BACKGROUND: In 2016, Colorado was first in the nation to develop and pilot a survey dedicated entirely to collecting information on cannabis use, in order to fill gaps identified in population-based survey data. The Cannabis Users Survey on Health (CUSH) collected detailed data on cannabis use, including methods, amounts and frequency of use, reasons for use, combined use with other substances, and any adverse effects experienced. Our objective is to describe the methods used to develop the survey tool, survey administration, preliminary results and the anticipated public health implications.
METHODS: The 32-question CUSH survey was developed by a team of epidemiologists at the Colorado Department of Public Health and Environment (CDPHE). Research was conducted on methods of cannabis use, units of cannabis products sold and potential health effects of cannabis use, to aid in the development of questions. The survey was self-administered online using a secure web-based platform to collect responses, ensuring the confidentiality of respondents. Current cannabis users, age 21+ years, residing in Colorado were the targeted demographic. Survey administration lasted from June through October 2016. CUSH was marketed to cannabis users via social media, in-print and online advertising. CDPHE staff also attended community events around the state to recruit participants to take the survey on electronic tablets. Incentives were offered to encourage participation at community events.
RESULTS: A total of 1812 responses were collected over the five-month time period. CDPHE staff attended 10 community events around Colorado, resulting in a diversified sample representative of the state. Sharp increases in survey participation were observed on days when staff attended community events and incentives were offered. Less pronounced increases in participation were observed on the first days of advertising on social media, online and in-print advertising. Overall, the top three modes of participation in CUSH occurred at community events (31.0%), followed by social media (21.9%) and via email (19.6%). The detailed data on multiple facets of marijuana use are currently being analyzed and results will be available later in 2017.
CONCLUSIONS: The Cannabis Users Survey on Health (CUSH) is a surveillance tool with great potential for public health. As more states legalize cannabis, the need for detailed cannabis use data becomes greater. CUSH can be a valuable tool in collecting this much needed data. Furthermore, if utilized by other states, data could be compared across states and aggregated for multi-state analyses.