Impact of Delta-8-THC warning labels on perceived intoxication, harm, and susceptibility among adolescents

Abstract

Background

Youth use of hemp-derived cannabis products containing psychoactive Δ8-tetrahydrocannabinol (delta-8-THC) is prevalent in the United States (US). Delta-8-THC is intoxicating, however delta-8-THC products are not subject to warning labeling requirements in many US states. This experiment determined effects of hypothetical cannabis warning labels on perception of delta-8-THC gummies and vape products.

Methods

A mixed within-between-subject experiment was embedded into a 2023 survey of 3,647 Southern California adolescents. Participants were randomized to view photos of delta-8-THC edible and vape products under one of three conditions (control [unmodified] vs. standard size warning label [universal cannabis warning symbol, government warning text, instructions for use, and text stating it was cannabis-infused] vs. larger warning label [same as standard label with larger cannabis warning symbol]). After image exposure, we measured anticipated intoxication, perceived harm, and susceptibility to use the respective delta-8-THC products. Moderation by product type and cannabis use status were assessed.

Results

Youth who viewed delta-8-THC products with larger warning labels (vs. control) reported greater anticipated intoxication (Mean Difference[MD]==2.50, 95 %CI=0.85–4.14 on 100-point scale), and higher likelihood that delta-8-THC products are bad for their health (Risk Ratio[RR]=1.07, 95 %CI=1.02–1.12), pose at least some risk (RR=1.03, 95 %CI: 1.01–1.05), and are the same or more harmful than marijuana (RR=1.04, 95 %CI=1.01–1.07). There were no warning label effects on susceptibility and minimal differences across outcomes between larger versus standard warning labels. Warning label effects on perceived harm were stronger for delta-8-THC gummies (vs. vape) and for never vs. ever cannabis-using youth (interaction p-values < 0.05).

Conclusion

Requiring delta-8-THC products to conform to labeling requirements for cannabis products may increase understanding of their intoxicating effects and harm among cannabis-naïve youth. In lieu of federal regulations, states should consider implementation of delta-8-THC regulations such as labeling requirements that promote safety and reduce potential harm to youth.