PC2135: Perceptions and Risks of Edible Marijuana Candy Products for Pediatric Populations: A Pilot Study

Background: As an increasing number of states legalize recreational marijuana use, unintentional pediatric exposures to marijuana have resulted in increased hospitalizations and poison control center calls. Edible marijuana products, or “edibles”, are consumable foods that contain cannabis extract and can closely resemble typical food items. Because the packaging of such products are often nearly identical to recognizable candy brands, there could be a high risk of children ingesting marijuana-infused products by mistake (Fig. 1). Several states have enacted legislation that restricts the imagery on edibles’ packaging to decrease its appeal to young children. There has been no specific study to date on whether children or parents are able to distinguish between regular candy packages, cannabis-infused candy, and regulated marijuana edibles’ packaging.

Methods: We performed a survey study in which children (ages 3-17) and their parents presenting at an outpatient office with 12 pediatric specialties were enrolled. Surveys aimed to test whether children and their parents were able to correctly identify marijuana edibles’ packaging compared to other products. Questions asked participants to identify (Yes/No) whether or not an item was a candy for children. Marijuana candy edible packaging, normal candy, and regulated marijuana edibles were included. Items such as Rx pharmacy medication bottles and over-the-counter medication bottles (e.g. Advil) were included as controls. This study was approved by the Northwell Health Institutional Review Board (IRB #21-1174).

Results: In this convenience sample, 68 adults and 38 children participated in the survey. The median age of the children was 15 years old. For marijuana products, 48.52% of the adults were able to correctly categorize marijuana-infused candies as “not a candy for kids”, and 93.94% were able to correctly categorize regulated marijuana product packaging (Figure 2). For the children, these figures were 16.21% for marijuana-infused candies and 81.08% for regulated marijuana packaging, respectively. In comparison, 94.74% of the children were able to correctly categorize over-the-counter medicine, and 100% were able to correctly categorize prescription bottles.

Conclusion: We found that the majority of children were not able to distinguish between marijuana edibles packaging and that of actual candy. When the edibles were pictured in medically-regulated packaging, more children were able to distinguish the product as “not candy.” This signifies that regulated packaging may be a successful method of decreasing the risk of accidental ingestion. Pediatricians should warn parents of the dangers of pediatric cannabis consumption and direct parents to carefully store their marijuana edibles out of children’s reach. The pediatric community should advocate for increased regulations in cannabis edibles product packaging to prevent accidental consumption by children. Future work can expand upon the sample size to elucidate the age at which children begin to have heightened awareness of potentially harmful substances in their surroundings.