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Official websites use. Share sensitive information only on official, secure websites. Author Note: Ideas and data appearing in this manuscript have been presented previously: Using Qualitative methods in measure development: Assessing behavioral economic demand for marijuana. Contributors Statement: All authors contributed in a significant way to the manuscript and all authors have read and approved the final manuscript. Behavioral economic demand for cannabis i. However, commodity ambiguities pose challenges and design concerns exist regarding current MPTs. The aim of this two-phase study was to modify and improve a MPT using qualitative methods. Phase I: Focus groups were conducted with regular i. Focus groups followed a semi-structured agenda, and executive summaries were made concerning key MPT themes. Feedback was used to refine the MPT. Phase I: Focus group analyses highlighted four critical areas for MPT improvement: 1 unit of purchase, 2 cannabis quality, 3 time duration specified for use episode, and 4 price. Participants suggested using grams as the unit of purchase, tailoring cannabis quality to the individual, and clarifying intended episode length. Phase II: Cognitive interviewing indicated additional areas for task refinement, resulting in a second iteration of the MPT based on the two phases. Qualitative research in both phases suggested a number of substantive modifications to the MPT format. MPT modifications are expected to improve comprehension, ecological validity, and general construct validity. Findings highlight the importance of careful instructional set development for drug purchase tasks for heterogeneous products that do not have standard units of consumption. Keywords: marijuana, cannabis, behavioral economics, purchase task, demand, qualitative methods, measure development. In these tasks, participants report how much of a substance they would purchase to consume at increasing price levels. Five indices of substance demand can be obtained via analysis of purchase task responses, including intensity i. Choosing an optimal substance unit of purchase is an integral part of purchase task design. Historically, measurement of alcohol and cigarettes has been expressed in standardized units of purchase i. However, there are substantial differences that must be taken into account in the quantification of cannabis units. In addition, its often illicit status, unpredictable availability, and often unregulated sale further obscure and confound accurate measurement of relative value. There are significant individual differences in administration mode Aston et al. Individuals report utilizing several modes of cannabis administration including joints, pipes, bongs, one-hitters, blunts, spliffs, dab-rigs, vaporizers, and consumption of cannabis in edible form Baggio et al. Further complicating accurate assessment, the majority of cannabis users report frequently using with others. Sharing cannabis with other users can complicate the ability to accurately self-report use level and frequency, highlighting the importance of quantifying the smallest measurable unit of use and cost. Similarly, in a sample in which the MPT has been previously validated Aston et al. The task assessed how many cannabis hits one would smoke at escalating prices, specifying that there were 10 hits of cannabis in a joint limiting responses to 99 hits. Selection of hits as the unit of purchase on this MPT was intended to increase resolution by using a smaller unit of analysis. Participants were informed that the cannabis available for purchase was of average quality. In contrast, the task employed by Collins and colleagues specified that the hypothetical cannabis available for purchase was high-grade. Importantly, demand for cannabis is influenced by specification of quality Vincent et al. The time period specified in the instructions from Aston et al. Similarly, Collins and colleagues restricted the task timeframe to four hours, similar to what has traditionally been used in alcohol purchase tasks. However, while four hours may be appropriate for an alcohol consumption episode, it is unclear whether this timeframe is characteristic of a cannabis use episode. Taken together, these initial studies highlight the large degree of variability in cannabis use practices and emphasize the importance of attending to such details during measure development. Qualitative research has high potential for addressing the aforementioned task issues in order to refine and validate the MPT. Qualitative methods can be used to improve existing assessments by soliciting feedback from members in the population of interest. Moreover, qualitative methods e. MPT formats and instructions have been designed by researchers Aston et al. Focus groups are well suited for measure development and improvement as group discussions with regular users of cannabis can reveal participant comprehension of instructions, provide opportunity to discuss key terms and appropriate language, and elucidate multifaceted concepts that may not be reflected in the current measures. Relatedly, cognitive interviews are ideally suited to evaluate measures intended to assess demand for cannabis. Cognitive interviewing may be used to evaluate instructional set and survey item comprehension. Utilizing feedback obtained with qualitative methods is essential to properly inform development of a valid and reliable measure of cannabis demand that will be effective across diverse modes of administration, use contexts, and amount commonly purchased. The current investigation employed a qualitative approach in two phases to identify strategies to improve the MPT. During Phase I, focus groups were completed with frequent regular cannabis users to identify strategies to optimize the MPT. Qualitative and quantitative data were collected on cannabis use patterns, purchase behavior, and cannabis demand, and feedback was solicited to effectively modify the marijuana purchase task. During Phase II, cognitive interviews were conducted with frequent regular cannabis users to evaluate task modifications and assess user comprehension. Participants met the following inclusion criteria: native English speaking, years of age, not seeking treatment for cannabis use, cannabis use at least 4 times in the past month on average and at least monthly for the past 6 months, and purchase of cannabis at least twice in the past 6 months. Participants were excluded from the study if they reported having obtained a medical cannabis registration card. Individuals with a medical cannabis registration card were interviewed as part of a separate study not presented here due to differences in cannabis access, cost, and legal ramifications. Study procedures were approved by the Institutional Review Board of Brown University and all participants provided informed consent prior to study participation. Participants completed self-report measures including a demographic information, the Marijuana History and Smoking Questionnaire Metrik et al. Focus groups were moderated by the study principal investigator EA who was accompanied by a research assistant trained in note-taking. Group discussions followed a semi-structured agenda designed to collect information from participants on evaluation of and suggested modifications to the MPT. Other data not presented here pertaining to cannabis use and purchase behavior were collected as well. Focus groups were digitally recorded and captured in observational notes. Debrief summaries were conducted immediately following completion of each group discussion. Participants were compensated for participation. Participants provided demographic information and completed the Marijuana History and Smoking Questionnaire to assess age of onset of marijuana use, typical cannabis use quantity, typical mode of self-administration, amount of money spent monthly on cannabis, and other questions related to cannabis use patterns Metrik et al. Participants were provided with an instructional vignette describing stipulations associated with hypothetical purchasing and consumption of cannabis i. Five metrics of cannabis demand were obtained from the MPT: breakpoint, intensity, elasticity, P max , and O max. An executive summary of each focus group was made via review of MPT section of the audio recording for each focus group. Key topics were summarized by a research assistant who was not involved in decisions regarding changes to the MPT. Illustrative quotes were subsequently selected to reflect each theme. The research team met and reviewed the executive summaries. Indices of cannabis demand were calculated from performance on the original MPT to confirm that the sample included in the current investigation reported similar levels of demand compared to those described in previous research Aston et al. Observed values for breakpoint, intensity, P max , and O max were estimated by directly examining MPT performance. The k value used in analyses was 1. An R 2 value was generated to reflect percentage of variance accounted for by the demand equation i. All responses exceeding 99 hits at any cost were recoded as 99 in an effort to compare purchase task performance in the current study with performance on a previously validated version of the MPT wherein consumption was capped at 99 for biological plausibility Aston et al. Demand analyses were conducted using GraphPad Prism 7. Demographic, cannabis use, and demand variables are presented in Table 1. Four participants showed evidence of constant demand i. A small number of outliers were detected 14 outlying data points; 2. Original raw data hits at these prices were 50, 30, 30, 30, 25, 25, 25, 25, 25, 25, 20, 20, 15, Figure 1 left illustrates the mean number of cannabis hits participants reported they would consume at 22 prices. Cannabis consumption generally decreased as a function of increasing price. Figure 1 right depicts the expenditure associated with each price. Demand curve for consumption of cannabis hits left ; expenditure curve for purchase of cannabis hits right. Four principal themes emerged during focus group discussions concerning areas for improvement in the original MPT measure, each described in detail below: unit of cannabis purchase, cannabis quality, time duration specified for use, and unit price. A summary of themes and subsequent modifications to the MPT following focus group completion is presented in Table 2. Many participants expressed confusion with the conversion of their typical administration mode to hits. Some participants provided additional explanation regarding why hits is not an optimal unit of measure for cannabis because hit size tends to vary as a function of administration mode. Grams as optimal unit of purchase : Overall, participants suggested using weight e. They explained that use of weight transcends administration mode. If you're smoking 0. It's 0. The majority of participants agreed that it may be problematic to specify quality on the MPT. Overall, participants agreed that high quality cannabis is typically available. That kind of affected \[it\]…if you put average…as between…the best weed and…the worst weed…that's still some pretty bad weed. So…generally, I wouldn't even buy that bad weed. Many participants agreed that cannabis quality should be tailored to the individual user on the MPT. Many participants indicated that the time duration designated on the MPT i. Because then I would have to do math. Say I use it only a couple times a month, or even just a couple times a week, then I have to divide that through…And that would be very hard for me. Overall, participants expressed concern with the requirement that all cannabis purchased on the MPT must be consumed immediately within the specified time duration. I'll buy a set amount and then smoke that over a period of time. One of them was you have to consume it all. I was assuming like the same day, I guess. That would pretty much exclude me from-from putting my amount here because I keep it for later occasions. The majority of participants stated that they typically purchase enough cannabis to last for some extended period of time, usually one or two weeks, and rarely purchase cannabis to use immediately. This was particularly true for less frequent, non-daily users. Some participants commented on the price ranges associated with hits that were designated on the initial MPT. Participants indicated that MPT prices should be altered to reflect changes made to a common unit of cannabis purchase i. Virtually all participants were familiar with the typical cost of cannabis per gram. Several other participants described the range of prices per gram that one might encounter in Rhode Island and Massachusetts, and subsequently explained how this range should be reflected on the MPT. And be like, how much would you pay for, like, one bowl pack, two bowl packs, or like, even half bowl packs, half joints, stuff like that? Overall, participants agreed that price points should realistically align with typical price per gram for cannabis in the US New England region. Exclusion criteria were identical to those presented in Phase I. Participants completed self-report measures before completing the cognitive interview. Cognitive interviews were conducted by the study principal investigator EA who was accompanied by a research assistant trained in note-taking. Interviews were intended to assess acceptability and comprehension of an MPT measure developed and refined following Phase I of this research see Table 2 for modifications to the MPT following Phase I completion. Thinking-aloud was demonstrated by the principal investigator, and then practiced by participants. Subsequently, for each point in the instructional set, comprehension was assessed. Participants were asked to explain the purpose of each instructional element in their own words and convey any potential points of confusion. Interviews were digitally recorded and captured in observational notes. Summaries were completed immediately following each interview. Participants completed identical measures to those presented in Phase I, with the addition of the modified MPT presented herein. Participant dialog regarding each component of the instructional set and task was transcribed and summarized across interviews. The interviewer EA documented the type and frequency of comments raised about the task. Dialog pertaining to each aspect of the instructional set focused on opinion, comprehension, or personal experience completing the MPT. An interpretivist analytic approach was employed i. Based on guidelines from previous research suggesting that sample sizes of five to 15 participants are sufficient for cognitive interviewing Willis, , an initial sample of 10 participants was recruited. Participants completed cognitive interviews using the version of the MPT modified following Phase I of this research. An executive summary of each interview was made and illustrative quotes were selected regarding each aspect of the instructional set. Subsequently, minor modifications were implemented based on feedback pertaining to the first iteration. An additional 10 participants were then interviewed, and theoretical saturation Morse, , was determined to have been met owing to repeated recurrent responses. Demand indices were generated from the refined MPT with identical formulae to that presented above. An R 2 value was generated to reflect percentage of variance accounted for by the demand equation. Demographic, marijuana use, and demand variables are presented in Table 1. A small number of outliers were detected 5 outlying data points; 1. Original raw data grams at these prices were 13, 13, 12, 10, The outliers were determined to be legitimate high-magnitude values and were recoded as one unit higher than the next lowest non-outlying value as follows: 6, 4. Figure 2 left illustrates the mean number of marijuana grams participants reported they would purchase at 20 prices. Cannabis purchase generally decreased as a function of increasing price. Figure 2 right depicts the expenditure associated with each price. Demand curve for consumption of cannabis grams left ; expenditure curve for purchase of cannabis grams right. At the beginning of the MPT discussion, participants were queried about the reference picture in the instructional vignette see supplemental materials. The instructional set next designates the timeframe for cannabis purchase and consumption as one week, and participants were asked about the appropriateness of this timeframe. The majority of participants endorsed this timeframe and indicated that it mapped on quite well with their own purchasing patterns. Participants also explained that longer timeframes might exclude less frequent users. The MPT vignette continued by instructing participants that they could only obtain marijuana from the current source and were not permitted to use any saved product. Participants were next instructed to assume they had access to their usual disposable income when making MPT decisions. Some participants were less constrained by this instruction, potentially reflecting an income effect. The vignette next asked participants to assume they had not used marijuana or other substances prior to completing the MPT, the intention being that participants would assume they were not under the influence while completing the task. While many participants understood the intention of this instruction, several others interpreted this point very differently, taking it to mean the task should be completed as if the individual had never purchased or used cannabis previously. Participants were subsequently instructed that they would not have the opportunity to use marijuana elsewhere after completing the MPT. The instruction was intended to create an isolated purchasing environment for cannabis. The next MPT requirement stated that participants were to assume they would have to use all marijuana they purchased. Importantly, other participants explained that this instruction altered their demand as it caused their purchasing to deviate somewhat from their typical patterns. The MPT next indicates that the participant should assume the marijuana available for purchase is similar to the quality and strength of marijuana that they typically use. In the first set of ten cognitive interviews, the maximum amount of cannabis available for purchase at any price was capped at 28 grams or approximately one ounce. However, other interviewees started to indicate that 28 grams may not be high enough. In response to these points, and in an effort to remove any unintentional suggestions about normative purchasing amounts that might result from a low cap, the cap was raised to 99 grams for the subsequent ten interviews. The final MPT instruction concerned the clarification that all marijuana purchased on the hypothetical task was for personal use and would not be shared with others. This point was easier to comprehend for individuals who usually smoke alone, but was substantially more difficult for those who tend to purchase and smoke with others. While most understood that this instruction was solely pertaining to purchase and use, others misunderstood the intention and thought it pertained to the hypothetical MPT environment. After integrating all feedback from Phase I and II, a finalized instructional vignette was developed as follows:. Assume that you can only get marijuana from this source. You have the typical amount of money available to you to purchase marijuana. You did NOT use marijuana or use any other drugs right before making these decisions. You will NOT have an opportunity to use marijuana elsewhere after making these decisions. You would use all the marijuana that you purchase. The marijuana you will purchase will be similar to the quality and strength of what you typically use. You can only buy a maximum of 99 grams. The present investigation represents the first comprehensive effort to refine the behavioral economic Marijuana Purchase Task for assessing marijuana demand. This study aimed to solicit narrative feedback from regular cannabis users on a MPT measure designed to assess demand for cannabis and to subject that feedback to qualitative analysis. Four themes regarding areas for improvement on the MPT emerged from focus group discussions including unit of cannabis purchase, cannabis quality, time duration specified for use, and unit price. In making decisions regarding adapting the MPT, we considered the range and breadth of suggestions reported by participants about their use and purchase behavior. We considered how experience and individual difference might shape task comprehension and aimed to select universally acceptable adaptations when appropriate. Feedback representative of each focus group was evaluated and compiled by the research team and was subsequently used to create a refined version of the MPT. The refined version was subsequently administered and evaluated during individual cognitive interviews. The MPT was subjected to final refinements and is presented herein. As cannabis is rarely purchased in hits, the term is not associated with the buying process. In addition, the majority of participants reported difficulty with determining number of hits taken during a typical use episode. While the term hits was initially chosen for higher resolution in terms of range and because it was thought to span across cannabis administration modes, it was revealed that administration mode impacts hit size, and thus does not transfer effectively across various methods of use. When presented with hits, participants did not typically understand this to mean that they should convert their own typical unit to hits, rather they interpreted the instructions to mean that they must purchase in hits, which was perceived to be unusual. According to participant feedback, grams appear to be an ideal unit of purchase and use for the MPT, effectively spanning administration mode and presenting with familiar and relatable price points. Participants largely agreed that replacing hits with grams as the unit of use and purchase on the MPT would greatly improve the task. Agreement with the decision to utilize grams as the unit of purchase was echoed across cognitive interview participants, who agreed that the real-world unit of purchase should be a central component of the task. It was suggested that cannabis quality be tailored to the individual user rather than ambiguously labeled as average in the MPT instructions. Many participants perceived average quality to be very poor compared to cannabis that is typically available for purchase, which ultimately impacted their demand. Similarly, participants explained that specification of high quality likely impacts demand as well, thus asking about typical quality of cannabis purchased and used by participants will facilitate more accurate assessment of cannabis demand. Indeed, a recent study showed that cannabis demand is significantly impacted by cannabis quality Vincent et al. Modifying the MPT language aligns well with instructions used in the alcohol and cigarette purchase tasks. Cognitive interview discussions reflected agreement with this change, including issues with specifying quality as average or high quality. Participants agreed that the time duration specified for use of cannabis on the task was vague, and it was suggested that the time period be extended to better correspond with purchase of grams. This time duration generated some confusion for non-daily users as well. Moreover, recent research suggests that time period specified in purchase task instructions can significantly impact demand, with demand increasing with duration of substance access Kaplan et al. As participants suggested that unit be changed to grams, the time duration for use needed to be greatly expanded to prevent a ceiling effect. Cognitive interview discussions reflected agreement with alterations to the instructions to permit cannabis to be purchased for use over a typical week, with participants pointing out that this length of time is more amenable to frequent and casual users alike. In both Phases of this research, participants commented that it was very difficult to place a price on a hit as hits are never associated with the buying process. Thus, it became difficult for them to ascertain the amount of cannabis in a hit and what an inexpensive versus expensive hit would cost. In the end, participants were firm regarding their opinion that researchers need to ask about prices in terms of a commonly used unit to remove uncertainty and increase ecological validity, and that these prices should align with accurate price per gram in the New England region. Importantly, prices on subsequent MPTs should be adjusted according to geographical location, as price per gram varies in response to origin, quality, and legal status in state of sale. Participants also suggested that administration mode be incorporated into the task. While this is not typically done with currently used substance purchase tasks e. There are several limitations to the current research of note. Thus far, MPT research, including the current study, has recruited relatively heavy cannabis users for study participation. Indeed, the demand indices in the current study were moderately higher than those in samples from previous MPT work Aston et al. Subsequent research should assess demand for cannabis among users with a diverse range of use level and frequency to increase generalizability. In the current qualitative research, individuals who reported possession of a medical cannabis registration card were excluded from participation due to differential access to cannabis and legal ramifications for use and purchase. However, over fifty percent of the sample still reported using cannabis for medical purposes at least occasionally. It is possible that individuals who use cannabis for medical purposes have different motives for use, and ultimately may exhibit divergent cannabis demand patterns. For such users, cannabis is used to treat an ongoing medical issue, and is therefore perceived to be a necessity. In this regard, the user may be willing to pay significantly greater prices. Future research should also examine demand in individuals who are eligible or choose to use cannabis for medicinal purposes. However, it is likely that many individuals use cannabis for both recreational and medical purposes depending on context, environment, peers, and the presence of medical symptoms. Subsequent research should aim to disentangle potential differences in cannabis demand based on recreational or medical reasons for using. Finally, the updated MPT has not yet been validated in a large representative sample of current cannabis users. Validating this new measure will be an essential step in this line of research. A state version of the original MPT has been administered in previous research and is sensitive in detecting cue-elicited changes in cannabis demand Metrik et al. It is important to note that the revised trait MPT measure presented herein is not appropriate for use in studies investigating phasic changes in demand for cannabis due to the use of grams as the unit of purchase and the specification that cannabis may be purchased for use over a one-week period of time. In this regard, some research indicates that daily cannabis users typically roll joints that hold less than 0. Consequently, grams as the unit of purchase and use is likely too large for assessing hypothetical immediate use of cannabis in a state-related paradigm. Alternatively, marijuana puffs may be a good unit of measurement for state assessment of cannabis demand as users may be able to accurately report how many puffs they would take in a short, clearly defined time period. Relatedly, cannabis joints may be an effective unit for experimental or ecological studies intending to assess phasic alterations in demand, and has been used effectively in previous experimental research Collins et al. However, issues may arise when assessing demand in less frequent users, as such users tend to use comparatively small amounts of cannabis, and thus may not smoke an entire joint in one session. The appropriate unit for research that assesses state changes in cannabis demand is an area for future study. Moreover, no MPT study has been linked to immediate outcomes i. Ongoing research from our group intends to link MPT responding to immediate outcomes as this is a key step in confirming measure validity. Behavioral economic approaches to the study of maladaptive cannabis use emphasize that perception of high relative substance value, despite elevated cost and risk for consequences, is a key determinant of use. As a result, valid measures for quantifying drug reinforcing value are essential for investigating hypotheses within this framework. Development of the refined MPT in this investigation was the culmination of a comprehensive assessment of variables surrounding purchase of a substance with mixed illicit status. Cannabis consumption and purchasing are heterogeneous and multifarious in nature, involving consideration of a multitude of factors including consequences, availability, variety, price, and quality, among others. Utilizing grams, a real-world unit of cannabis purchase, and permitting purchase for a week rather than a day, will improve accuracy of the demand indices. Cannabis demand will more accurately map on to real-world use and purchasing patterns, effectively increasing ecological validity. In this regard, the refined purchase task is anticipated to allow for more precise assessment of cannabis demand and, in turn, enhance a wide array of subsequent studies, including demand as a determinant of cannabis misuse, cannabis taxation policy, and how cannabis demand shifts during co-use with other substances such as alcohol, nicotine, and opiates. Public Significance Statement: This investigation employed qualitative methods to refine the behavioral economic marijuana purchase task MPT. Findings suggest that qualitative techniques can be highly informative for behavioral economic measure development, particularly for substances with inconsistent legality and regulation. We are grateful to Rachel Souza, Alana Mercurio, and Miriam Midoun for assistance with data collection and analysis, as well as to Kate Guthrie for assistance with data collection techniques and analysis approach. All funding sources had no other role in study design or manuscript preparation other than financial support. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Exp Clin Psychopharmacol. Published in final edited form as: Exp Clin Psychopharmacol. Find articles by Elizabeth R Aston. Find articles by Jane Metrik. Find articles by Rochelle K Rosen. Find articles by Robert Swift. Find articles by James MacKillop. Issue date Feb. PMC Copyright notice. The publisher's version of this article is available at Exp Clin Psychopharmacol. Open in a new tab. Conflicts of Interest: There are no conflicts of interest to declare. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Money spent on cannabis past 30 days. A typical day over the last month when you would use marijuana.

Al Ain buying ganja