Cannabis information-seeking and engagement within the medication use process: The roles of health literacy, stigma, and system-level factors.

Westall K.; Bear D.; Gerges S.; Donnan J.; Hosker-Field A.; Cresswell M.; Bishop L. · Research in social & administrative pharmacy : RSAP · 2026

**Background & Methods** This qualitative study examined how Canadian adults (≥18 years) currently using or considering cannabis seek information and engage with healthcare providers, particularly pharmacists. Twenty-one participants participated in seven semi-structured virtual focus groups, with data analyzed using reflexive thematic analysis following Braun and Clarke methodology. **Key Findings** - Health literacy significantly influenced participants' ability to access, evaluate, and interpret cannabis information, as well as assess source credibility. Individuals with varying levels of health literacy demonstrated different approaches to navigating the complex landscape of cannabis-related information. - Stigma emerged as a critical barrier to information-seeking and disclosure, with participants reporting reluctance to engage with healthcare professionals about cannabis use due to perceived negative judgments and social concerns. - Engagement with pharmacists was substantially shaped by multiple interconnected factors: perceived pharmacist expertise in cannabis, role clarity within the healthcare system, accessibility of pharmacy services, and critically, the current absence of pharmacy involvement in cannabis distribution. Participants expressed uncertainty about pharmacists' qualifications and roles regarding cannabis consultations. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. **Evidence Quality** This qualitative study represents moderate-level evidence with notable limitations. The small sample size (n=21) and recruitment through email lists and professional networks introduces potential selection bias, as participants may not represent broader cannabis-using populations. The Canadian-specific context may limit generalizability to other jurisdictions with different legal and healthcare frameworks. As a qualitative focus group study, findings provide rich descriptive insights but lack quantitative measurement and statistical power. The lack of reported inter-rater reliability or reflexivity statements regarding potential researcher bias represents additional methodological considerations. However, the study's strength lies in providing in-depth exploration of previously understudied barriers and facilitators to cannabis-related healthcare engagement. The findings suggest system-level interventions are needed alongside individual-level health literacy and stigma reduction efforts to optimize pharmacists' roles in cannabis information provision and distribution.

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