What do irreversible brain damage and an increased risk of psychosis and depression have in common?
Adolescents who regularly use cannabis are at a greater risk of developing these mental health disorders as well as being involved in car accidents—which is the leading cause of death among young people.
Dr. Deborah Scharf, a Lakehead University clinical and health psychologist, is one of many health researchers who's worried about what's been happening to Canadian teenagers since the sale of cannabis was legalized in 2018.
"Since youngsters aren't brand affiliated, cannabis companies have been aggressively marketing to them with the intention of persuading kids that cannabis will have a positive effect on them. The end goal is to make them lifelong consumers of their products," she says. And these companies appear to be succeeding. "Cannabis is everywhere, and adolescents believe it's less harmful than alcohol and other drugs."
She points to research summarized by the American Pediatrics Association which shows that in all the hype about the purported benefits of cannabis, its negative effects on young people—whose brains aren't fully developed until they're 25—are often ignored.
"Legalization has led to increased recreational cannabis use, especially among people aged 15-34," says Chelsea Noël, a Lakehead PhD student and Dr. Scharf's research coordinator. "Moreover, it has resulted in the proliferation of new modes of cannabis use (such as 'dabbing' and vaping extracts) and the consumption of diverse forms of cannabis such as edibles, THC oils, chocolate, baked goods, and gummies."
Before coming to Lakehead, Dr. Scharf worked at the RAND corporation—an American non-profit, non-partisan policy research institute—where she studied the negative effects of cigarette and alcohol marketing designed to encourage adolescents to smoke and drink.
This is occurring even though the Canadian Cannabis Act clearly states that advertising aimed at children and teenagers is prohibited and that all advertising must be neutral.
"Ads featuring bright colours, animals, and cartoons, or that focus on cannabis consumption as an appealing lifestyle choice, are illegal," Dr. Scharf says.
She and her research team recently investigated how cannabis advertising is affecting14 to 18-year-olds.
"The Cannabis Act is supposed to prevent cannabis advertisements from appearing in areas where they're visible to youth under the age of 18, so we designed a study in which Thunder Bay youth documented instances of cannabis advertising in their daily lives," explains Dr. Scharf's research assistant, Chris Armiento.
Risky Business
Dr. Scharf's team assumed that adolescents would be exposed to cannabis advertising primarily through digital ads because this is a space where government regulations are lax. They were surprised to learn, however, that the majority of ads viewed by young people came in the form of billboards and the signage of the brick-and-mortar cannabis stores that have sprouted up across Thunder Bay.
These physical ads dominate young people's cannabis advertising experiences because Ontario has the most lenient laws in Canada when it comes to the sale of cannabis products.
"We have 20 times the density of cannabis stores compared to other provinces," Dr. Scharf says. "In Quebec, for example, only one cannabis store per 100,000 people is permitted to operate—in Thunder Bay, we have one store per 5,000-6,000 people."
The teens participating in Dr. Scharf's study used a smartphone app to record images of the cannabis ads they encountered in their natural environment, as well as their reaction to being exposed to these ads.
"We mapped both the geographic locations where teens reported seeing cannabis advertisements and common locations frequented by youth—such as malls, movie theatres, and schools," Armiento says.
"What we discovered is that the highest density of cannabis stores is within 300 to 500 metres of places where teens hang out," Armiento says. "In other words, not only are teens being exposed to these advertisements, but they're being exposed to them in the places they visit most often."
And what are the consequences of all this cannabis advertising?
"As predicted, we found that teens' intention to use cannabis after seeing youth-appealing cannabis ads really went up," Noël says. "These ads significantly increased their intention to use cannabis."
They were further disheartened to find no cases of the government prosecuting cannabis ad violations in court. In fact, instead of tightening restrictions, "the province is loosening existing advertising regulations in an effort to steer people away from buying black market cannabis," Dr. Scharf says.
The researchers are similarly concerned that the legal age for cannabis consumption in Ontario is 19.
"This was entirely a business decision made because it coincides with the drinking age and because it generates more money than a higher—and safer—age limit would," Dr. Scharf says.
Teens have a Target on their Backs
Her team would like to counteract what is becoming an epidemic with evidence-based approaches to preventing underage cannabis use.
"This includes providing accurate information to youth and implementing comprehensive regulatory measures—such as a complete ban on all cannabis advertising and the early implementation of effective advertising regulations," Noël says. "Without strict, science-based laws and prevention strategies, research shows that early, frequent cannabis use and the use of high strength and multiple types of cannabis products could result in more problematic use and harms."
Cannabis sellers are not only contravening rules against advertising to adolescents, but they're also violating a government ban against selling cannabis products that appeal to children, as can be seen in the cherry-flavoured cannabis products above.
Dr. Scharf's research team has partnered with the Thunder Bay Drug Strategy to raise awareness about cannabis use by local teens. They have also presented their findings at national and international meetings where representatives from other jurisdictions are deciding how to regulate cannabis advertising and sales.
"Decades of research on alcohol and tobacco have shown us that government public health spending will struggle to keep up with the deep pockets and the seductive marketing of cannabis sellers," Dr. Scharf says. "The cannabis lobby is extremely powerful and there is so much money to be made."
She urges parents and caregivers to have conversations with their children about what is safe and to share Canada's Lower-Risk Cannabis Use Guidelines with them.
"Discuss how they're being targeted through advertising and let them know that celebrities are being paid to promote cannabis products."
Dr. Scharf would also like to see broader societal conversations about the dangers of cannabis use for young people.
"Decisions are being made by governments and cannabis retailers that are having a negative impact on the health of our children, and parents and community agencies are being left to pick up the pieces."
If you'd like to donate to research aimed at preventing adolescents from using cannabis, please visit lakeheadu.ca/donate and designate your gift to: BRANCHES Research Lab.