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Implementation and Effectiveness of an Online Responsible Vendor Training Program for Recreational Marijuana Stores in Colorado, Oregon, and Washington State.

ABSTRACT: CONTEXT:Six US states have implemented retail sales of recreational marijuana. Training in responsible sales practices has been effective in the alcohol market. An online responsible marijuana vendor (RMV) training was produced and implemented with stores in a randomized trial. PROGRAM:An online RMV training was developed through meetings with state regulators and local law enforcement personnel, curriculum standards published by the Colorado Marijuana Enforcement Division in May 2015, interviews with recreational marijuana store personnel (n = 15), and usability testing of a prototype training with store personnel (n = 19) in Colorado and Washington State. The training contained 5 modules: state laws and regulations, ID checking, health effects of marijuana, customer service practices including recognizing intoxicated patrons, and rules of the trade. IMPLEMENTATION:A randomized controlled trial testing the training enrolled a random sample of state-licensed retail recreational marijuana stores (n = 225) in Colorado, Oregon, and Washington State. In total, 125 stores were randomly assigned to receive the RMV training. A total of 420 store employees completed the online training between June 2017 and February 2018 (43.5% female, 88.4% younger than 40 years, and 74.1% non-Hispanic white). EVALUATION:Responses to posttraining surveys showed that most trainees found the training user-friendly (78.4%), were satisfied (68.8%), and would recommend it to another employee (91.1%). The training improved trainees' ability to check IDs (pretraining mean = 3.91 [SD = 1.36], posttraining mean = 4.58 [SD = 0.66], t387,388 = 8.68, P < .001) and their confidence to use the state's inventory tracking system (pretraining mean = 2.52 [SD = 0.65], posttraining mean = 2.85 [SD = 0.39], t387, 388 = 10.89, P < .001) and spot intoxicated customers (pretraining mean = 2.79 [SD = 0.41], posttraining mean = 2.94 [SD = 0.25], t387,388 = 6.87, P < .001). DISCUSSION:Online RMV training was acceptable to retail recreational marijuana personnel and potentially improved responsible sales practices. Responsible vendor training has been successful under certain conditions in the alcohol market and should be considered for the recreational marijuana market.

SUBMITTER: Buller DB

PROVIDER: S-EPMC6395576 | biostudies-literature | 2019 May/Jun

REPOSITORIES: biostudies-literature

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Implementation and Effectiveness of an Online Responsible Vendor Training Program for Recreational Marijuana Stores in Colorado, Oregon, and Washington State.

Buller David B DB Woodall W Gill WG Saltz Robert R Grayson Andrew A Buller Mary Klein MK

Journal of public health management and practice : JPHMP 20190501 3

<h4>Context</h4>Six US states have implemented retail sales of recreational marijuana. Training in responsible sales practices has been effective in the alcohol market. An online responsible marijuana vendor (RMV) training was produced and implemented with stores in a randomized trial.<h4>Program</h4>An online RMV training was developed through meetings with state regulators and local law enforcement personnel, curriculum standards published by the Colorado Marijuana Enforcement Division in May ...[more]

PMID: 30180110

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Project description:BackgroundIn some U.S. states, laws prohibit sales of recreational marijuana to intoxicated customers to prevent associated harms. In alcohol markets, training in responsible sales practices is one intervention to help reduce such sales to intoxicated customers. Similar training may be beneficial in the recreational cannabis market.MethodsAn online responsible marijuana vendor (RMV) training was developed. Among its five modules, learning elements taught store personnel to recognize signs of alcohol impairment and intoxication, refuse sales, and understand the risks of driving under the influence of cannabis. A sample of n = 150 recreational cannabis stores in Colorado, Oregon, and Washington State, USA were enrolled in a randomized controlled trial, half of which were randomly assigned to use the RMV training. Stores were posttested using a pseudo-customer protocol in which confederate buyers feigned obvious signs of alcohol intoxication.ResultsDeterrence of sales to intoxicated customers does not seem to exist, regardless of whether the states' laws prohibit it. Only 16 of 146 stores (11.0%; 4 Oregon stores were eliminated that were not in business) refused sales. There was no difference in refusal rates between intervention (11.6% [3.9%]) and control stores (7.6% [3.1%], F = 0.71, p = 0.401 [1-tailed]) or between stores that used the RMV training (6.3% [4.0%]) or not (12.0% [5.7%], F = 0.91, p = 0.343 [2-tailed]). In 11 visits, store personnel commented on the buyers' behavior, or expressed concern/suspicion about buyers, but sold to them anyway.ConclusionsTraining in responsible sales practices alone did not appear to reduce sales to apparently alcohol-intoxicated customers. Legal deterrence from making these sales may be insufficient or nonexistent for store management to support adherence to this responsible sales practice. Regulatory and policy actions may be needed to increase perceived risk with such sales (i.e., clear policy and swift, severe, and certain penalties) to achieve training's benefits.

Project description:A potential unintended consequence of legalizing recreational marijuana is increased marijuana-related driving impairment. Some states where recreational marijuana is legal have begun implementing interventions to mitigate driving under the influence (DUI) of marijuana, including media campaigns to increase knowledge about DUI laws. However, little is known about the associations between knowledge of DUI laws and marijuana DUI behavior. In this study, we provide new data from a survey of marijuana users in Colorado and Washington to examine associations between marijuana drugged driving and two potential behavioral precursors of marijuana DUI. We also explore other factors that may influence marijuana DUI.Data are from an online survey of marijuana users in Colorado and Washington. Respondents who reported any marijuana use in the past 30 days (n = 865) served as the analytic sample. We examined prevalence of two behavioral outcomes: (1) any driving of a motor vehicle while high in the past year and (2) driving a motor vehicle within 1 hour of using marijuana 5 or more times in the past month. Additional outcomes measuring willingness to drive while high were also assessed. Logistic regressions were used to estimate each outcome as a function of two multi-item scales measuring knowledge of the legal consequences of driving high and perceptions that driving while high is not safe. Additional covariates for potential confounders were included in each model.Prevalence of past-year driving while under the influence of marijuana was 43.6% among respondents. The prevalence of driving within 1 hour of using marijuana at least 5 times in the past month was 23.9%. Increased perception that driving high is unsafe was associated with lower odds of past-year marijuana DUI (OR = 0.31, P < 0.01) and lower past-month odds of driving 5 or more times within 1 hour of using marijuana (OR = 0.26, P < 0.01). Increased knowledge of marijuana DUI laws was also associated with lower odds of each of these outcomes (OR = 0.63, P < 0.01, OR = 0.69, P = 0.02, respectively). Post-estimation Wald tests confirmed the negative associations with marijuana DUI were greater in magnitude for safety perceptions than knowledge of DUI laws. Increased perceptions that driving while high is unsafe was associated with significantly lower willingness to drive after using marijuana while increased knowledge of marijuana DUI laws was not associated with these outcomes.Despite recent interventions targeting public awareness of the legal consequences of marijuana DUI, our results suggest that knowledge of these laws is a weaker predictor of DUI behavior than perceptions that driving high is unsafe. In addition, safety perceptions predict decreased openness to driving high while knowledge of DUI laws was not associated with openness. These findings suggest that interventions for reducing the incidence of marijuana DUI are likely to be more successful by targeting safety perceptions related to marijuana DUI rather than knowledge of DUI laws. We caution that because these data are limited to an online convenience sample, results may not be generalizable beyond our sample.

Project description:ImportanceAn important consequence of cannabis legalization is the potential increase in the number of cannabis-impaired drivers on roads, which may result in higher rates of traffic-related injuries and fatalities. To date, limited information about the effects of recreational cannabis laws (RCLs) on traffic fatalities is available.ObjectiveTo estimate the extent to which the implementation of RCLs is associated with traffic fatalities in Colorado and Washington State.Design, setting, and participantsThis ecological study used a synthetic control approach to examine the association between RCLs and changes in traffic fatalities in Colorado and Washington State in the post-RCL period (2014-2017). Traffic fatalities data were obtained from the Fatality Analysis Reporting System from January 1, 2005, to December 31, 2017. Data from Colorado and Washington State were compared with synthetic controls. Data were analyzed from January 1, 2005, to December 31, 2017.Main outcome(s) and measuresThe primary outcome was the rate of traffic fatalities. Sensitivity analyses were performed (1) excluding neighboring states, (2) excluding states without medical cannabis laws (MCLs), and (3) using the enactment date of RCLs to define pre-RCL and post-RCL periods instead of the effective date.ResultsImplementation of RCLs was associated with increases in traffic fatalities in Colorado but not in Washington State. The difference between Colorado and its synthetic control in the post-RCL period was 1.46 deaths per 1 billion vehicle miles traveled (VMT) per year (an estimated equivalent of 75 excess fatalities per year; probability = 0.047). The difference between Washington State and its synthetic control was 0.08 deaths per 1 billion VMT per year (probability = 0.674). Results were robust in most sensitivity analyses. The difference between Colorado and synthetic Colorado was 1.84 fatalities per 1 billion VMT per year (94 excess deaths per year; probability = 0.055) after excluding neighboring states and 2.16 fatalities per 1 billion VMT per year (111 excess deaths per year; probability = 0.063) after excluding states without MCLs. The effect was smaller when using the enactment date (24 excess deaths per year; probability = 0.116).Conclusions and relevanceThis study found evidence of an increase in traffic fatalities after the implementation of RCLs in Colorado but not in Washington State. Differences in how RCLs were implemented (eg, density of recreational cannabis stores), out-of-state cannabis tourism, and local factors may explain the different results. These findings highlight the importance of RCLs as a factor that may increase traffic fatalities and call for the identification of policies and enforcement strategies that can help prevent unintended consequences of cannabis legalization.

Project description:ImportanceHistorical shifts are occurring in marijuana policy. The effect of legalizing marijuana for recreational use on rates of adolescent marijuana use is a topic of considerable debate.ObjectiveTo examine the association between the legalization of recreational marijuana use in Washington and Colorado in 2012 and the subsequent perceived harmfulness and use of marijuana by adolescents.Design, setting, and participantsWe used data of 253 902 students in eighth, 10th, and 12th grades from 2010 to 2015 from Monitoring the Future, a national, annual, cross-sectional survey of students in secondary schools in the contiguous United States. Difference-in-difference estimates compared changes in perceived harmfulness of marijuana use and in past-month marijuana use in Washington and Colorado prior to recreational marijuana legalization (2010-2012) with postlegalization (2013-2015) vs the contemporaneous trends in other states that did not legalize recreational marijuana use in this period.Main outcomes and measuresPerceived harmfulness of marijuana use (great or moderate risk to health from smoking marijuana occasionally) and marijuana use (past 30 days).ResultsOf the 253 902 participants, 120 590 of 245 065(49.2%) were male, and the mean (SD) age was 15.6 (1.7) years. In Washington, perceived harmfulness declined 14.2% and 16.1% among eighth and 10th graders, respectively, while marijuana use increased 2.0% and 4.1% from 2010-2012 to 2013-2015. In contrast, among states that did not legalize recreational marijuana use, perceived harmfulness decreased by 4.9% and 7.2% among eighth and 10th graders, respectively, and marijuana use decreased by 1.3% and 0.9% over the same period. Difference-in-difference estimates comparing Washington vs states that did not legalize recreational drug use indicated that these differences were significant for perceived harmfulness (eighth graders: % [SD], -9.3 [3.5]; P = .01; 10th graders: % [SD], -9.0 [3.8]; P = .02) and marijuana use (eighth graders: % [SD], 5.0 [1.9]; P = .03; 10th graders: % [SD], 3.2 [1.5]; P = .007). No significant differences were found in perceived harmfulness or marijuana use among 12th graders in Washington or for any of the 3 grades in Colorado.Conclusions and relevanceAmong eighth and 10th graders in Washington, perceived harmfulness of marijuana use decreased and marijuana use increased following legalization of recreational marijuana use. In contrast, Colorado did not exhibit any differential change in perceived harmfulness or past-month adolescent marijuana use following legalization. A cautious interpretation of the findings suggests investment in evidence-based adolescent substance use prevention programs in any additional states that may legalize recreational marijuana use.

Project description:BackgroundOver the past two decades, state and local governments across the U.S. have been increasingly reforming marijuana laws. Despite growing support for marijuana as a medical treatment, little is known about medical students' perceptions of marijuana use.ObjectiveTo assess Colorado medical students' personal and professional opinions on current and future marijuana use in a healthcare setting.DesignA voluntary, anonymous, online cross-sectional survey.ParticipantsMedical students (n = 624) at the University of Colorado School of Medicine between January and February 2014 were invited to participate.Main measuresNumerical responses were quantified using counts and percentages, and Likert scale responses were collapsed for bivariate analysis. Items were gathered thematically and additively scored for each subscale. Internal consistency reliability statistics were calculated for each subscale to ensure that items were assessing similar constructs. Unadjusted t tests and one-way analysis of variance (ANOVA) were used to calculate mean differences in subscale scores between subgroups.Key resultsWe received 236 responses (37%). Students indicated support for marijuana legalization (64%), and few believed that physicians should be penalized for recommending marijuana to patients (6%). Nearly all (97%) believed that further marijuana research should be conducted, and believed marijuana could play a role in the treatment of various medical conditions. Seventy-seven percent reported that they believed marijuana use had the potential for psychological harm, and 68% indicated concern for potential physical harm. Only a minority of students would recommend marijuana to a patient under current law (29%), or if it were legally available (45%). Acceptability of marijuana for treatment of approved conditions was not correlated with age or gender, but was positively correlated with living in Colorado prior to medical school (p < 0.001) and with prior marijuana use (p < 0.001).ConclusionsMedical students support marijuana legal reform, medicinal uses of marijuana, and increased research, but have concerns regarding risks of marijuana use, and appear hesitant to recommend marijuana to patients.

Dataset Information

Implementation and Effectiveness of an Online Responsible Vendor Training Program for Recreational Marijuana Stores in Colorado, Oregon, and Washington State.

Publications

Implementation and Effectiveness of an Online Responsible Vendor Training Program for Recreational Marijuana Stores in Colorado, Oregon, and Washington State.

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