General Public Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/30812
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Browsing General Public Health by Author "LoParco, Cassidy"
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Item Characteristics of Delta-8 THC retailers in a large metropolitan city(2022) LoParco, Cassidy; Walker, Drew; McDonald, Kayla; Pathak, Sunidhi Santosh; Eggleston, Jensen; Olsson, Sofia; Yockey, Robert; Luningham, Justin M.; Kong, Amanda; Henry, Doug; Rossheim, MatthewBackground: Retail sales of Delta-8 THC, an isomer of the more common form of cannabis (Delta-9 THC), have increased in the U.S. market since the passing of the 2018 Farm Bill. Specifically, the Farm Bill allowed for the sale of hemp products, which are classified as products having less than 0.3% Delta-9 THC by dry weight. Importantly, sales of Delta-8 THC are unregulated and may introduce possible risk arising from either psychoactive effects or unregulated solvents left behind from the synthesis of Delta-8 THC from CBD. The current study describes the Delta-8 THC retail sales environment in a large metropolitan city. Methods: Potential Delta-8 THC retailers were identified by identifying lists of current retail locations with alcohol, CBD, and tobacco licenses in Fort Worth, Texas (n = 1,961). Research assistants called retailers between September 8 and October 14, 2021, to query about sales of products containing Delta-8 THC; 69% (n = 1,223) of retailers answered and provided data on Delta-8 THC. Outlets' 9-digit ZIP codes were merged with area socioeconomic deprivation index scores. Chi-squared tests compared socioeconomic deprivation index scores between outlets that sold Delta-8 THC versus those that did not sell Delta-8 THC. Among a subsample of those who did sell Delta-8 THC, t-tests examined associations between prices and the type of Delta-8 THC products. Results: Approximately one in ten retail outlets (11%, n = 133) reported selling products containing Delta-8 THC. Most (96%) sold Delta-8 THC in the form of flower/vapes, and three-fourths (76%) sold edibles. Among the least expensive Delta-8 THC products available at these retail outlets were edibles (mean price = $15.39), which cost $8.58 less than flowers/vapes (mean price: $23.97; p < 0.001) on average. Retail outlets that sold Delta-8 THC, compared to those that did not, were in zip codes with greater deprivation (p = 0.02). Most outlets reported having a minimum age for sales of Delta-8 THC as 21 years; however, 4% reported 18 years or no minimum age for sale of Delta-8 THC products. Discussion: Delta-8 THC retail outlets were disproportionately located in ZIP codes with higher levels of socioeconomic deprivation. Legal intervention, such as zoning laws, may be warranted to prevent potential health disparities from overexposing a subset of communities to these products. Policies, such as increasing Delta-8 THC product prices and restricting the types of products sold may help reduce access and appeal to people under 21 years old.Item Drink prices, drink specials, and tobacco policies in a national sample of on-premise drinking establishments(2022) LoParco, Cassidy; Walker, Drew; Livingston, Melvin D.; Trangenstein, Pamela; Khoshhal, Bita; Gonzalez-Pons, Kwynn; Thombs, Dennis; Rossheim, MatthewBackground: Bar and nightclub practices, such as offering inexpensive drinks, having pricing promotions (e.g., 2-for-1, happy hour), and permitting e-cigarette use indoors can increase the amount of alcohol that individuals consume and the number of negative consequences they experience. College students in particular may have a greater risk of increased consumption and related harms to themselves and others. Despite the implications, few studies have assessed the presence of low-cost alcohol and e-cigarette-friendly environments around colleges. The current study surveilled drink prices and specials and examined associated characteristics of on-premise drinking establishments near large universities. Methods: In 2018, telephone calls about prices, practices, and policies were made to 404 randomly selected bars and nightclubs within 2 miles of the largest residential universities in each U.S. state. The Alcohol Policy Information System provided data on state-level alcohol policies. Multivariable linear and logistic regression models examined associations between drinking establishment characteristics, drink prices, and drink specials. Results: The average price for a beer and a shot of vodka were $3.62 and $4.77, respectively. Most establishments (65%) had happy hour specials and 6% had 2-for-1 drink specials. Nearly all (91%) sold food, while 9% sold cigarettes on-premise and 8% allowed smoking inside. Almost 1 in 5 establishments (18%) allowed e-cigarette use inside. Allowing e-cigarette use indoors (b = -0.54) and selling cigarettes on-premise (b = -0.79) were associated with significantly lower vodka prices, whereas allowing cigarette smoking inside (b = -0.46) was associated with significantly lower beer prices. Several factors were significantly associated with higher odds of having a happy hour special, including lower beer prices (OR = 1.38), selling food (OR = 2.97), no state law banning happy hour specials with full day price reductions permitted (OR = 12.74), and no complete bans on happy hour specials (OR = 4.24). Allowing e-cigarette use indoors was significantly associated with higher odds of having a 2-for-1 drink special (OR = 6.38). Conclusions: The current study is one of the first to identify associations between business practices/policies of on-premise drinking establishments and drink prices. This study used a national sample of on-premise drinking locations near large universities to provide insight into how alcohol prices may be discounted to promote sales of other products. For example, locations selling cigarettes on-premise were associated with lower vodka prices. Importantly, previous research indicates positive associations between alcohol consumption and smoking. Coupled with the lowered drink prices, settings that are permissive of smoking and vaping may be associated with increased risk of both heavy drinking and tobacco use, as well as their related harms. Given the frequently offered drink specials and strong association between price and consumption, more research is needed regarding alcohol prices/specials at on-premise drinking sites.Item Qualitative Descriptions of "What is Delta-8 THC"?(2022) Olsson, Sofia; LoParco, Cassidy; Rossheim, MatthewBackground: Delta-8 THC is a chemical isomer of the more common form of THC found in the Cannabis plant, Delta-9. Delta-8 THC retail increased after the 2018 Farm Bill was passed. This bill defined hemp as anything having less than 0.3% Delta-9 THC by dry weight, thus implicitly defining Delta-8 THC as hemp rather than marijuana. The retail of Delta-8 THC is unregulated, and both consumers and retailers may lack an understanding of the substance. This study utilized qualitative responses of retailers selling Delta-8 THC products in Fort Worth, Texas to understand how retailers are explaining the product to consumers. Methods: Retail locations in Fort Worth, Texas with alcohol, CBD, or tobacco retail licenses was compiled (n = 1,777). Retail locations were contacted between September 8 and October 14, 2021, by research assistants to query the retail of Delta-8 THC products. This study utilized a subsample of retail locations (n = 125) that answered the question asking, "What is Delta-8?" Qualitative analysis was performed by authors SO and CRL. Results: Cohen's kappa was 0.92, indicating a good inter-rater reliability. Many retailers (20.8%, n = 26) reported that they were unsure of what Delta-8 is while 7 (5.6%) told surveyors to look it up themselves. Several retailers (8.8%, n = 11) withheld information, stating they would provide information over the phone. Nearly a quarter (23.2%, n = 29) of retailers made claims on the legal status of Delta-8 THC (e.g., that it was legal), seven (5.6%) of which specifically mentioned the 0.3% Delta-9 THC threshold. Delta-8 THC was often described as a form of marijuana (34.4%, n = 43). Importantly, Delta-8 THC was also frequently described as CBD (19.2%, n = 24) or hemp (7.2%, n = 9), substances without psychoactive effects. Several retailers described the potential effects of Delta-8 (e.g., "It relaxes you"; 26.4%, n = 33) or the potency (e.g., "Not high dose"; 13.6%, n = 17). Discussion: Comments on the legal status of Delta-8 products may be misleading to consumers as lack of regulation may result in illegal product composition. For example, recent research has found that 76% (n = 51) of Delta-8 products surveyed had Delta-9 THC levels above the legal limit (Johnson 2021). Several retailers verbally withheld information or said they were unsure of what the product is, which may be due to the lack of clarity surrounding Delta-8 THC product composition and/or legality. Retailers often described Delta-8 THC by focusing on psychoactive experiences or potency, rather than an explicit definition of the product, which may be a marketing strategy. Without proper laws regulating the marketing or packaging of Delta-8 THC products, individuals may be unaware of the contents. This may lead to increased consumption, particularly among adolescents and young adults or those not expecting psychoactive effects. Regulation, surveillance, and product definitions of Delta-8 are important to reduce the risk of adverse effects.