Risk Perception of Cannabis Use Among a Sample of Thai Cannabis Users
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Abstract
Amid the recent cannabis legalization in Thailand, this research captured and analyzed cannabis-related health risk perception among Thai cannabis users. This study used a cross-sectional design with 376 Thailand-based cannabis users recruited through an anonymous online survey from July to August 2022 using the SurveyMonkey application. Descriptive analysis and ordinary least squares regression analysis were performed to describe overall respondents’ characteristics and to identify predictors of low cannabis health-risk perception. Out of 376 respondents, 24.2% perceived cannabis as not risky for health, 46% considered cannabis as low risk, 26.6% as moderate risk, 2.7% as high risk, and 0.5% as most risky. Perceived risk of using cannabis was lower among respondents who had a higher perceived benefit of using cannabis (β = -0.133), a lower education level (β = -0.342), were full-time employed (β = -0.271,) and used cannabis more than twenty days in the past month compared to their counterparts (β = -0.373). Our results suggest that using cannabis in any form and frequency is perceived as a no to low health risk consumption by Thai cannabis users, calling for additional prevention and cannabis health literacy efforts.
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References
• Adair, E. B. G., Craddock, S. G., Miller, H. G., & Turner, C. F. (1995). Assessing consistency of responses to questions on cocaine use. Addiction, 90(11), 1497–1502. https://doi.org/10.1046/j.1360-0443.1995.901114978.x
• Ajzen, I. (2001). Nature and operation of attitudes. Annual Review of Psychology, 52(1), 27–58. https://doi.org/10.1146/annurev.psych.52.1.27
• Alzghari, S. K., Fung, V., Rickner, S. S., Chacko, L., & Fleming, S. W. (2017). To dab or not to dab: Rising concerns regarding the toxicity of cannabis concentrates. Cureus, 9(9), Article e1676. https://doi.org/10.7759/cureus.1676
• Areerat, P. (2021). ความรู้ และความเชื่อด้านสุขภาพเกี่ยวกับการใช้กัญชาทางการแพทย์ของผู้รับบริการ ในโรงพยาบาล จังหวัดพระนครศรีอยุธยา [Knowledge and the health beliefs about the medical use of marijuana among Ayutthaya Province hospital clients]. Research and Development Health System Journal, 14(2), 1–12. https://he02.tci-thaijo.org/index.php/RDHSJ/article/view/253185
• Assanangkornchai, S., Thaikla, K., Talek, M., & Saingam, D. (2022). Medical cannabis use in Thailand after its legalization: A respondent-driven sample survey. PeerJ Life & Environment, 10, Article e12809. https://doi.org/10.7717/peerj.12809
• Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice Hall.
• Bidwell, L. C., Martin‐Willett, R., & Karoly, H. C. (2021). Advancing the science on cannabis concentrates and behavioural health. Drug and Alcohol Review, 40(6), 900–913. https://doi.org/10.1111/dar.13281
• Bidwell, L. C., YorkWilliams, S. L., Mueller, R. L., Bryan, A. D., & Hutchison, K. E. (2018). Exploring cannabis concentrates on the legal market: User profiles, product strength, and health-related outcomes. Addictive Behaviors Reports, 8, 102–106. https://doi.org/10.1016/j.abrep.2018.08.004
• Callaghan, R. C., Sanches, M., & Kish, S. J. (2020). Quantity and frequency of cannabis use in relation to cannabis-use disorder and cannabis-related problems. Drug and Alcohol Dependence, 217, Article 108271. https://doi.org/10.1016/j.drugalcdep.2020.108271
• Chatterjee, S., & Simonoff, J. S. (2013). Handbook of regression analysis. John Wiley & Sons. https://doi.org/10.1002/9781118532843
• Chiu, V., Hall, W., Chan, G., Hides, L., & Leung, J. (2022). A systematic review of trends in US attitudes toward cannabis legalization. Substance Use & Misuse, 57(7), 1052–1061. https://doi.org/10.1080/10826084.2022.2063893
• Crippa, J. A., Zuardi, A. W., Martín‐Santos, R., Bhattacharyya, S., Atakan, Z., McGuire, P., & Fusar‐Poli, P. (2009). Cannabis and anxiety: A critical review of the evidence. Human Psychopharmacology: Clinical and Experimental, 24(7), 515–523. https://doi.org/10.1002/hup.1048
• Danseco, E. R., Kingery, P. M., & Coggeshall, M. B. (1999). Perceived risk of harm from marijuana use among youth in the USA. School Psychology International, 20(1), 39–56. https://doi.org/10.1177/0143034399201004
• Di Forti, M., Quattrone, D., Freeman, T. P., Tripoli, G., Gayer‐Anderson, C., Quigley, H., Rodríguez, V., Jongsma, H. E., Ferraro, L., La Cascia, C., La Barbera, D., Tarricone, I., Berardi, D., Szöke, A., Arango, C., Tortelli, A., Velthorst, E., Bernardo, M., Del-Ben, C. M., . . . Van Der Ven, E. (2019). The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): A multicentre case-control study. The Lancet Psychiatry, 6(5), 427–436. https://doi.org/10.1016/s2215-0366(19)30048-3
• Di Forti, M., Sallis, H. M., Allegri, F., Trotta, A., Ferraro, L., Stilo, S. A., Marconi, A., La Cascia, C., Marques, T. R., Pariante, C. M., Dazzan, P., Mondelli, V., Paparelli, A., Kolliakou, A., Prata, D., Gaughran, F., David, A. S., Morgan, C., Ståhl, D., . . . Murray, R. M. (2014). Daily use, especially of High-Potency cannabis, drives the earlier onset of psychosis in cannabis users. Schizophrenia Bulletin, 40(6), 1509–1517. https://doi.org/10.1093/schbul/sbt181
• Florimbio, A. R., Walton, M. A., Coughlin, L. N., Lin, L. A., & Bonar, E. E. (2023). Perceived risk of harm for different methods of cannabis consumption: A brief report. Drug and Alcohol Dependence, 251, Article 110915. https://doi.org/10.1016/j.drugalcdep.2023.110915
• Florimbio, A. R., Walton, M. A., Duval, E. R., Bauermeister, J. A., Young, S. D., McAfee, J., & Bonar, E. E. (2024). Direct and indirect effects of cannabis risk perceptions on cannabis use frequency. Addiction Research & Theory, 32(1), 68–73. https://doi.org/10.1080/16066359.2023.2221029
• Gilman, J. M., Iyer, M. T., Pottinger, E. G., Klugman, E. M., Hughes, D., Potter, K., Tervo-Clemmens, B., Roffman, J. L., & Evins, A. E. (2022). State-level recreational cannabis legalization is not differentially associated with cannabis risk perception among children: A multilevel regression analysis. Cannabis and Cannabinoid Research. https://doi.org/10.1089/can.2022.0162
• Gobbi, G., Atkin, T., Zytynski, T., Wang, S., Askari, S., Boruff, J., Ware, M., Marmorstein, N., Cipriani, A., Dendukuri, N., & Mayo, N. (2019). Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood: A systematic review and meta-analysis. JAMA Psychiatry, 76(4), 426–434. https://doi.org/10.1001/jamapsychiatry.2018.4500
• Grant, B. F., & Pickering, R. (1998). The relationship between cannabis use and DSM-IV cannabis abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse, 10(3), 255–264. https://doi.org/10.1016/S0899-3289(99)00006-1
• Gukasyan, N., & Strain, E. C. (2020). Relationship between cannabis use frequency and major depressive disorder in adolescents: Findings from the national survey on drug use and health 2012–2017. Drug and Alcohol Dependence, 208, Article 107867. https://doi.org/10.1016/j.drugalcdep.2020.107867
• Haroutounian, S., Ratz, Y., Ginosar, Y., Furmanov, K., Saifi, F., Meidan, R., & Davidson, E. (2016). The effect of medicinal cannabis on pain and quality-of-life outcomes in chronic pain. The Clinical Journal of Pain, 32(12), 1036–1043. https://doi.org/10.1097/AJP.0000000000000364
• Hartman, R. L., & Huestis, M. A. (2013). Cannabis effects on driving skills. Clinical Chemistry, 59(3), 478–492. https://doi.org/10.1373/clinchem.2012.194381
• Johnson, T. P., & Mott, J. A. (2001). The reliability of self‐reported age of onset of tobacco, alcohol and illicit drug use. Addiction, 96(8), 1187–1198. https://doi.org/10.1046/j.1360-0443.2001.968118711.x
• Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2005). Monitoring the Future National Survey Results on Drug Use, 1975–2004. Volume I: Secondary school students (NIH Publication No. 05-5727). National Institute on Drug Abuse. https://deepblue.lib.umich.edu/bitstream/handle/2027.42/137792/vol1_2004.pdf?sequence=1
• Kalayasiri, R., & Boonthae, S. (2023). Trends of cannabis use and related harms before and after legalization for recreational purpose in a developing country in Asia. BMC Public Health, 23(1), Article 911. https://doi.org/10.1186/s12889-023-15883-6
• Kanato, M., Leeyakilul, P., & Wongauppa, R. (2019). ผลกระทบจากกฎหมายกัญชาทางการแพทย์ในประทศไทย [Impacts from Medical Cannabis Law in Thailand]. ONCB Journal, 36(2), 24–34. https://dl.parliament.go.th/backoffice/viewer2300/web/previewer.php
• Kilmer, J. R., Hunt, S. B., Lee, C. M., & Neighbors, C. (2007). Marijuana use, risk perception, and consequences: Is perceived risk congruent with reality? Addictive Behaviors, 32(12), 3026–3033. https://doi.org/10.1016/j.addbeh.2007.07.009
• Lathrop, J. R., Rosen, S. N., Heitkemper, M. M., & Buchanan, D. T. (2023). Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: The state of the science. Gastroenterology Nursing, 46(3), 208–224. https://doi.org/10.1097/SGA.0000000000000730
• McCartney, D., Arkell, T. R., Irwin, C., & McGregor, I. S. (2021). Determining the magnitude and duration of acute Δ9-tetrahydrocannabinol (Δ9-THC)-induced driving and cognitive impairment: A systematic and meta-analytic review. Neuroscience & Biobehavioral Reviews, 126, 175–193. https://doi.org/10.1016/j.neubiorev.2021.01.003
• Miller, E. T., Neal, D. J., Roberts, L. J., Boer, J. S., Cresskr, S. O., Metrik, J., & Marlatt, G. A. (2009). Test-retest reliability of alcohol measures: Is there a difference between internet-based assessment and traditional methods? In G. A. Marlatt & K. Witkiewitz (Eds.), Addictive behaviors: New readings on etiology, prevention, and treatment (pp. 323–341). American Psychological Association. https://doi.org/10.1037/11855-013
• Minister of Public Health [Thailand]. (2021, July 5). Notification of the Ministry of Public Health (No. 427), B.E. 2564 (2021) Issued under the Food Act, B.E. 2522 (1979) Re: Food products containing certain parts of cannabis or hemp. Food and Drug Administration, Thailand. https://food.fda.moph.go.th/media.php?id=509438793015762944&name=P427_E.pdf
• Ngampoopun, M., Nabangchang, C., & Suwanpakdee, P. (2022). Survey of local cannabidiol use in parents of children with epilepsy in Thailand: The prevalence, perceptions, and knowledge. Journal of Cannabis Research, 4(1), Article 43. https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-022-00155-8
• Organic Village. (2024, January 29). Best Cannabis THC & CBD. https://organic-village.co.th/groceryshop/cannabis-thc-cbd/
• Pallant, J. (2020). SPSS survival manual: A step by step guide to data analysis using IBM SPSS (7th ed.). Routledge. https://doi.org/10.4324/9781003117452
• Pardo, M., Matalí, J. L., Sivoli, J., Vila-Badía, R., Butjosa, A., Dolz, M., Sánchez, B., Barajas, A., Del Cacho, N., Baños, I., Ochoa, S., & Usall, J. (2021). Early onset psychosis and cannabis use: Prevalence, clinical presentation and influence of daily use. Asian Journal of Psychiatry, 62, Article 102714. https://doi.org/10.1016/j.ajp.2021.102714
• Parker, M. A., & Anthony, J. C. (2018). A prospective study of newly incident cannabis use and cannabis risk perceptions: Results from the United States Monitoring the Future study, 1976–2013. Drug and Alcohol Dependence, 187, 351–357. https://doi.org/10.1016/j.drugalcdep.2018.03.012
• Pierre, J. M. (2017). Risks of increasingly potent cannabis: the joint effects of potency and frequency. Current Psychiatry, 16(2), 15–20. https://cdn.mdedge.com/files/s3fs-public/CP01602014.PDF
• Ramathibodi Poison Center. (2022). ข้อมูลกรณีผู้บาดเจ็บจากการได้รับกัญชาที่ปรึกษามายังศูนย์พิษวิทยารามาธิบดี ช่วงวันที่ 9-15 มิถุนายน พ.ศ.2565 (7 วันนับจากการปลดล็อคกัญชา) [Information on injured patients from receiving cannabis consultants to Ramathibodi Poison Center during June 9-15, 2022]. https://www.rama.mahidol.ac.th/poisoncenter/sites/default/files/public/ผู้บาดเจ็บจากกัญชาที่ปรึกษาศูนย์พิษวิทยารามาธิบดี%209%20ถึง%2015%20มิย%2065.pdf
• Reddy, D. S., & Golub, V. M. (2016). The pharmacological basis of cannabis therapy for epilepsy. Journal of Pharmacology and Experimental Therapeutics, 357(1), 45–55. https://doi.org/10.1124/jpet.115.230151
• Savonen, J., Hakkarainen, P., & Karjalainen, K. (2023). The perceived risk of illicit drug use and views on drug policy in the general population. Drugs: Education, Prevention and Policy, 30(2), 164–172. https://doi.org/10.1080/09687637.2021.1970114
• Soriano-Co, M., Batke, M., & Cappell, M. S. (2010). The cannabis hyperemesis syndrome characterized by persistent nausea and vomiting, abdominal pain, and compulsive bathing associated with chronic marijuana use: A report of eight cases in the United States. Digestive Diseases and Sciences, 55(11), 3113–3119. https://doi.org/10.1007/s10620-010-1131-7
• Soussan, C., & Kjellgren, A. (2016). The users of Novel Psychoactive Substances: Online survey about their characteristics, attitudes and motivations. International Journal of Drug Policy, 32, 77–84. https://doi.org/10.1016/j.drugpo.2016.03.007
• Sukrueangkul, A., Phimha, S., Panomai, N., Laohasiriwong, W., & Sakphisutthikul, C. (2022). Attitudes and beliefs of cancer patients demanding medical cannabis use in the north of Thailand. Asian Pacific Journal of Cancer Prevention: APJCP, 23(4), 1309–1314. https://doi.org/10.31557%2FAPJCP.2022.23.4.1309
• Tanguay, P. (2024, January 16). Cannabis legalization in Thailand: Exploring impacts on markets and organized crime. Global Initiative Against Transnational Organized Crime. https://globalinitiative.net/analysis/cannabis-legalization-thailand/
• Thaikla, K., Pinyopornpanish, K., Jiraporncharoen, W., & Angkurawaranon, C. (2018). Cannabis and Kratom online information in Thailand: Facebook trends 2015–2016. Substance Abuse Treatment, Prevention, and Policy, 13(1), Article 15. https://doi.org/10.1186/s13011-018-0155-4
• United Nations Office on Drugs and Crime (UNODC). (2023). World Drug Report 2023: Special Points of Interest. https://www.unodc.org/unodc/en/data-and-analysis/wdr-2023_Special_Points.html
• Wall, M. M., Poh, E., Cerdá, M., Keyes, K. M., Galea, S., & Hasin, D. S. (2011). Adolescent marijuana use from 2002 to 2008: Higher in states with medical marijuana laws, cause still unclear. Annals of Epidemiology, 21(9), 714–716. https://doi.org/10.1016/j.annepidem.2011.06.001
• Wang, Y., Zuo, C., Wang, W., Xu, Q., & Hao, L. (2021). Reduction in hippocampal volumes subsequent to heavy cannabis use: A 3-year longitudinal study. Psychiatry Research, 295, Article 113588. https://doi.org/10.1016/j.psychres.2020.113588