3 %). Current use of a vapourizer was associated with fewer respiratory symptoms (AOR = 1.28, 95 % CI 1.05–1.56, p = 0.01). Conclusions The findings suggest an increase in the popularity of vapourizers as the primary mode of delivery among approved medical users. Using vapourizers has the potential to prevent some of the adverse respiratory health consequences associated with smoking and may serve as an effective harm reduction method. Monitoring implications of such current and future changes to medical cannabis regulations may be beneficial to policymakers

Assessing contraband tobacco in two jurisdictions: a direct collection of cigarette butts

Abstract Background The sale of contraband tobacco allows for tobacco tax evasion, which can undermine the effectiveness of tobacco tax policies in reducing the number of smokers. Estimates of the proportion of contraband vary widely as do the methods used to measure the proportion of contraband being smoked. The purpose of this study is to determine the proportion of contraband use in two different jurisdictions. Methods A cross-sectional direct collection of cigarette butts was conducted in Peel and Brantford, Ontario, Canada in 2013 and 2014, respectively. Cigarette butts were collected from a variety of locations within both regions. Cigarette butts were assessed and classified into one of the following categories: contraband, legal Canadian, legal Native, International, unknown, and discards. Results The overall proportion of contraband cigarettes in Peel was 5.3 %, ranging from 2.8 to 8.6 % by location. In Brantford, the proportion of contraband was 33.0 %, with a range from 32.8 to 33.1 % by location. Conclusions The direct collection of cigarette butts was determined to be a feasible method for a local public health unit in determining the proportion of contraband cigarettes. This approach showed that Brantford has a higher proportion of contraband consumption compared to Peel, which may be due to geographic location and proximity to the United States (US)-Canada border and Native Reserves. More research is needed to confirm this geographic association with other jurisdictions

Assessing contraband tobacco in two jurisdictions: a direct collection of cigarette butts

Abstract Background The sale of contraband tobacco allows for tobacco tax evasion, which can undermine the effectiveness of tobacco tax policies in reducing the number of smokers. Estimates of the proportion of contraband vary widely as do the methods used to measure the proportion of contraband being smoked. The purpose of this study is to determine the proportion of contraband use in two different jurisdictions. Methods A cross-sectional direct collection of cigarette butts was conducted in Peel and Brantford, Ontario, Canada in 2013 and 2014, respectively. Cigarette butts were collected from a variety of locations within both regions. Cigarette butts were assessed and classified into one of the following categories: contraband, legal Canadian, legal Native, International, unknown, and discards. Results The overall proportion of contraband cigarettes in Peel was 5.3 %, ranging from 2.8 to 8.6 % by location. In Brantford, the proportion of contraband was 33.0 %, with a range from 32.8 to 33.1 % by location. Conclusions The direct collection of cigarette butts was determined to be a feasible method for a local public health unit in determining the proportion of contraband cigarettes. This approach showed that Brantford has a higher proportion of contraband consumption compared to Peel, which may be due to geographic location and proximity to the United States (US)-Canada border and Native Reserves. More research is needed to confirm this geographic association with other jurisdictions