UC San Diego

Background: The passage of the 2018 United States (US) Farm Bill, which separated “hemp” from the definition of “marijuana”, resulted in the growth of a market for hemp-derived cannabinoid products, such as cannabidiol (CBD) and delta-8-THC. Hemp-derived cannabinoid products are those derived from Cannabis Sativa L. that contain less than 0.3% delta-9-THC, which is the main psychoactive compound in cannabis. Although the new and unregulated marketplace of hemp-derived cannabinoid products poses several health risks to consumers, there is a scarcity of data to answer basic epidemiological questions about their use. Methods: This dissertation is comprised of three chapters. Chapters 2 and 3 utilized data from a nationally representative sample of US adults recruited from the Ipsos KnowledgePanel to describe the characteristics and motivations of hemp-derived cannabinoid product use (Chapter 2) and estimate the association between lifetime use of delta-8-THC and state cannabis use laws and regulations on delta-8-THC, independently and in combination (Chapter 3). Chapter 4 used data from a sample of e-commerce tobacco retailers serving San Diego County to examine the association between hemp-derived cannabinoid product availability and website visits and assess compliance with state hemp regulations. Results: In Chapter 2 we found that there is heterogeneity among US adults who use hemp-derived cannabinoid products in terms of sociodemographic characteristics, medical versus recreational reasons for use, and specific medical reasons for use. Most adults used CBD for medical reasons and delta-8-THC for recreation. Anxiety and pain were the most frequently reported medical conditions for using hemp-derived cannabinoid products. In Chapter 3 we showed that medical and recreational cannabis use laws and delta-8-THC restrictions were associated with a lower probability of delta-8-THC use. Among states with recreational cannabis use laws, having delta-8-THC restrictions decreased the probability of delta-8-THC use. In Chapter 4 we found that tobacco retailers that offered hemp-derived cannabinoid products received more website visits, and a sizeable number of retailers were out of compliance with state hemp regulations. Conclusion: These data suggest that hemp-derived cannabinoid products are widely available, used to relieve medical symptoms, and used as a legal substitute to cannabis. Evidence-based education, federal regulations, and better enforcement of existing state laws for hemp-derived cannabinoid products are crucial for ensuring consumer safety and limiting youth access, both essential for protecting public health.