Abstract: Examining Salient Social Media Content about Cannabis Products and Cancer among Cancer Survivors and Caregivers

◆ Sarah V. Bencivenga, University of Illinois at Urbana-Champaign
◆ Abbey Schneider, University of Illinois at Urbana-Champaign
◆ Sarah Julien-Bell, University of Illinois at Urbana-Champaign
◆ Mia J. Salas, University of Illinois at Urbana-Champaign
◆ Cabral Bigman, University of Illinois at Urbana-Champaign

Introduction: Online cancer misinformation can include outright false or deceptive marketing claims, promotion of unproven products and treatments, and claims in media and user-generated comments that reflect a mischaracterization or misinterpretation of scientifically accurate claims. While there has been much concern about health misinformation on social media, scholars have called for research that focuses on linking cancer misinformation exposure and sharing to clinically relevant outcomes that are consequential from a public health and medical perspective (Southwell et al., 2019). At a time of increasing legal access to and popularity of cannabis products, this study contributes to the literature by investigating what cancer survivors and caregivers recall seeing and sharing online about cancer and cannabis on social media in order to gain insight into the kinds of messages that contain misinformation that could be clinically relevant. Method: In November-December 2020, we conducted a cross-sectional survey assessing salient online messages about cannabis products and cancer among cancer survivors (N=248) and caregivers (N=231) who also reported using social media. The online survey recruited participants through Dynata and oversampled Black and Hispanic participants. As part of the study, we asked separate closed-ended items about whether/where participants had seen/shared anything on social media about cannabis products (e.g., CBD, marijuana, or hemp) and cancer. Those who had seen and/or shared content, also answered open-ended questions about what specifically they had seen/shared. We conducted a content analysis of the responses. One researcher first immersed themselves in the data. After solidifying codes, the data was subsequently coded using a proportional stratified method to account for correct inclusion of small themes. Two researchers coded a sample of the data to establish intercoder reliability (ICR; Krippendorff's alpha 0.62-1); the remaining responses were then coded using the codebook that had been developed. Results: Respondents reported both seeing (Survivors=152, Caregivers=167) and, to a lesser extent, sharing (Survivors=76, Caregivers=60) information about cannabis products and cancer online. Facebook, Instagram, and Twitter were among the most commonly reported platforms. Among cancer survivors and caregivers who saw or shared content, more recalled seeing testimonials (n=48, ICR=.86) than advertisements (n=14, ICR=1.00) or other kinds of information (e.g., news articles; n=29, ICR=.76) based on frequencies. Of particular note from a clinical perspective was the emergent category of cancer treatments and cures (ICR=.85) respondents reported seeing (n=71) and sharing (n=17), which included claims about cannabis products curing cancer. The category also included recalling seeing and sharing messages about use of cannabis products for other cancer-related conditions such as pain and nausea. Within the same survey, 29.4% (n=73) of cancer survivors said information on social media affected a decision about how to treat an illness or condition. Additionally, 26.6% (n= 66) of cancer survivors reported using CBD to supplement conventional medicine while 11.3% (n=28) said they used it to replace treatments. Conclusions: Taken together, the content analysis and survey results suggest the need for more focus on effects of cannabis product claims on clinically relevant health behaviors among cancer survivors and those who influence their care.