The websites identified (n = 70) had on average 30.9 (median, 21) CBD products for sale (see Table 1). The most popular form of CBD product available was oil/tincture/concentrate (n = 755), followed by edibles (n = 428), vaporizer pen/cartridge/liquid (n = 290), topical/cosmetic products (n = 200), capsules/pills/soft gels (n = 178), dried cannabis flower products (n = 163), bath products (n = 80), beverages (n = 36), patches (n = 21), assorted product (n = 7), suppositories (n = 5), and other forms (n = 2) (see Table 2).
Table 1 Number of CBD Products by Website and Framing Code Table 2 Number of CBD Products by Form Frame #1: treatment or cure for specific ailments
The first framing theme identified, treatment or cure for specific ailments (n = 1153 products), contained product claims of suggestive efficacy and effectiveness for 171 medical conditions, ailments or symptoms (Table 3 summarizes claims with a minimum frequency of 20 claims). Treatment and curative claims ranged from minor ailments such as pain, inflammation, or bruising, to severe ailments such as replacement of conventional cancer treatment, Parkinson’s disease treatment, and neurological conditions. For example, a dried flower product from the bestpotdelivery.ca website stated their product was “very effective for chronic medical conditions like bipolar disorder, chronic stress, depression, panic attacks, anxiety disorders, and post-traumatic stress disorder” and that “one lungful and you’ll feel all your depression and stress melt away.” Other CBD product descriptions contained long lists of purported treatments and conditions. For example, a product description for a CBD infused lollipop from herbapproach.com listed the following purported uses: “Medical Conditions [treated by CBD]: ADD, ADHD, Anxiety, Appetite, Arthritis, Asthma, Back Pain, Bipolar Disorder, Body Pain, Cachexia, Cancer, Cramps, Crohn’s Disease, Depression, Epilepsy, Fibromyalgia, Gastrointestinal Disorder, Glaucoma, Headaches, Hepatitis C, HIV/Aids, IBS, Inflammation, Insomnia.”
Table 3 Number of Medical Claims by Condition/Symptom (minimum frequency, n = 20) To support CBD as a treatment for the numerous conditions or ailments collected in the product descriptions, retailers or the CBD companies provided references to published research studies or used anecdotal feedback from their customers or, in some cases, themselves. When describing the research, retailers often used animal-based studies or study designs that were not suitable for clinical adoption to support their claims. For example, a CBD capsule product from thehealingco.ca stated: “A rarely discussed health benefit of CBD oil is how it can reduce the risk of developing diabetes. In a study … 32% of the mice that received the CBD were diagnosed with diabetes, compared to 100% of the untreated group.” The details of the studies, including information on study limitations, were often not disclosed. For example, a CBD infused vaporizer liquid from thefoggyforest.ca stated: “A lot of studies have been done that point to CBD being beneficial for fighting cancer. Less potent cancer cells were found in breast tumours when a person uses CBD.” The product description further states: “[T]here’s also one study that shows dependent cell death thanks to the CBD oil. This non-toxic compound, when used at 700 mg per day for six weeks, showed no signs of toxicity.”
Testimonials for product efficacy were referenced in some product descriptions. Statements of anecdotal effectiveness did not make general claims, but rather detailed how they had been helpful for certain people and relieved their symptoms or condition. For example, a product description from a CBD Move gummy product on the healingco.ca website contained anecdotal feedback from the company founder and his social network. He described how his experience with CBD had motivated him to bring the benefits to others: “After an injury, the creator of CBD Move discovered the power of CBD. As he says himself [he] started recommending CBD to friends and relatives suffering from different physical ailments, arthritis, headaches etc. Every single time CBD provided them ease and welcome relief.” The framing of CBD as a treatment or cure for specific ailments was represented through direct claims, seller interpretation of CBD research, and through anecdotal product testimonials.
Frame #2: natural health product
The second framing identified, a natural health product (n = 872 products), sold the natural benefits of CBD and its advantage over conventional health products. Most often, products described CBD as a natural option to treat pain. For example, a CBDfx lotion product sold on the chilliwackcbd.ca website stated: “This skin-nourishing cream lets you target your pain ‘hot spots’ with the healing power of 150 mg of full-spectrum CBD hemp oil and other natural pain relievers.” Products in numerous cases advocated using CBD in place of other conventional medications or treatments. These ranged from minor substitutions, such as using CBD for inflammation, to suggestions of potential treatment replacement of severe illnesses. For example: “Over the past few decades, informed consumers have begun a major shift away from synthetic pharmaceutical drugs with their long lists of debilitating side effects, in favour of health-enhancing natural remedies” and that “CBD, from hemp is providing that all-natural solution for many, and word of its success at providing an amazing variety of therapeutic benefits for a host of physical and mental disorders.”
Natural framing of CBD commonly described the cultivation methods and additional ingredients or precautions used to formulate the product. Natural health product terms such as “organic”, “pure”, “non-GMO”, “pesticide-free”, and “naturally grown” were viewed in product descriptions as selling qualities. For instance, an edible CBD infused gummy product from balancecbd.com made the following statement to support the role of organically produced products on health: “Our tasty gummies are made with the finest organic ingredients, without any animal by-products, cementing our commitment to providing a natural way to enjoy the benefits of CBD.” Another tincture product from earthchoicessupply.com used a similar method of selling the organic production of their product and its effect on health: “try our 3000mg Premium Hemp Tincture Oil if you want a quick and effective way of getting all the benefits offered by this unique plant. Natural and Organic are the best words to describe our 30ml Tincture Oil that contains 3000 MG CBD Oil and 0% of THC!” CBD was framed as a natural health product through descriptions of natural benefits, cultivation methods, or ingredients. The natural characteristics of CBD were used by sellers to illustrate its claimed advantages over conventional products and terminology associated with natural products emphasized for safety.
Frame #3: a product used in specific ways to achieve particular results
The third frame, a product used in specific ways to achieve particular results (n = 1388), utilized characteristics of treatments to describe CBD products and advertise them to potential buyers. These included describing CBD products in terms of treatment unit quantities, labelling the use of CBD products as treatment, offering comparison to medical or pharmaceutical standards, and identifying treatment methods of administration. CBD quantities were characterized as “doses” and contained language using precise amounts to describe CBD concentration. These statements were similar to pharmaceutical advice and direction. For example, a CBD gummy product from happybears.ca stated that “[e] ach chewy gummy combines a concentrated dose of pure CBD with the natural calming properties of Melatonin to promote restful sleep and morning wakefulness.” Product descriptions contained language that referenced the person taking CBD as receiving “treatment” or being a “patient” for using a CBD product. For example, a zenabis.com CBD spray stated the intended user of their product was a patient: “Each 0.1 ml spray (at full compression) of Zenabis’ High CBD 30:0 Spray offers patients 3 mg of CBD and 0 mg of THC in Medium-chain Triglyceride (MCT) oil.”
Comparisons to existing standards of conventional treatment were observed in these campaigns. Products utilized such terminology such as “pharmaceutical grade” or “medical grade” to support the potential health impact of product use. For example, a CBD product from CBD-EEZ on the birachandfog.com website that is sold in powder form stated: “each effervescent packet comes with 50mg of 99.9% pharmaceutical grade CBD to give you easy relief from anxiety, pain, insomnia and/or stress.” Similarly, the recommended intake method of CBD emulated conventional treatments. CBD product administration methods included ingestion, sublingual intake, topically, through capsules, pills, soft gels, syringes, suppositories and droppers. For example, an Emerald Health product on the Ontario Cannabis Store website (ocs.ca) stated: “This flavourless concentrated cannabis oil comes in a 20-mL bottle which includes a precision 1mL dosage syringe.” Sellers framed CBD as a product used in specific ways to achieve particular results by equating CBD to conventional forms of medications and treatment.