How Do Cannabis Ads Influence Youth Perceptions of Cannabis?

BACKGROUND: Cannabis marketing exposure has been shown to influence use among youth by increasing positive cannabis perceptions and interest. However, little is known about what specific cannabis advertising features influence youth's perceptions, a key precursor to youth use. METHODS: Respondents consisted of 409 youth (age 16-20 years) surveyed in 2022 who reported susceptibility to using cannabis and were living in California, which legalized adult-use cannabis sales in 2018. Using an online experiment, respondents were randomly assigned to view cannabis advertisements with and without features previously shown to be appealing to adolescents, followed by questions related to cannabis perceptions. Exploratory factor analysis identified three underlying types of cannabis perceptions following ad exposure: cannabis as fun, healthy, or dangerous. Multivariable ordered logistic regressions tested associations of specific advertisement content features with these perceptions. RESULTS: Results revealed features that created perceptions of cannabis as fun, including depictions of positive sensations, psychoactive appeal, food or flavor references, the use of illustrated imagery, and animals or creatures. Features associated with perceptions of cannabis as healthy included positive sensations, adventure, showing the product, and price information. Ads depicting heavy consumption, faces, socializing, and using cannabis to avoid negative moods resulted in youth perceptions of cannabis as dangerous, and those with food or flavor references were perceived as less dangerous. CONCLUSION: Results provide new insight into the psychological pathways by which marketing may operate. This can inform marketing standards and regulations to limit the effects of cannabis marketing on youth.