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Sarah Kowitt, PhD, MPH, and Leah Ranney, PhD, MA have found that U.S. cannabis warning labels are largely ineffective in educating consumers about health risks. Through a content analysis and focus groups, Drs. Kowitt and Ranney developed mock designs for warning labels that could increase health knowledge among cannabis users. This research was supported by a 2022 planning grant from the UNC Center for Health Promotion and Disease Prevention (HPDP).

headshots of Sarah Kowitt (left) and Leah Ranney (right)
Drs. Sarah Kowitt (left) and Leah Ranney (right)

“Through the HPDP planning grant, we were able to systematically evaluate the current state of cannabis warning labels in the U.S. and conduct comprehensive research on how to improve warning labels,” Dr. Kowitt said. “We produced evidence to develop improved cannabis warning labels that will be more effective in educating consumers about health risks.”

Warning labels are required by all U.S. states in which cannabis is legal, but regulations vary widely. Drs. Kowitt and Ranney conducted a content analysis of cannabis labels and regulations in 20 U.S. states. The researchers then identified several opportunities to strengthen the effectiveness of cannabis warning labels, such as listing specific physical health risks, acknowledging mental health risks, featuring attention-grabbing icons and front-of-package placement, standardizing language, and requiring a minimum font size.

Leveraging their past research into tobacco packaging, Drs. Kowitt and Ranney drew on the content analysis to design prototypes of potentially more effective cannabis warning labels. Their mock-ups feature larger text size, eye-catching font color and label placement, clear and specific language, and some simple imagery.

The researchers then convened six focus groups among cannabis users to discuss their awareness of cannabis risks and learn from their engagement with cannabis warning labels. Focus group participants perceived cannabis to be of lower risk than tobacco and alcohol and reported that warning labels often go unnoticed.

These findings demonstrate the importance of Drs. Kowitt and Ranney’s research to inform more effective cannabis warning labels.

“The focus groups, along with our content analysis, identified opportunities to improve the efficacy of cannabis warning labels in the U.S.,” Dr. Ranney said. “We hope this research, informed by our previous research into tobacco warning labels, can inform policy and practice that will increase health knowledge among cannabis users.”

Drs. Kowitt and Ranney will present and publish their research in the coming year.

Dr. Sarah Kowitt, PhD, MPH is an assistant professor in the department of family medicine in the UNC School of Medicine. Her primary research interests are substance use prevention in youth and young adults.

Dr. Leah Ranney, PhD, MA is an associate research professor in the department of family medicine in the UNC School of Medicine as well as the director of the UNC Tobacco Prevention and Evaluation Program (TPEP). She primarily conducts tobacco prevention and regulatory science research.

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