How Are Retailers Describing Delta-8 THC? A Mixed-Methods Study in Fort Worth, Texas

Abstract

Objective:

Delta-8 tetrahydrocannabinol (THC) is a largely unregulated psychoactive substance rising in popularity in the United States. This study aimed to understand how retailers explained Delta-8 THC to potential customers and if these descriptions were associated with socioeconomic deprivation surrounding the retail location.

Method:

In Fort Worth, Texas, stores with retail alcohol, cannabidiol (CBD), or tobacco licenses were called. Among the 133 stores that sold Delta-8 THC, 125 retailers (94%) answered the question “What is Delta-8?” Qualitative methods were used to identify related themes; logistic regression models tested associations between themes and area deprivation index (ADI) scores, a measure of socioeconomic deprivation (1–10; 10 = most deprived areas).

Results:

Retailers often compared Delta-8 THC to other substances (49%). Although most often described as a type of cannabis (34%), several retailers likened Delta-8 to CBD (19%) or hemp (7%), which are nonpsychoactive. Retailers also described potential effects from use (35%). Some retailers reported that they were unsure of what Delta-8 was (21%), told surveyors to look it up themselves (6%), or withheld information (9%). Higher ADI scores were associated with higher odds of retailers communicating limited information (odds ratio = 1.21, 95% CI [1.04, 1.40], p = .011).

Conclusions:

Study findings may inform the development of marketing regulations, as well as informational campaigns for both retailers and consumers.

Delta-8 tetrahydrocannabinol (thc) is a psychoactive component of the Cannabis plant. The sale of Delta-8 THC was implicitly legalized in the United States in 2018, after the Federal Agriculture Improvement Act (also known as the 2018 Farm Bill) was passed (United States Congress, 2019). This bill legalized the sale of products from the Cannabis plant with less than 0.3% Delta-9 THC by dry weight (United States Congress, 2019). There was no mention of THC other than Delta-9 THC; thus, Delta-8 THC is considered implicitly legal because of this loophole (United States Congress, 2019).

Although no national data exist on Delta-8 THC use prevalence, Google and Twitter trends indicate a rising interest (Leas et al., 2022; Livingston et al., 2022; Walker et al., 2022), particularly in states where adult nonmedical use of cannabis remains illegal (Food and Drug Administration [FDA], 2022; Leas et al., 2022; Livingston et al., 2022). Moreover, a recent study among cannabis users demonstrates that 16.7% had used Delta-8 THC in the past month (Livne et al., 2022). Similar to Delta-9 THC, Delta-8 THC products are sold in a variety of forms including flower, concentrates, edibles, and tinctures (3CHI, n.d.; Johnson, 2021; Moonwlkr, n.d.).

Consequences of Delta-8 THC use are similar to those from Delta-9 THC, including lethargy, anxiety, and rapid changes in blood pressure (Centers for Disease Control and Prevention [CDC], 2021; Chan-Hosokawa, 2021; FDA, 2022; Johnson, 2021; Johnson-Arbor & Smolinske, 2022). However, largely because of the lack of regulations, there are several consequences unique to Delta-8 THC use (Johnson-Arbor & Smolinske, 2022). One major concern is the leftover solvents, heavy metals, and chemical byproducts remaining from the process of creating Delta-8 THC from cannabidiol (CBD; Babalonis et al., 2021; CDC, 2021; FDA, 2022; Johnson, 2021; Leas, 2021; Roush & Hudalla, 2021). Doses of the active ingredient also vary between batches and are often different than what is on the packaging label (Johnson, 2021). In addition, there are no federally set age restrictions or requirements for using child-safe packaging (FDA, 2022; Johnson, 2021; Johnson-Arbor & Smolinske, 2022; Leas, 2021; Roush & Hudalla, 2021). As such, there have been thousands of cases of accidental ingestion of Delta-8 THC and related hospitalizations, particularly among minors (CDC, 2021; FDA, 2022).

There is abundant messaging about Delta-8 THC on the internet via forums, blogs, news articles, and social media that provide anecdotal, and often conflicting, information (Erickson, 2021; Kruger & Kruger, 2021; Leas et al., 2022). As such, potential consumers may seek to better understand Delta-8 THC by asking retailers (Kruger & Kruger, 2021; Lee et al., 2018). However, little is known about how retailers describe Delta-8 THC products to potential customers despite these descriptions potentially shaping a potential user's expectancies and behaviors (Noël et al., 2021). In the absence of governmental labeling requirements, retailers may be the “first line of defense” for getting accurate information about Delta-8 THC to the public.

Previous research demonstrates associations between neighborhood deprivation, cannabis dispensary density, and cannabis use (Firth et al., 2020; Rhew et al., 2022). Specifically, research indicates that across 117 neighborhoods in Portland, OR, each 1 SD increase in a neighborhood's deprivation score was associated with 73% more cannabis retailers, adjusting for important covariates including population density (Firth et al., 2020). Moreover, findings from a study conducted in Washington State indicated that individuals living in neighborhoods that were more socioeconomically disadvantaged used cannabis more frequently and perceived cannabis use to be more acceptable than individuals living in less socioeconomically disadvantaged neighborhoods (Rhew et al., 2022).

Preliminary evidence using a convenience sample in Fort Worth, TX, found that outlets that were located in areas with greater socioeconomic deprivation were more likely to sell Delta-8 THC (Rossheim et al., 2022). Substance-related marketing also differs by socioeconomic status (Lee et al., 2015). Results from a systematic review of disparities in tobacco marketing, for example, indicated that lower-income neighborhoods tended to have more substance-related marketing (Lee et al., 2015). Thus, messages provided by retailers may differ based on the socioeconomic deprivation surrounding the retail location. However, associations between area deprivation and how retailers may understand and explain Delta-8 THC have yet to be examined.

To provide insight on the type of information provided by Delta-8 THC retailers, we conducted a mixed-methods study in Fort Worth, TX. This study had two aims: Aim 1 identified qualitative themes related to how Delta-8 THC retailers explained the product to potential customers; Aim 2 tested associations between these themes and the level of socioeconomic deprivation surrounding the retail store.

Method

Study design and procedure

A sequential exploratory mixed-methods design was used. Data were collected in Fort Worth, TX, where a retail consumable hemp license ($250/year) was needed to sell Delta-8 THC (Texas Department of State Health Services, n.d.). Lists of retail alcohol, tobacco, and CBD licenses as of 9/1/2021 were gathered from the Texas Alcoholic Beverage Commission, Comptroller, and Department of State Health Services. Trained research assistants called the 1,777 retail locations, using available contact information, to ask if they sold Delta-8 THC. Calls were made from September 8, 2021, to October 14, 2021, when Delta-8 THC sales had little regulation in Texas. The Texas Department of State Health Services randomly selects stores with a consumable hemp retail license to test products for their compliance with the legal Delta-9 THC limit set in the Farm Bill (Congress.gov, 2019). Because of the current litigation in Texas, Delta-8 THC legality has remained the same more than 1 year later (i.e., as of October 2022; Johnson, 2022; Texas Department of State Health Services, n.d.). Outlets were called three times before assigning a nonresponse; 1,223 (69%) answered the phone and provided data. Retailers that did not answer their phones tended to be in neighborhoods with higher levels of socioeconomic disadvantage than those who did answer their phone. Of those who answered the phone, 1,069 (87%) locations had alcohol retail licenses, 547 (45%) had tobacco retail licenses, and 29 (2%) had consumable hemp/ CBD retail licenses (see Rossheim et al., 2022, for more detailed information).

Retailers were asked, “Do you sell Delta-8?” If retailers did not sell Delta-8, then the call ended; otherwise, they were asked, “What is Delta-8?” Retailers at 133 outlets (11%) reported selling Delta-8 THC and 125 of these (94%) provided descriptions, thus comprising the analytic sample. This study was considered “not human subjects research” by the institutional review board.

Qualitative coding and analysis

Interviewers recorded responses verbatim in a Microsoft Excel document. To ensure independence of coding and minimize bias, authors conducted an independent, iterative, and inductive coding process. Analysis used an inductive and grounded theory approach (Hodkinson, 2008), with the following steps: familiarization with the data, identification of overarching themes, open coding, establishing consensus and development of subcodes, creating a descriptive code-book, and independent coding using the codebook (Blair, 2015; Wicks, 2017; Williams & Moser, 2019). Qualitative descriptions could be coded under multiple codes. Analyses were performed by authors CRL and SO, and Cohen's kappa was .92. A third author (MER) helped reach consensus on remaining discrepant items.

Quantitative analyses

A series of bivariate logistic regression models examined whether the presence or absence of a theme (1 = mentioned by the retailer or 0 = not mentioned) was associated with Area Deprivation Index (ADI) scores (v3.1). ADI scores are a validated measure of socioeconomic deprivation in areas, calculated using weighted data for 17 indicators that are derived from the long form census questionnaire and American Community Survey 5-year estimates (University of Wisconsin School of Medicine and Public Health, 2015). ADI scores are measured on a scale of 1–10, with 10 representing the most deprived areas. ADI scores were obtained for the nine-digit zip code areas of 117 of the 125 retail locations (94%) and represent a state-level decile rank relative to all nine-digit zip codes in Texas.

Results

Aim 1: How are retailers explaining Delta-8 THC?

Three overarching themes emerged related to retailers’ responses to “What is Delta-8?”: (a) substance-specific (n = 61 retailers; 49%), (b) effects mentioned (n = 44 retailers; 35%), and (c) limited information communicated (n = 40 retailers; 32%). Table 1 provides the codebook and sample quotes. Delta-8 THC was often described by relating it to other substances including cannabis (34%, n = 43), CBD (19%, n = 24), or hemp (7%, n = 9). A quarter of the retailers described the potential effects of Delta-8 (26%, n = 33), which included relaxation, sleep aid, and treatment for pain, depression, and anxiety. Some retailers mentioned the potency (14%, n = 17), which included describing it as weaker than “regular” cannabis (n = 9) or stronger than CBD (n = 6). Approximately one fifth of retailers (21%, n = 26) reported that they were unsure of what Delta-8 was, and seven retailers (6%) told surveyors to look it up themselves. Some retailers (9%, n = 11) purposely withheld information, stating that they would not provide information about Delta-8 THC over the phone.

Table 1.

Qualitative codebook

Overarching theme	Subcode	Inclusion factors	Example quotes from data
Substance specific	Cannabis (34%)	References cannabis, marijuana, weed, or THC	“It's marijuana but not a high dose”
	CBD (19%)	References CBD	“Like CBD to relax”
	Hemp (7%)	References hemp	“Formed from hemp, barely any THC in it”
Effects mentioned	Effects (26%)	Describes Delta-8 by the way it makes user feel	“It relaxes you”
	Potency (14%)	Describes potency, strength, or dosage	“Not a high dose”
Limited information communicated	Unsure (21%)	Any statement that indicates the retailer does not know what Delta-8 THC is	“I don't know, I’m not a scientist”
	Look it up yourself (6%)	Any statement telling callers to look up what Delta-8 THC is themselves	“Do your research and Google it” “
	Withholding (9%)	Any statement in which the retailer is unwilling to share information with the caller	I cannot discuss this over the phone, you have to come in”

Notes: Responses could be classified into multiple subcodes; thus, percentages do not add to 100. THC = tetrahydrocannabinol; CBD = cannabidiol.

Aim 2: Differences in explanations by socioeconomic deprivation

The mean ADI score was 5.13 for retailers who made substance-specific comments versus 6.11 for those who did not. For the theme mentioning effects, the mean ADI score was 4.98 for those who did mention effects versus 6 for those who did not. Last, the mean ADI score was 6.65 for those who communicated limited information versus 5.18 for those who did not.

Results of bivariate logistic regression models indicated that each one-point increase in a location's ADI score (indicating greater socioeconomic deprivation) was associated with 21% higher odds of communicating limited information over the phone (odds ratio [OR] = 1.21, 95% CI [1.04, 1.40]). Sensitivity analyses revealed that being unsure was statistically significantly associated with ADI scores (OR = 1.25, 95% CI [1.05, 1.49]), whereas telling callers to look it up themselves (OR = 1.12, 95% CI [0.83, 1.51]) or withholding information (OR = 1.06, 95% CI [0.85, 1.33]) were not statistically significant. Substance-specific comments (OR = 0.88, 95% CI [0.78, 1.01]) and mentioning effects (OR = 0.88, 95% CI [0.77, 1.01]) were not statistically significantly associated with ADI scores.

Discussion

This is the first study to examine retailers’ descriptions of Delta-8 THC products. More than one in five retailers only described Delta-8 THC by drawing similarities to hemp and CBD, two substances commonly known to not be psychoactive. Although Delta-8 THC is a hemp-derived cannabinoid, comparisons to nonpsychoactive substances may contribute to misunderstanding and may increase the number of individuals unintentionally experiencing psychoactive effects (CDC, 2021; FDA, 2022).

Nearly one third of the sample (32%) did not provide information about Delta-8 THC. In more than one quarter of these instances (9% of the overall sample), retailers indicated that they would not explain what Delta-8 THC was over the phone. Withholding information may be due to its legal ambiguity (Feldman, 2021; Reynolds, 2021). More research is needed to determine the reason certain retailers were less likely to provide information over the phone. It may be that these areas are more likely to be concerned about future prosecution, given that Texas is a one-party consent state for audio recordings (Texas State Law, n.d.). It is also possible that these locations are less informed about Delta-8 THC.

Results support some differences based on the retailers’ location. Retailers located in more socioeconomically deprived areas were less likely to know and/or provide information about Delta-8 THC over the phone. Given the potential for retailer messages to affect consumer behaviors (Noël et al., 2021), the limited information available to potential consumers by phone may exacerbate substance use disparities in these neighborhoods.

Strengths and limitations

The current study used a mixed-methods approach, coding retailers’ qualitative responses and linking them with socioeconomic deprivation scores for the area surrounding the outlet. However, a few limitations should be mentioned. First, this study used brief phone calls to retailers, limiting the amount of data that could be collected. Retailers were not explicitly asked whether Delta-8 THC was psychoactive. It is unclear whether retailers who did not provide information over the phone did this to purposefully withhold this information or because they did not have time to talk. Sensitivity analyses were conducted to observe potential differences between associations with ADI scores when combining the eight retailers who did not answer the question “What is Delta-8” with the “withholding information” category; no differences were observed. Second, given the large number of locations, we did not conduct in-person assessments. As such, it is unclear if these numbers are entirely representative of Delta-8 THC retail availability in Fort Worth. However, telephone calls allowed us to rapidly screen nearly 1,800 locations to identify where Delta-8 THC was sold, and the response rate was reasonably high (69%). Third, there was a relatively small sample size for some subcodes of themes, affecting the precision of quantitative estimates. Last, findings may not generalize to areas outside of Fort Worth given that Delta-8 THC legality varies between states and may vary across localities.

Conclusions

This study provides unique insight into Delta-8 THC products from retailers’ perspectives. Results demonstrate that Delta-8 THC products are being described in a variety of ways, sometimes only in terms related to nonpsychoactive substances. In addition, findings indicated that retailers in areas with greater socioeconomic deprivation may be less likely to discuss Delta-8 THC over the phone. There is currently no governing body to monitor how Delta-8 THC products are marketed, including claims of effects or purported safety. Standard warning messages and labels mentioning psychoactivity would seem to be important. Study findings may inform the development of marketing regulations, as well as informational campaigns to increase consumers’ and retailers’ understanding of Delta-8 THC.