Behind the Idea

When I first began thinking about this research, cannabis legalization in Canada was gaining momentum and with it, a wave of public opinions, media buzz, and policy shifts. But I felt as though something was missing. While cannabis is generally considered low risk compared to other substances, the reality is: anything you put in your body carries potential risks.

The normalization of cannabis use was moving quickly — maybe faster than our collective understanding. That was the spark. I started wondering: What do people really know about cannabis, its effects, and its potential harms? Not just anecdotally or on social media, but in a way that could be measured, studied, and used to inform public health strategies. If cannabis was going mainstream, so should cannabis education.

That led me to an idea that felt simple at first: build a tool to measure cannabis health literacy. A questionnaire. Something that could capture what the public knows (or doesn't know) about cannabis, validate that measure, and potentially use it later as a way to inform or assess education efforts in clinical or community settings.

Why It Matters

This research began with a core question: What do people actually know about cannabis, its risks, its effects, and its role in health? As legalization moves forward, understanding doesn’t automatically follow. Public education efforts exist, but their reach and impact remain unclear.

So, we asked: What should people know to make informed decisions? And just as importantly, how can we measure that knowledge in a valid, reliable way?

Cannabis health literacy isn’t just about knowing what Tetrahydrocannabinol (THC) or Cannabidiol (CBD) stand for. It’s about having the skills to make informed, safe, and intentional choices — especially as cannabis becomes more accessible. It draws on core health literacy principles: the ability to seek, understand, and apply health information to real-life decisions.

By creating a validated tool to measure that knowledge, we’re one step closer to supporting public education, informed policy, and better integration of cannabis-related conversations in healthcare. Whether it’s doctors screening patients, educators shaping harm reduction curricula, or governments assessing the impact of legalization, a literacy tool is a foundation to build on.

Key Highlights from the study

• We developed the Cannabis Health Literacy Questionnaire (CHLQ) to assess individuals’ knowledge, understanding, and application of cannabis-related health and safety information across four dimensions:
  1. Knowledge of Cannabis (e.g. components, potency)
  2. Knowledge of Risks (e.g. mental and physical health)
  3. Understanding of Harms and Consequences (i.e., applying risk knowledge to real life)
  4. Ability to Seek, Access, and Use Cannabis Health Information (i.e., interacting with cannabis- health related information)
• The tool was guided by established health literacy frameworks and refined through three iterative rounds with input from stakeholders and cannabis consumers.
• We used Rasch analysis to validate the four dimensions, evaluating item difficulty, model fit, item and person separation, reliability, and unidimensionality.
• Each dimension has a separate scoring system; higher raw scores indicate greater literacy in that area.
• The CHLQ is suitable for use in descriptive and educational research. However, further validation — particularly across diverse populations and over time — is needed.

Looking Ahead

I hope this paper sparks a broader conversation about what I’d call “substance literacy” — not just for cannabis, but across the spectrum of substances. When we talk about harm reduction, we often focus on access and treatment. But understanding is harm reduction too.

We’re continuing to assess cannabis health literacy and are preparing a follow-up paper exploring what Canadians knew at the time of data collection. We welcome feedback and collaboration to further strengthen and refine the questionnaire.

My hope is that it opens doors for further research, better dialogue, and more thoughtful public health approaches. As cannabis shifts from taboo to typical, we need tools that keep pace with public knowledge and conversation.

The paper is now out in the world — but the conversation is just beginning.

Read the full paper here: Development of a cannabis health literacy questionnaire: preliminary validation using the Rasch model