Cannabis retailer marketing strategies and regulatory compliance: A surveillance study of retailers in 5 US cities

Carla J Berg; Katelyn Romm; Alexandria Pannell; Priyanka Sridharan; Tanvi Sapra; Aishwarya Rajamahanty; Yuxian Cui; Yan Wang; Y Tony Yang; Patricia A Cavazos-Rehg

doi:10.1016/j.addbeh.2023.107696

. Author manuscript; available in PMC: 2024 Aug 1.

Published in final edited form as: Addict Behav. 2023 Mar 17;143:107696. doi: 10.1016/j.addbeh.2023.107696

Cannabis retailer marketing strategies and regulatory compliance: A surveillance study of retailers in 5 US cities

Carla J Berg ^a,^b,^*, Katelyn Romm ^c,^d, Alexandria Pannell ^e, Priyanka Sridharan ^f, Tanvi Sapra ^f, Aishwarya Rajamahanty ^g, Yuxian Cui ^a, Yan Wang ^a,^b, Y Tony Yang ^b,^h, Patricia A Cavazos-Rehg ^g

PMCID: PMC10674052 NIHMSID: NIHMS1888109 PMID: 36966547

Abstract

As cannabis retail expands in the US, its surveillance is crucial to inform regulations and protect consumers. This study addresses this need by conducting point-of-sale audits examining regulatory compliance (e.g., age verification, signage), advertising/promotional strategies, products, and pricing among 150 randomly-selected cannabis retailers in 5 US cities (30/city: Denver, Colorado; Seattle, Washington; Portland, Oregon; Las Vegas, Nevada; Los Angeles, California) in Summer 2022. Descriptive and bivariate analyses characterized the retailers overall and across cities. Age verification rates were high (>90%). The majority of retailers had signage indicating restricted access (e.g., no minors; 87.3%), onsite consumption (73.3%), and distribution to minors (53.3%). Retailers were likely to post warnings regarding use during pregnancy/breastfeeding (72.0%), followed by health risks (38.0%), impacts on children/youth (18.7%), and DUI (14.0%). Overall, 28.7% posted health claims, 20.7% posted youth-oriented signage, and 18.0% had youth-oriented packaging. Price promotions were prevalent, particularly price specials (75.3%), daily/weekly/monthly specials (66.7%), and membership programs (39.3%). One-fourth had signs/promotions indicating curbside delivery/pick-up (28.0%) and/or online ordering (25.3%); 64.7% promoted their website or social media page. The most potent cannabis products were most often e-liquids (38.0%) or oils (24.7%); the least potent were often edibles (53.0%). The most expensive product was often bud/flower (58.0%); the least was joints (54.0%). The vast majority (≥81%) sold vaporizers, wrapping papers, and hookah/waterpipes/bongs, and 22.6% sold CBD products. Marketing strategies differed across cities, reflecting differences in state-specific regulations and/or gaps in compliance/enforcement. Findings underscore the need for ongoing cannabis retail surveillance to inform future regulatory and enforcement efforts.

Keywords: Cannabis, Marijuana, Marketing, Health communication, Health policy, Drug use

INTRODUCTION

Despite federal prohibition of cannabis, 21 states and 3 territories (including the District of Columbia) have legalized recreational use, and ~40 states and 4 territories have legalized medical use as of November 2022.¹ Cannabis retail sales have rapidly increased in the US, from ~$10 billion in 2019 to over $20 billion in 2021,² and are estimated to be ~$25 billion in 2025.³

Marketing efforts (i.e., product offerings, pricing, promotions) are critical for consumer uptake, attracting new users, promoting continued use, building brand loyalty, and shaping consumer perceptions, particularly for novel products.⁴ Tobacco and alcohol research shows robust associations between exposure to retail marketing and use;^5–9 similar findings are emerging regarding cannabis.^10–15 Marketing surveillance tools have been critical in informing tobacco and alcohol retail, and early cannabis surveillance protocols and tools are increasingly relevant and necessary in public health research^16–20 and practice¹⁷ to address cannabis retail.

A major component of retail surveillance is monitoring products and their attributes, such as packaging and price. Cannabis retailers offer products diverse in their effects, depending on CBD vs. THC levels, strain (i.e., indica, sativa, hybrid), and mode of use (e.g., smoked, vaporized, ingested, applied topically).^{14,19,21–24} Product packaging promotes product attributes and articulates proper use (i.e., serving size, potency).^25,26 Influential product attributes include higher CBD (among users and nonusers), higher THC, higher quality, and lower price.^27,28 Relatedly, product pricing and price promotions impact consumer purchasing behaviors and are commonly used among retailers.^22,23,29 For example, prevalent price promotion strategies at cannabis retailers include coupons, price reductions, daily/weekly deals, “buy one, get one free” promotions, giveaways or free samples, loyalty club memberships, and promotions via social media.^22,24,30

A major regulatory issue is underage access and marketing exposure. While some research indicates high age verification rates among cannabis retailers,^22,23,31,32 a 2019 California-based study found that only 12% of retailers checked ID before entry,³³ and more than one-third marketed youth-oriented items,³³ particularly prominent among cannabis retailers near schools,¹⁶ coinciding with other evidence.³² Also, a 2016 study of dispensaries across 10 states found that ~30% offered online ordering, and 21% offered delivery services,²⁴ which may facilitate underage access.³⁴

A related concern is the targeting of certain subpopulations. Evidence suggests that licit drug retailers^35–40 (including cannabis retailers^{35–37,39,40}) cluster in neighborhoods with high proportions of young adults, racial/ethnic minorities, sexual/gender minorities, and low-income individuals, and may vary their marketing strategies to target these subpopulations.^{21,38,41–43} These strategies impact substance use.^44–47

Another concern is that the diversity and nature of products has implications for advertising messaging, particularly related to health claims.^18,22–24 For example, a 2019 POS audit study in California found that ~40% of retailers promoted the health benefits of cannabis.³³ Other studies of cannabis retail websites found that over half (61–67%) made inaccurate health benefit claims while omitting potential side effects.^18,24

Cannabis regulatory frameworks are evolving and require additional sophistication based on the nuances of cannabis retail.^21,48–55 This work can be informed by prior work in licit drug retail,²¹ as well as the early experiences of US recreational cannabis retail.^21,48–55 Based on these experiences, state laws address various factors; for example, they may prohibit/restrict marketing targeting those underage and using health claims, online sales and/or delivery, and/or customer discounts.⁵⁵ However, the literature highlights concerns related to noncompliance and underscores the need for cannabis retail and marketing surveillance to inform regulatory and enforcement efforts. Thus, this study examined regulatory compliance and marketing practices among cannabis retailers in 5 cities in different US states with different recreational cannabis regulations.

METHODS

Study Overview

The current study conducted primary data collection and analysis as part of the Cannabis Regulation, Marketing & Appeal (CARMA) study. CARMA was launched in Spring 2022 and examines recreational cannabis retail, marketing, and consumer impact. The current study focuses on cannabis marketing in 5 cities with well-established recreational cannabis markets: Denver, Colorado (established in January 2014); Seattle, Washington (July 2014); Portland, Oregon (October 2015); Las Vegas, Nevada (July 2017); and Los Angeles (LA), California (January 2018). Supplementary Table 1 summarizes key state policies.

In Spring 2022, locations with recreational retail licenses in these 5 cities were identified using data from the respective state cannabis regulatory agency websites (n=641). Online searches and phone calls were conducted to verify whether the license referred to an open brick- and-mortar storefront (n=561), and had a website not including social media, Leafly, Weedmaps, etc. (related to website audits also included in this study;⁵⁶ n=541, of which 372 were distinct). We then randomly selected 150 retailers (30/city) not part of the same chain. Specifically, all eligible retailers in each city were assigned a number using a random number generator and then listed chronologically. The top 30 in each city were selected for audits; replacement stores (as needed) were chosen from the remainder of the list (starting at number 31 and chronologically thereafter). See Supplementary Figure 1 for the retailer flowchart.

Data Collection

Training & Quality Control.

In July–August 2022, data collection was conducted in LA, Las Vegas, Denver, Portland, and Seattle, respectively. Data collectors were 6 research staff (ages 22–25, female). Each cannabis retailer was visited twice, with mystery shopper and POS assessments conducted 1–3 days apart. Mystery shopper assessments were conducted by individual staff; POS audits were conducted by staff pairs to assess inter-rater reliability. Data were recorded via electronic forms on iPads/iPhones.

Prior to data collection (July 2022), staff participated in a 2-day training, involving didactics, mock audits, field practice, group debriefing, and quizzes. Once data collection began in each city, staff met with the first and second authors (CB, KR) within the first day to address any issues and ensure data quality.

Mystery Shopper Assessment.

Using previously-published strategies,⁵⁷ staff entered each retailer without identifying as research staff to retail personnel or customers. They coded if they were asked for and required to show their government-issued identification while at the store (i.e., immediately to enter, later, never). After leaving, they assessed whether there were key facilities (e.g., schools, parks/playgrounds, public transit, see Table 1 for complete list) within 2 blocks (radius) from the retailer, as several states have zoning restrictions related retailers locating within 1,000 feet of youth-oriented facilities, etc.

Table 1.

Characteristics of 150 cannabis retailers across 5 US cities in Summer 2022

			Denver	Seattle	Portland	Las Vegas	LA
	Total		N=30	N=30	N=30	N=30	N=30
Variable	N=150		(20.0%)	(20.0%)	(20.0%)	(20.0%)	(20.0%)
	N (%)	Kappa	N (%)	N (%)	N (%)	N (%)	N (%)	p

Store type, N (%)		.89						<.001
Recreational and medical	94 (62.7)		19 (63.3)^a	1 (3.3)^c	30 (100.0)^b	28 (93.3)^b	16 (53.3)^a
Recreational only	56 (37.3)		11 (36.7a	29 (96.7)^c	0 (0)^b	2 (6.7)^b	14 (46.7)^a
Building type, N (%)		.94						<.001
Storefront on street	58 (38.7)		11 (36.7)^a,b	11 (36.7)^a,b	14 (46.7)^a	3 (10.0)^b	19 (63.3)^a
Warehouse	44 (29.3)		10 (33.3)	15 (50.0)	5 (16.7)	8 (26.7)	6 (20.0)
House	19 (12.7)		4 (13.3)	3 (10.0)	9 (30.0)	2 (6.7)	1 (3.3)
Office building	16 (10.7)		5 (16.7)^a,b	0 (0)^a	1 (3.3)^a,b	9 (30.0)^b	1 (3.3)^a,b
Shopping center	13 (8.7)		0 (0)^a	1 (3.3)^a,b	1 (3.3)^a,b	8 (26.7)^b	3 (10.0)^a,b
Structural features, N (%)
Interior security camera	149 (99.3)	--	30 (100.0)	30 (100.0)	30 (100.0)	30 (100.0)	29 (96.7)	.402
Exterior security camera	144 (96.0)	.79	29 (96.7)	30 (100.0)	30 (100.0)	30 (100.0)	25 (83.3)	.003
Waiting room	84 (56.0)	.87	26 (86.7)^c,d	5 (16.7)^a	17 (56.7)^b,d	27 (90.0)^c	9 (30.0)^a,b	<.001
Security guard	75 (50.0)	.91	2 (6.7)^b	13 (43.3)^c	1 (3.3)^b	30 (100.0a	29 (96.7)^a	<.001
Seating area available	64 (42.7)	.79	24 (80.0)^c	3 (10.0)^a	16 (53.3)^c	13 (43.3)^b	8 (26.7)^a,b	<.001
Private room/consultation with staff	18 (12.0)	.94	16 (53.3)^b	0 (0)^a	0 (0)^a	2 (6.7)^a	0 (0)^a	<.001
Attached to consumer lounge	2 (1.3)	1	0 (0)	0 (0)	0 (0)	1 (3.3)	1 (3.3)	.551
Adjacent shop sold related paraphernalia	6 (4.0)	.91	2 (6.7)	3 (10.0)	0 (0)	1 (3.3)	0 (0)	.207
Promotional media channels, N (%)
Exterior
Canopy signs	38 (25.3)	.89	14 (46.7)^b	20 (66.7)^b	0 (0)^a	1 (3.3)^a	3 (10.0)^a	<.001
Portable/temporary signs	37 (24.7)	.95	2 (6.7)^b,c	10 (33.3)^b	0 (0)^c	4 (13.3)^b,c	21 (70.0)^a	<.001
Light up signs	19 (12.7)	.96	1 (3.3)	4 (13.3)	7 (23.3)	4 (13.3)	3 (10.0)	.226
Supergraphic signs	9 (6.0)	.94	0 (0)	1 (3.3)	5 (16.7)	1 (3.3)	2 (6.7)	.068
Digital signs	6 (4.0)	1	0 (0)	1 (3.3)	1 (3.3)	4 (13.3)	0 (0)	.052
Interior
Stickers/decals	124 (82.7)	.82	28 (93.3)	23 (76.7)	26 (86.7)	25 (83.3)	22 (73.3)	.258
TV/other screens	107 (71.3)	.95	15 (50.0)^a	24 (80.0)^a,b	15 (50.0)^a	29 (96.7)^b	24 (80.0)^a,b	<.001
Chalkboards/whiteboards	53 (35.3)	.88	12 (40.0)^a,b	9 (30.0)^a	20 (66.7)^b	5 (16.7)^a	7 (23.3)^a	<.001
Functional items	34 (22.7)	.98	6 (20.0)^a,b	13 (43.3)^a	8 (26.7)^a	0 (0)^b	7 (23.3)^a	.002
Light up signs	32 (21.3)	.92	12 (40.0)^a	5 (16.7)^a,b	0 (0)^b	8 (26.7)^a	7 (23.3)^a	.004
Forms of payment accepted, N (%)
ATM on site	147 (98.0)	1	28 (93.3)	30 (100.0)	30 (100.0)	30 (100.0)	29 (96.7)	.245
Cash	133 (88.7)	.63	30 (100.0)^b	23 (76.7)^a	30 (100.0)^b	29 (96.7)^a,b	21 (70.0)^a	<.001
Debit card	64 (42.7)	.99	25 (83.3)^b	7 (23.3)^a	8 (26.7)^a	12 (40.0)^a	12 (40.0)^a	<.001
Credit card	14 (9.3)	.96	1 (3.3)^a,b	2 (6.7)^a,b	0 (0)^b	2 (6.7)^a,b	9 (30.0)^a	<.001

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Notes: Kappas are for initial inter-rater reliability among pairs of point-of-sale auditors. Superscript letters indicate significant differences in post-hoc analyses.

Point-of-Sale (POS) Assessment.

Adapted from previously-published brick-and-mortar^22,23 and online²⁴ cannabis retail audit protocols, the POS assessment tool (duration 15–45 minutes) assessed: retailer characteristics; regulation-related factors; cannabis advertisement and promotion; cannabis product availability and prices; and other products sold/advertised; see Tables 1–4 for details regarding all codes for each assessment summarized below. After data collection was complete, the staff pairs discussed and reconciled all discrepancies.

Table 4.

Cannabis products and prices at 150 cannabis retailers across 5 US cities in Summer 2022

			Denver	Seattle	Portland	Las Vegas	LA
	Total		N=30	N=30	N=30	N=30	N=30
Variable	N=150		(20.0%)	(20.0%)	(20.0%)	(20.0%)	(20.0%)
	N (%)	Kappa	N (%)	N (%)	N (%)	N (%)	N (%)	p

Cannabis products available, N (%)
Bud/flower, joints, e-liquids, edibles, oils	150 (100.0)	--	30 (100.0)	30 (100.0)	30 (100.0)	30 (100.0)	30 (100.0)	--
Hash	149 (99.3)	1	30 (100.0)	30 (100.0)	30 (100.0)	30 (100.0)	29 (96.7)	.402
Topicals	142 (94.7)	.94	26 (86.7)	30 (100.0)	30 (100.0)	30 (100.0)	26 (86.7)	.013
Beverages	137 (91.3)	.81	28 (93.3)	30 (100.0)	25 (83.3)	24 (80.0)	30 (100.0)	.011
Tinctures	107 (71.3)	.95	20 (66.7)^b	30 (100.0)^a,c	0 (0)^d	30 (100.0)^c	27 (90.0)^a,b,c	<.001
Clones	7 (4.7)	1	0 (0)	0 (0)	5 (16.7)	0 (0)	2 (6.7)	.006
Seeds	6 (4.0)	1	2 (6.7)	0 (0)	1 (3.3)	0 (0)	3 (10.0)	.207
Other	4 (2.7)	1	2 (6.7)	2(6.7)	0 (0)	0 (0)	0 (0)	.187
Most potent cannabis product sold, N (%) ^*
E-liquids	57 (38.0)	.98	0 (0)^b	12 (40.0)^a,c	27 (90.0)^d	12 (40.0)^c	6 (20.0)^a,b,c	<.001
Oils	37 (24.7)	.98	8 (26.7)^a,b,c	12 (40.0)^a,c	1 (3.3)^b	11 (36.7)^c	5 (16.7)^a,b,c	.006
Hash	25 (16.7)	.98	18 (60.0)^b	4 (13.3)^a	2 (6.7)^a	0 (0)^a	1 (3.3)^a	<.001
Tinctures	20 (13.3)	.93	1 (3.3)^b	1 (3.3)^b	0 (0)^b	4 (13.3)^b	14 (46.7)^a	<.001
Bud/flower	9 (6.0)	1	1 (3.3)	0 (0)	0 (0)	3 (10.0)	5 (16.7)	.025
Joints	6 (4.0)	.33	0 (0)	0 (0)	4 (13.3)	1 (3.3)	1 (3.3)	.052
Least potent cannabis product sold, N (%) ^*
Edibles	80 (53.3)	.96	15 (50.0)^a	27 (90.0)^b	0 (0)^c	24 (80.0)^a,b	14 (46.7)^a	<.001
Joints	16 (10.7)	.93	5 (16.7)^a,b	1 (3.3)^a,b	0 (0)^b	2 (6.7)^a,b	8 (26.7)^a	.005
Beverages	13 (8.7)	1	0 (0)^a	2 (6.7)^a,b	1 (3.3)^a,b	7 (23.3)^b	3 (10.0)^a,b	.015
Bud/flower	11 (7.3)	1	10 (33.3)^b	0 (0)^a	0 (0)^a	0 (0)^a	1 (3.3)^a	<.001
Most expensive cannabis product sold, N (%) ^{^}
Bud/flower	87 (58.0)	1	15 (50.0)^a	25 (83.3)^a,b	0 (0)^c	28 (93.3)^b	19 (63.3)^a	<.001
Hash	10 (6.7)	1	6 (20.0)	1 (3.3)	0 (0)	0 (0)	3 (10.0)	.008
Tinctures	7 (4.7)	.93	0 (0)	1 (3.3)	1 (3.3)	0 (0)	5 (16.7)	.012
E-liquids	6 (4.0)	1	3 (10.0)	1 (3.3)	0 (0)	1 (3.3)	1 (3.3)	.384
Topicals	4 (2.7)	1	3 (10.0)	1 (3.3)	0 (0)	0 (0)	0 (0)	.068
Oils	4 (2.7)	1	0 (0)	3 (10.0)	0 (0)	1 (3.3)	0 (0)	.068
Least expensive cannabis product sold, N (%) ^{^}
Joints	81 (54.0)	1	21 (70.0)^a	21 (70.0)^a	0 (0)^b	17 (56.7)^a	22 (73.3)^a	<.001
Edibles	35 (23.3)	.98	7 (23.3)	9 (30.0)	5 (16.7)	6 (20.0)	8 (26.7)	.761
Bud/flower	19 (12.7)	.97	4 (13.3)^a,b	2 (6.7)^a	11 (36.7)^b	0 (0)^a	2 (6.7)^a	<.001
Beverages	15 (10.0)	1	2 (6.7)^a,b	1 (3.3)^a,b	0 (0)^a	9 (30.0)^b	3 (10.0)^a,b	<.001
Paraphernalia, apparel, etc. sold, N (%) ^¥
Vaporizers	139 (92.7)	.94	26 (86.7)	30 (100.0)	29 (96.7)	28 (93.3)	26 (86.7)	.179
Wrapping papers	138 (92.0)	1	25 (83.3)^a,b	30 (100.0)^b	30 (100.0)^b	30 (100.0)^b	23 (76.7)^a	<.001
Hookah pipes/waterpipes/bongs	122 (81.3)	1	25 (83.3)^a,b	27 (90.0)^b	28 (93.3)^b	27 (90.0)^b	15 (50.0)^a	<.001
Apparel	93 (62.0)	.94	25 (83.3)^a	1 (3.3)^b	25 (83.3)^a	24 (80.0)^a	18 (60.0)^a	<.001
Other glassware	84 (56.0)	.90	26 (86.7)^c	9 (30.0)^a,b	24 (80.0)^c	18 (60.0)^b,c	7 (23.3)^a	<.001

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Notes: Kappas are for initial inter-rater reliability among pairs of point-of-sale auditors. Superscript letters indicate significant differences in post-hoc analyses.

Other most potent: edibles n=2, beverages n=1, other n=9. Other least potent: e-liquids n=1, tinctures n=1, other n=1.

^{^}

Other most expensive product: joints n=1, edibles n=1, other n=4. Other least expensive: oils n=2, tinctures n=2, topicals n=1.

^¥

Other paraphernalia, apparel, etc.: art, candy machine, chocolates, dog toys, eye drops, greeting cards, hats, journals, immunity boost drinks, candy, snacks.

Retailer characteristics.

POS auditors coded: store type (i.e., recreational-only, recreational/medicinal); building/structure type (e.g., storefront); structural features (e.g., security cameras/guards, attached to consumer lounge); media types for outside the store (e.g., light-up signs, digital signs) and inside the store (e.g., chalkboards/whiteboards, TV/other screens); and forms of payment accepted (e.g., cash, credit card).

Regulation-related factors.

POS auditors recorded whether they were asked to provide their ID (as with mystery shoppers) and whether anyone was using cannabis inside or outside the store, or seemed intoxicated inside the store.

For both inside and outside (separately), POS auditors also recorded: regulation-related signage posted (e.g., retail license posted; no minors; no onsite consumption); warning-related signage (e.g., pregnancy/breastfeeding; driving under the influence [DUI]; harm to health); and visibility of these signs (e.g., difficult to see because of location).

Cannabis product advertisement/promotion.

POS auditors coded: ads/signs indicating health benefits/claims; youth-oriented signs; youth-oriented packaging; and signs/promotions targeting special populations (e.g., teens/young adults, LGBTQ+; see Supplementary Table 2 for codes and code definitions/examples). “Health benefits/claims” and “youth-oriented” were defined referencing states’ definitions (see Supplementary Table 1).

POS auditors also coded (for inside and outside) whether there were cannabis product ads/signage indicating: price promotions; showing actual cannabis use; emphasizing “research”; promoting free products; celebrity endorsements; etc. They also assessed cannabis price promotions (e.g., daily/weekly/monthly specials) and signage regarding online sales and/or delivery. Additional assessments included other promotional messages (e.g., website or social media promotion) and take-away materials (e.g., product menus).

Cannabis product availability and prices.

POS auditors coded cannabis products sold (e.g., bud/flower; joints/pre-rolled; e-liquids; edibles), as well as the potency and form of the most and least potent products sold. They also coded the most and least expensive cannabis product sold (per dose) and the respective cost (pre-tax).

Other products sold/advertised.

POS auditors assessed whether the store sold paraphernalia, apparel, or other outside products (e.g., glassware, apparel), and if available, content the paraphernalia/apparel featured (e.g., store itself, targeting specific populations). They also coded other products sold (e.g., CBD, delta-8 THC), and related ads.

Data Analysis

Analyses were conducted using SPSS v28.0 and alpha=.05. To determine initial inter-rater reliability, we computed kappas for categorical variables and intra-class correlations (ICCs) for continuous variables. Almost all initial kappa values exceeded .70 (representing good agreement), with very few below .40 (adequate agreement; i.e., products highest/lowest in potency of .27).⁵⁸ Descriptive and bivariate analyses (Chi-square tests, Fisher’s exact tests) were used to characterize the sample and differences across cities.

RESULTS

Regulatory Compliance & Regulation-related Signage

Table 1 provides an overview of retailer characteristics (62.7% recreational/medical, 37.3% recreational). Retailers were found within 2 blocks of youth-oriented facilities (schools: 14.3%; parks/playgrounds: 8.6%), most frequently in LA (where the required distance was 600 feet vs. 1,000 feet elsewhere, e.g., 53.3% for schools in LA vs. <10% elsewhere, p’s<.001, Table 2). Retailers were also located within 2 blocks of public transportation (14.3%) and other locations related to licit drug consumption (bars/pubs/clubs: 30.0%, liquor stores: 11.4%; other cannabis retailers: 7.1%).

Table 2.

Regulatory compliance and regulation-related signage at 150 cannabis retailers across 5 US cities in Summer 2022

	Total		Denver	Seattle	Portland	Las Vegas	LA
Variable	N (%)	Kappa	N (%)	N (%)	N (%)	N (%)	N (%)	p

			N=30	N=30	N=30	N=20	N=30
Mystery Shopper Data	N=140		(21.4%)	(21.4%)	(21.4%)	(14.3%)	(21.4%)

Within 2 blocks, N (%)		--
Schools	20 (14.3)		0 (0)^a	0 (0)^a	2 (6.7)^a	2 (10.0)^a	16 (53.3)^b	<.001
Parks/playgrounds	11 (7.9)		0 (0)^a	1 (3.3)^a	1 (3.3)^a	1 (5.0)^a	8 (26.7)^b	<.001
Other youth-oriented establishments	8 (5.7)		3 (10.0)	1 (3.3)	0 (0)	2 (10.0)	2 (6.7)	.421
Public transit	20 (14.3)		4 (13.3)	8 (26.7)	5 (16.7)	1 (5.0)	2 (6.7)	.150
Medical clinic	14 (10.0)		0 (0)^a	0 (0)^a	0 (0)^a	4 (20.0)^a,b	10 (33.3)^b	<.001
Bar/pub/club	42 (30.0)		10 (33.3)^a	11 (36.7)^a	6 (20.0)^a,b	12 (60.0)^b	3 (10.0)^a,b	.002
Liquor store	16 (11.4)		12 (40.0)^a	2 (6.7)^b	0 (0)^b	1 (3.3)^b	1 (5.0)^b	<.001
Casinos	6 (4.3)		0 (0)^a	0 (0)^a	0 (0)^a	6 (30.0)^b	0 (0)^a	<.001
Other cannabis retailer	10 (7.1)		4 (13.3)	5 (16.7)	0 (0)	1 (5.0)	0 (0)	.032
Asked to provide ID, N (%)		--						<.001
No	9 (6.5)		0 (0)^a	1 (3.3)^a	8 (27.6)^b	0 (0)^a	0 (0)^a
Yes, immediately upon entry	125 (89.9)		29 (96.7)^a	28 (93.3)^a	18 (62.1)^b	20 (100.0)^a	30 (100.0)^a
Yes, but not immediately upon entry	5 (2.9)		1 (3.3)	1 (3.3)	3 (10.3)	0 (0)	0 (0)

			N=30	N=30	N=30	N=30	N=30
POS Audit Data	N=150		(20.0%)	(20.0%)	(20.0%)	(20.0%)	(20.0%)

Asked to provide ID, N (%)		.96						.020
No	7 (4.7)		0 (0)	1 (3.3)	5 (16.7)	0 (0)	1 (3.3)
Yes, immediately upon entry	137 (91.3)		30 (100.0)^a,b	27 (90.0)^a,b	24 (80.0)^a	30 (100.0)^b	29 (96.7)^a,b
Yes, but not immediately upon entry	3 (2.0)		0 (0)	2 (6.7)	1 (3.3)	0 (0)	0 (0)
Onsite use and intoxication, N (%)
Cannabis use inside the store	1 (0.7)	0	0 (0)	0 (0)	0 (0)	0 (0)	1 (3.3)	.388
Cannabis use outside the store	6 (4.0)	.66	1 (3.3)	1 (3.3)	0 (0)	2 (6.7)	2 (6.7)	.657
Anyone seemingly intoxicated inside the store	7 (4.7)	.92	1 (3.3)	4 (13.3)	0 (0)	0 (0)	2 (6.7)	.078
Regulation-related signage, N (%) ^*
Retail license posted	131 (87.3)	.90	24 (80.0)^a,b	22 (73.3)^a	30 (100.0)^a,b	27 (90.0)^a,b	28 (93.3)^a,b	.015
Restricted access - no minors allowed	131 (87.3)	.87	30 (100.0)^a	29 (96.7)^a	29 (96.7)^a	29 (96.7)^a	14 (46.7)^b	<.001
No onsite consumption	110 (73.3)	.93	8 (26.7)^a	28 (93.3)^b	24 (80.0)^b	28 (93.3)^b	22 (73.3)^b	<.001
No distribution to minors	80 (53.3)	.84	2 (6.7)^a	28 (93.3)^b	20 (66.7)^b	21 (70.0)^b	9 (30.0)^a	<.001
Security cameras in use	73 (48.7)	.96	8 (26.7)^a	16 (53.3)^a,b	17 (56.7)^a,b	22 (73.3)^b	10 (33.3)^a	.002
Limits on purchase amount	47 (31.3)	.98	3 (10.0)^a	2 (6.7)^a	15 (50.0)^b	26 (86.7)^c	1 (3.3)^a	<.001
Transport across state lines prohibited	38 (25.3)	.98	3 (10.0)^a	0 (0)^a	13 (43.3)^b	22 (73.3)^b	0 (0)^a	<.001
Right to refuse service to those intoxicated	34 (22.7)	.86	3 (10.0)	4 (13.3)	10 (33.3)	10 (33.3)	7 (23.3)	.087
Cannabis health warning signage, N (%) ^* ^{^}
Pregnancy/breastfeeding	108 (72.0)	1.00	20 (66.7)^a	29 (96.7)^b	26 (86.7)^b	13 (43.3)^a	20 (66.7)^a	<.001
Harm to health	57 (38.0)	.98	1 (3.3)^a	28 (93.3)^b	1 (3.3)^a	6 (20.0)^a	21 (70.0)^b	<.001
Negative impacts on children/youth	28 (18.7)	.43	0 (0)^a	1 (3.3)^a	1 (3.3)^a	10 (33.3)^b	16 (53.3)^b	<.001
DUI	21 (14.0)	.97	9 (30.0)^a	9 (30.0)^a	0 (0)^b	3 (10.0)^a,b	0 (0)^b	<.001
Child access	8 (5.3)	1.00	0 (0)^a	0 (0)^a	1 (3.3)^a,b	7 (23.3)^b	0 (0)^a	<.001
Addiction	6 (4.0)	1.00	0 (0)	6 (20.0)	0 (0)	0 (0)	0 (0)	<.001
Other physical or mental health	5 (3.3)	.91	2 (6.7)	0 (0)	2 (6.7)	1 (3.3)	0 (0)	.388
Amount of THC cautions	5 (3.3)	.79	0 (0)	0 (0)	0 (0)	4 (13.3)	1 (3.3)	.015
Overconsumption	5 (3.3)	1.00	1 (3.3)	0 (0)	0 (0)	3 (10.0)	1 (3.3)	.184
Serving size cautions	4 (2.7)	1.00	0 (0)	1 (3.3)	0 (0)	3 (10.0)	0 (0)	.068
Negative interactions with alcohol/drugs	1 (0.7)	1.00	0 (0)	0 (0)	0 (0)	1 (3.3)	0 (0)	.402
Nature of regulation-related signage, N (%) ^*^#
Difficult to see because of location	31 (20.7)		1 (3.3)^a	4 (13.3)^a,b	3 (10.0)^a,b	13 (43.3)^c	10 (33.3)^c	<.001
Difficult to see; covered by other signs/materials	3 (2.0)		2 (6.7)	0 (0)	0 (0)	1 (3.3)	0 (0)	.245
Other (tiny font, printed onto glass door)	10 (6.7)		1 (2.2)	3 (10.0)	0 (0)	4 (13.3)	2 (6.7)	.253

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Notes: Kappas are for initial inter-rater reliability among pairs of point-of-sale auditors. Superscript letters indicate significant differences in post-hoc analyses.

Interior or exterior.

^{^}

None referenced poisoning.

None damaged, torn, etc.

Mystery shoppers were required to show ID immediately upon entry at 89.9% of retailers; 2.9% asked later and 6.5% never asked, most frequently in Portland (27.6% vs. <3% elsewhere, p<.001), despite no differences in age-verification regulations. This pattern was similar for POS auditors (91.3% immediately, 2.0% later, 6.5% never, most frequently in Portland). In all sites except LA, onsite consumption (inside or outside) was prohibited. Intoxicated patrons were suspected at 4.7%, and on-premise cannabis use inside and outside was 0.7% and 4.0%, respectively (4.2%, 0%, and 3.3% excluding LA).

All states but California required signage indicating restricted access and no onsite consumption, which was posted in 87.3% and 73.3% (97.5% and 81.7% excluding LA); Denver retailers least frequently posted no onsite consumption signs (26.7% vs. ≥73.3% elsewhere, p<.001). Nevada was the only state that required signs indicating no distribution to minors, yet 53.3% of all retailers posted such signs, most frequently in Las Vegas (70.0%), Seattle (93.3%), and Portland (66.7%, p<.001). Nevada was also the only state that required signage indicating purchase/possession limits and no transport across state lines; this occurred in 86.7% and 73.3% of Las Vegas retailers, respectively, but infrequently elsewhere (≤50% and 43.3%; overall 31.3% and 25.3%, p<.001). Colorado was the only state that required signage indicating right to refuse service to those intoxicated, but this signage occurred infrequently among Denver retailers (10.0%) and overall (22.7%).

All 5 states required health warning signage regarding use during pregnancy, found in 72.0% of retailers, least frequently in Las Vegas (43.3%), LA (66.7%), and Denver (66.7%, p<.001). Health harms signage, only required in California, was found in 38.0% of retailers; this occurred most frequently in LA (70.0%) and Seattle (93.3% vs. ≤20% elsewhere, p<.001). Only 18.7% posted warning signage indicating negative impacts on children/youth, only required in Nevada where 33.3% were compliant. Colorado and Nevada required DUI warning signage, which occurred in 14.0% overall, 30.0% in Denver, and 10.0% in Las Vegas (p<.001). Very few (<6%) posted warning signage related to child access, addiction, other physical/mental health risks, amount of THC cautions, overconsumption, serving size cautions, negative interactions with alcohol/drugs, or poisoning. In 20.7%, regulation-related signage was difficult to see due to the location posted, most frequently in Las Vegas (43.3%) and LA (33.3% vs. ≤13.3% elsewhere, p<.001).

Advertising & Promotional Strategies

Although Colorado, Washington, and Oregon explicitly prohibited health claims in advertising, 28.7% had signage with health claims (17.3% excluding LA and Las Vegas; Table 3). Additionally, 20.7% displayed youth-oriented signage, and 18.0% youth-oriented packaging (most frequently in Denver: 43.3% and 53.3% vs. ≤20% elsewhere, p’s<.01).

Table 3.

Cannabis advertising and promotion among 150 cannabis retailers across 5 US cities in Summer 2022

			Denver	Seattle	Portland	Las Vegas	LA
	Total		N=30	N=30	N=30	N=30	N=30
Variable	N=150		(20.0%)	(20.0%)	(20.0%)	(20.0%)	(20.0%)
	N (%)	Kappa	N (%)	N (%)	N (%)	N (%)	N (%)	p

Signage with cannabis health claims, N (%) ^*	43 (28.7)	.88	10 (33.3)	7 (16.3)	9 (30.0)	8 (26.7)	9 (30.0)	.932
Youth-oriented signage, N (%) ^*^§	31 (20.7)	.83	13 (43.3)^a	6 (20.0)^a,b	6 (20.0)^a,b	3 (10.0)^b	3 (10.0)^b	.009
Youth-oriented product packaging, N (%) ^§	27 (18.0)	.89	16 (53.3)^b	3 (10.0)^a,c,d,e	0 (0)^c,e	2 (6.7)^d,e	6 (20.0)^a,b,c,d,e	<.001
Signage targeting special populations, N (%)
LGBTQ+	16 (10.7)	.92	4 (13.3)	7 (23.3)	1 (3.3)	1 (3.3)	3 (10.0)	.070
Teens/young adults	14 (9.3)	.84	9 (30.0)^a	2 (6.7)^a,b	0 (0)^b	2 (6.7)^a,b	1 (3.3)^a,b	<.001
Racial/ethnic minority	6 (4.0)	.76	0 (0)	2 (6.7)	3 (10.0)	1 (3.3)	0 (0)	.207
Veterans	4 (2.7)	.74	1 (3.3)	2 (6.7)	0 (0)	1 (3.3)	0 (0)	.463
Seniors	4 (2.7)	.85	1 (3.3)	2 (6.7)	0 (0)	1 (3.3)	0 (0)	.463
Pregnant/postpartum women	1 (0.7)	1	0 (0)	1 (3.3)	0 (0)	0 (0)	0 (0)	.402
Other ^#	9 (6.0)	.76	1 (3.3)	0 (0)	1 (3.3)	3 (10.0)	4 (13.3)	.172
Ad content, N (%) ^*^{^ &}
Pop culture references	23 (15.3)	.84	6 (20.0)	3 (10.0)	8 (26.7)	3 (10.0)	3 (10.0)	.245
Emphasizing research or science	22 (14.7)	.84	5 (16.7)^a,b	10 (33.3)^a	3 (10.0)^a,b	3 (10.0)^a,b	1 (3.3)^b	.014
Showing actual use	13 (8.7)	.92	5 (16.7)	3 (10.0)	0 (0)	3 (10.0)	2 (6.7)	.235
Celebrity endorsements	11 (7.3)	.78	1 (3.3)	3 (10.0)	0 (0)	4 (13.3)	3 (10.0)	.258
Promoting free products/giveaways	8 (5.3)	.65	2 (6.7)	0 (0)	1 (3.3)	3 (10.0)	2 (6.7)	.488
Promoting intoxication	4 (2.7)	.85	0 (0)	1 (3.3)	0 (0)	0 (0)	3 (10.0)	.068
Targeting out of state customers	3 (2.0)	.66	1 (3.3)	0 (0)	1 (3.3)	1 (3.3)	0 (0)	.728
References to school	3 (2.0)	1.00	1 (3.3)	0 (0)	0 (0)	1 (3.3)	1 (3.3)	.728
Any exterior price promotions, N (%) ^£	17 (11.3)	.75	1 (3.3)^a	1 (3.3)^a	0 (0)^a	5 (16.7)^a,b	10 (33.3)^b	<.001
Interior cannabis price promotions, N (%) ^£
Price specials	113 (75.3)	.83	22 (73.3)	23 (76.7)	23 (76.7)	20 (66.7)	25 (83.3)	.668
Daily/weekly/month specials	100 (66.7)	.92	21 (70.0)	23 (76.7)	23 (76.7)	19 (63.3)	14 (46.7)	.078
Membership programs	59 (39.3)	.91	18 (60.0)^a	8 (26.7)^a,b	7 (23.3)^b	17 (56.7)^a,b	9 (30.0)^a,b	.004
Almost free products	23 (15.3)	.73	10 (33.3)^a	0 (0)^b,c	0 (0)^c	6 (20.0)^a,b,c	7 (23.3)^a	<.001
Drawings or raffles	20 (13.3)	.89	3 (10.0)^a,b	1 (3.3)^a	2 (6.7)^a,b	10 (33.3)^b	4 (13.3)^a,b	.006
Happy hour specials	19 (12.7)	.93	3 (10.0)	2 (6.7)	6 (20.0)	4 (13.3)	4 (13.3)	.618
Free product	12 (8.0)	.83	3 (10.0)	0 (0)	2 (6.7)	3 (10.0)	4 (13.3)	.384
Incentives/discounts for review on social media	12 (8.0)	.96	6 (20.0)	0 (0)	4 (13.3)	2 (6.7)	0 (0)	.015
Discounts for first-time customers	12 (8.0)	.89	4 (13.3)	0 (0)	2 (6.7)	5 (16.7)	1 (3.3)	.100
Discounts for military/veterans	12 (8.0)	.89	1 (3.3)^a,b	2 (6.7)^a,b	0 (0)^a	7 (23.3)^b	2 (6.7)^a,b	.010
Product of day/week/month	9 (6.0)	.71	4 (13.3)	2 (6.7)	0 (0)	1 (3.3)	2 (6.7)	.267
Bargain bins	6 (4.0)	1	1 (3.3)	1 (3.3)	4 (13.3)	0 (0)	0 (0)	.052
Early bird specials	5 (3.3)	.89	1 (3.3)	1 (3.3)	2 (6.7)	0 (0)	1 (3.3)	.723
Discounts for college students	5 (3.3)	1	1 (3.3)	0 (0)	0 (0)	3 (10.0)	1 (3.3)	.184
Other ^¥	29 (19.3)	.88	9 (30.0)^a,b	1 (3.3)^b	1 (3.3)^b	4 (13.3)^b	14 (46.7)^a	<.001
Signs/promotions for ordering/delivery, N (%)
Curbside delivery or pick up	42 (28.0)	.98	2 (6.7)^a	10 (33.3)^a,b	7 (23.3)^a,b	17 (56.7)^b	6 (20.0)^a	<.001
Online ordering	38 (25.3)	.95	13 (43.3)^b,c	17 (56.7)^c	5 (16.7)^a,b	1 (3.3)^a	2 (6.7)^a	<.001
Home delivery	20 (13.4)	.96	3 (10.0)^a,b	0 (0)^a	2 (6.7)^a,b	10 (33.3)^b	5 (16.7)^a,b	.001
Drive through	2 (1.3)	1	1 (3.3)	0 (0)	0 (0)	3 (10.0)	0 (0)	.068
Other signs/promotions, N (%)
Website or social media for own product line	97 (64.7)	.90	17 (56.7)^a	1 (3.3)^c	26 (86.7)^a,b	28 (93.3)^b	25 (83.3)^a,b	<.001
Website or social media for other brand	26 (17.3)	.69	4 (13.3)^a,b	0 (0)^a	10 (33.3)^b	6 (20.0)^a,b	6 (20.0)^a,b	.015
Information about how to get medical card	15 (10.0)	1	10 (33.3)^b	0 (0)^a	0 (0)^a	4 (13.3)^a,b	1 (3.3)^a	<.001
Indicates store’s sponsorship of local events	10 (6.7)	.73	1 (3.3)	2 (6.7)	0 (0)	3 (10.0)	4 (13.3)	.253
Information about medical/mental resources	9 (6.0)	.87	9 (30.0)^b	0 (0)^a	0 (0)^a	0 (0)^a	0 (0)^a	<.001
Promotes who owns store	7 (4.7)	.89	0 (0)	1 (3.3	1 (3.3)	2 (6.7)	3 (10.0)	.420
Posted requirements of medical card needed	4 (2.7)	1	3 (10.0)	0 (0)	0 (0)	1 (3.3)	0 (0)	.068
Take-away materials, N (%)
Product menus	79 (52.7)	.93	1 (3.3)^b	5 (16.7)^b	27 (90.0)^a	25 (83.3)^a	21 (70.0)^a	<.001
Product flyers	57 (38.0)	.83	4 (13.3)^c	3 (10.0)^c	22 (73.3)^a	11 (36.7)^b,c	17 (56.7)^a,b	<.001
Brand flyers	57 (38.0)	.87	15 (50.0)^a	12 (40.0)^a	0 (0)^b	11 (36.7)^a	19 (63.3)^a	<.001
Magazines	52 (34.7)	.95	15 (50.0)^b,c	14 (46.7)^b,c	17 (56.7)^c	6 (20.0)^a,b	0 (0)^a	<.001
Retailer flyers	40 (26.7)	.83	0 (0)^c	0 (0)^c	23 (76.7)^b	10 (33.3)^a	7 (23.3)^a	<.001
Flyers for events	17 (11.3)	.81	4 (13.3)	6 (20.0)	0 (0)	1 (3.3)	6 (20.0)	.035
Information about medical/mental resources	14 (9.3)	.96	14 (46.7)^b	0 (0)^a	0 (0)^a	0 (0)^a	0 (0)^a	<.001
Information about how to get medical card	13 (8.7)	.96	10 (33.3)^b	0 (0)^a	0 (0)^a	2 (6.7)^a,b	1 (3.3)^a	<.001

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Notes: Kappa are for initial inter-rater reliability among pairs of point-of-sale auditors. Superscript letters indicate significant differences in post-hoc analyses.

Interior or exterior.

^§

Instructions: Examples might include images of minors (i.e., looking to be under 21), cartoons, toys, candy, brands (e.g., of non-cannabis products) or similar images and items typically marketed towards minors, likeness to characters (e.g., movie, cartoon, action figures, mascots, balloons/inflatables) popularly used to advertise to children, symbols or celebrities that are commonly used to market products to minors, or flavors (e.g., fruit) popular with minors.

Other included: athletes, frontline workers, industry workers, women, etc.

^{^}

None compared the safety of cannabis to alcohol, tobacco, or other drugs.

Ads defined as: 8.5 × 11 inches or larger; branded with intent to sell product; either professionally-made and/or amateur (hand-written); and not limited to signage.

^£

Price promotions defined as: Any discounts on products. “Any price promotions” recorded for outdoor only; assessments for indoor promotions detailed as noted.

^¥

Other included: summertime discounts; backpack filled with flower 25% off; birthday discount; discount cards; discount for medical card holders; discount for sports jersey; discounts for women on Mondays; refer a friend; show hotel key and get discount; social security disability discount; Wednesdays 10% off online orders, etc.

Other specially-targeted populations included LGBTQ+ (10.7%) and teens/young adults (9.3%, most often in Denver, 30.0% vs. ≤6.7% elsewhere, p<.001). Ad content featured various messaging/imagery; 15.3% depicted pop culture, 14.7% research/science, 8.7% actual use, and 7.3% celebrity endorsements. Despite all states but Colorado prohibiting free samples, 5.3% posted ads indicating free products/giveaways (7.5% excluding Denver).

While only 11.3% posted exterior signage indicating cannabis price promotions, large proportions used general price specials (75.3%) and daily/weekly/monthly specials (66.7%), 39.3% membership programs (particularly in Denver [60.0%] and Las Vegas [56.7%]), 13.3% drawings/raffles, 12.7% happy hour specials, 8.0% giveaways, and 15.3% almost free products (i.e., <$1, product in exchange for donation).

Overall, 28.0% had signs/promotions indicating curbside delivery/pick-up, most frequently in Las Vegas (56.7%) and Seattle (33.3%). Online ordering and home delivery were promoted by 25.3% and 13.4%. Washington was the only state of the 5 that prohibited online ordering and home delivery; while home delivery was not indicated at any Seattle retailer, online ordering was documented in 56.7% of Seattle retailers – the highest proportion of retailers across cities. Two-thirds (64.7%) promoted their website or social media page, 52.7% provided product menus, and 38.0% circulated product/brand flyers.

Products & Pricing

All retailers sold bud/flower, joints, e-liquids, edibles, and oils, >90% sold hash, topicals, beverages, and tinctures, and <5% sold clones or seeds (Table 4). The most potent products sold were frequently e-liquids (38.0%) or oils (24.7%), with potency ranging from 93% THC (Denver) to 99% THC (elsewhere), and 600 mg THC (Seattle) to 3500 mg THC (Las Vegas and LA; not in tables), exceeding limits imposed in Washington and Oregon. The least potent product sold was frequently edibles (53.0%), with potency ranging from 1% THC (Las Vegas) to 6% THC (Denver), and 0.25 mg THC (Denver) to 1 mg THC (Las Vegas).

The most expensive product was frequently bud/flower (58.0%), and ranged from $35.00 (Denver) to $500 (Seattle; not in tables). The least expensive product was frequently single joints (54.0%) or edibles (23.3%), and ranged from $1.00 (Portland) to $20.00 (LA).

Almost all (≥92%) sold vaporizers and wrapping papers, 81.3% hookah/waterpipes/bongs, 56.0% other glassware, and 62.0% apparel. Among those with paraphernalia/apparel, content featured on paraphernalia/apparel included: store (57.3%), cannabis brand (11.3%), and images/language targeting specific populations (e.g., LGBTQ+; 2.0%). Regarding other consumable substances, in all sites, CBD products were allowed; all but Seattle and Las Vegas allowed synthetic THC. In this sample, 22.6% sold CBD products, and 1 sold delta-8/O/10 (LA); other products were rarely sold. There were no ads for other products, except 7.3% CBD.

DISCUSSION

This study yielded novel, timely data regarding regulatory compliance and marketing among cannabis retailers in 5 US cities with different state regulations regarding cannabis retail. Findings underscore concerns regarding regulatory compliance, targeting of young people, underage access, and the diversity of cannabis products, pricing strategies, and advertising efforts.

Roughly 10% of cannabis retailers were found within 2 blocks of youth-oriented facilities (e.g., schools, parks/playgrounds), which more often occurred in LA, where zoning restrictions were shorter (600 vs. 1,000 ft). This is concerning, as retailers near such locations are particularly likely to have products appealing to youth,¹⁶ and about one-fifth of retailers in this sample had youth-oriented signage/packaging and/or content appealing to teens/young adults. These issues were most represented in Denver, despite Colorado’s regulatory language being similar to or more specific than that of the other 4 states. Ads also referenced pop culture and/or used celebrity endorsements, and nearly one-tenth posted ads depicting cannabis use, which raise concerns about impact on young people.^21,29,59,60

Furthermore, two-thirds of retailers promoted their website or social media page, and although many social media platforms prohibit paid cannabis advertising, several loopholes enable cannabis retailer promotion via social media, which has high reach to those underage.⁶¹ These findings are concerning given that cannabis marketing exposure predicts positive attitudes towards cannabis and use onset.^10–15 In addition, similar to rates noted previously,²⁴ over one-fourth of retailers had signs/promotions indicating curbside delivery/pick-up and/or online ordering, and over one-tenth promoted home delivery. These services raise concerns regarding underage access, due to ease of bypassing age verification.³⁴ Unlike the other states, Washington prohibited home delivery and online sales. Accordingly, no home delivery was documented in Seattle; however, online ordering was particularly prevalent in Seattle, as well as Denver. Despite concerns related to underage targeting and access, rates of age verification upon entry were high (~90%), similar to prior research.^22,23,31,32 Noncompliance was most frequently in Portland, although there were no major differences in age verification related regulations.

Noncompliance with required signage was common. Compliance with signage regarding restricted access and onsite consumption, required in all 5 states except California, was high on average, but ~75% of Denver retailers were noncompliant with the onsite consumption signage. Las Vegas retailers demonstrated relatively high rates of compliance with Nevada-specific required signs (i.e., no distribution to minors, limits on purchase amounts, prohibited transportation across state lines, ≥70%), while Denver retailers showed low rates of compliance with Colorado-specific required signage (i.e., right to refuse service to those intoxicated, 10%). Regarding state-required warning signage, >25% of retailers lacked warnings related to use during pregnancy (required in all 5 states; particularly low compliance in Las Vegas, LA, and Denver), >80% of Las Vegas retailers lacked warning signs regarding the negative impacts on children, 90% of Las Vegas retailers and 70% of Denver retailers lacked state-required DUI warning signs, and 30% of LA retailers lacked California-required health risk warning signs. Very few (<6%) posted warnings regarding child access, addiction, consumption-related risks/cautions, etc., and in general, the prevalence of warning signage was lower where it was not required. One question is the impact of such signage – especially given the wide range in the number of state-required regulatory and warning signage – with Nevada requiring the most signage and California requiring the least. The evidence has been mixed for such regulatory^62–64 and health warning signage,^65–67 and little research has examined how much information can be comprehended by consumers,⁶⁸ particularly at point-of-sale. Thus, one important are of future research is examining what information – and how much – is most effectively attended to and comprehended by consumers.

Over one-fourth of retailers posted signage with cannabis health claims, which may be an underestimation of health claim messaging being conveyed at the point-of-sale, as suggested by mystery shopper studies.^57,69 For example, mystery shopper research conducted in these 5 cities documented that 95.0% endorsed use for anxiety, 93.6% insomnia, 97.9% pain, and 54.3% pregnancy-related nausea.⁷⁰ Interestingly, there were no differences in the prevalence of health claims in states with vs. without such prohibitions. This regulatory concern has been documented in prior research²⁴ and represents an ongoing regulatory challenge.

Findings indicated the wide variety of products sold, in terms of cost, form/mode, and potency (among other factors), suggesting a broad range of factors likely playing a role in consumer decisions among various consumer segments.^27,28 We also documented extremely high potencies (up to 99% THC or 3500 mg THC), underscoring noncompliance in 2 sites with potency limits, and more general concerns about the availability and implications of these high-potency products.⁷¹ Regarding other products, most retailers sold products to facilitate cannabis use (e.g., vaporizers, wrapping papers, glassware), but rarely other consumable products (e.g., synthetic THC).

Cannabis price promotions were prevalent and most frequently included general price specials, daily/weekly/monthly specials, and membership programs, consistent with prior research.^22,24,30 Additionally, 5–8% promoted and/or offered free products/giveaways. The prevalence of price-minimizing strategies is concerning, given their impact on use,^72,73 particularly among more price-sensitive subpopulations (e.g., young adults, women, lower-income individuals).⁷⁴

Limitations

Limitations include retailer representativeness and generalizability of findings, given that this was a randomly-selected sample of 150 retailers in 5 US cities. Moreover, as noted in Supplementary Table 1, not all regulations in each state were clearly specified; thus, in presenting findings, we used caution in asserting compliance vs. noncompliance. Additionally, specific audit forms were not created for each site; thus, assessments of such factors (e.g., health claims, youth-oriented signage) used definitions from core concepts across state regulatory language. Another limitation is that proximity to specific locations (e.g., schools) was based on mystery shopper surveillance of the 2-block radius from each retailer, a common method used in systematic social observation studies as a practical way to conduct in-the-field data collection.⁷⁵ However, this distance does not perfectly reflect the 1,000-foot radius relevant to several state zoning regulations. Nonetheless, study strengths include the inclusion of a relatively large and diversified sample across states and providing timely data regarding cannabis retail practices and marketing across several cities with different regulations.

Conclusions

Current findings highlight concerns about regulatory compliance and marketing strategies used by cannabis retailers, particularly their impact on young people. We documented suboptimal age verification rates, noncompliance with required signage, marketing content targeting young people and other key populations (LGBTQ+), and promotional activities that may impact subpopulations differently. While some differences across cities reflected variations in regulations, others did not, potentially indicating implementation and enforcement gaps. Thus, as cannabis markets emerge and evolve, ongoing surveillance is necessary to inform cannabis retail regulatory efforts, including enforcement, and to protect consumers.

Supplementary Material

Supplementary Figure 1. Retailer selection flowchart

Supplementary Table 1. State and local policy context for 5 cities/states, 2022

Supplementary Table 2. Code definitions and examples

NIHMS1888109-supplement-1.docx^{(67.6KB, docx)}

HIGHLIGHTS.

Cannabis retail surveillance is crucial to inform regulations and protect consumers.
Among 150 US retailers in 2022, >90% verified age, but 20.7% had youth-oriented signs.
Required health warnings was absent in many cities, but 28.7% posted health claims.
Product availability, potency, and prices varied, and >75% had price promotions.
Differing practices across cities reflected both distinct laws and enforcement gaps.

Acknowledgements

This work was supported by the National Institute on Drug Abuse (R01DA054751-01A1, MPIs: Berg, Cavazos-Rehg). Dr. Berg is also sup-ported by other US National Institutes of Health funding, including the National Cancer Institute (R01CA215155-01A1, PI: Berg; R01CA239178-01A1, MPIs: Berg, Levine; R21 CA261884-01A1, MPIs: Berg, Arem; R01CA278229-01, MPIs: Berg, Kegler), the Fogarty Inter-national Center (R01TW010664-01, MPIs: Berg, Kegler; D43 TW012456-01A1; MPIs: Berg, Paichadze, Petrosyan), and the National Institute of Environmental Health Sciences/Fogarty (D43ES030927-01, MPIs: Berg, Caudle, Sturua). Dr. Romm is supported by the National Institute on Drug Abuse (R25DA054015; MPIs: Obasi, Reitzel), the Oklahoma Tobacco Settlement Endowment Trust (TSET) contract #R22- 03, and the National Cancer Institute grant awarded to the Stephenson Cancer Center (P30CA225520). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpre-tation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Footnotes

Conflict of Interest: The authors declare no conflicts of interest.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Author Credit Statement

Carla J. Berg: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. Katelyn F. Romm: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Validation, Visualization, Writing – original draft, Writing – review & editing. Alexandria Pannell: Conceptualization, Data curation, Writing – review & editing. Priyanka Sridharan: Conceptualization, Data curation, Writing – review & editing. Tanvi Sapra: Conceptualization, Data curation, Writing – review & editing. Aishwarya Rajamahanty: Conceptualization, Data curation, Writing – review & editing. Yuxian Cui: Conceptualization, Methodology, Writing – review & editing. Yan Wang: Conceptualization, Methodology, Writing – review & editing. Y. Tony Yang: Conceptualization, Methodology, Writing – review & editing. Patricia A. Cavazos-Rehg: Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Visualization, Writing – review & editing.

Author Credit Statement: CJB and PC (MPIs: R01DA054751-01A1) led the study design and obtained funding. All team members contributed to the conceptualization of the study design. CJB, KFR, and PC supervised the execution of the study (i.e., data collection). AR, SN, RW, PS, TS, CD, and AP contributed to data collection. CJB and KFR drafted the initial manuscript. All authors reviewed and approved the final manuscript for submission.

Author Agreement Statement: We the undersigned declare that this manuscript is original, has not been published before and is not currently being considered for publication elsewhere. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. We understand that the Corresponding Author is the sole contact for the Editorial process. He/she is responsible for communicating with the other authors about progress, submissions of revisions and final approval of proofs.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplementary Figure 1. Retailer selection flowchart

Supplementary Table 1. State and local policy context for 5 cities/states, 2022

Supplementary Table 2. Code definitions and examples

NIHMS1888109-supplement-1.docx^{(67.6KB, docx)}

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PERMALINK

Cannabis retailer marketing strategies and regulatory compliance: A surveillance study of retailers in 5 US cities

Carla J Berg, PhD

Katelyn Romm

Alexandria Pannell

Priyanka Sridharan

Tanvi Sapra

Aishwarya Rajamahanty

Yuxian Cui

Yan Wang

Y Tony Yang

Patricia A Cavazos-Rehg, PhD

Abstract

INTRODUCTION

METHODS

Study Overview

Data Collection

Training & Quality Control.

Mystery Shopper Assessment.

Table 1.

Point-of-Sale (POS) Assessment.

Table 4.

Retailer characteristics.

Regulation-related factors.

Cannabis product advertisement/promotion.

Cannabis product availability and prices.

Other products sold/advertised.

Data Analysis

RESULTS

Regulatory Compliance & Regulation-related Signage

Table 2.

Advertising & Promotional Strategies

Table 3.

Products & Pricing

DISCUSSION

Limitations

Conclusions

Supplementary Material

HIGHLIGHTS.

Acknowledgements

Footnotes

REFERENCES

Associated Data

Supplementary Materials

ACTIONS

PERMALINK

RESOURCES

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