Public interest in Cannabis during election season: a Google Trends analysis

Abstract

Introduction: Given that 72% of internet users seek out health information using an internet search engine (Google being the most popular); we sought to investigate the public internet search interest in cannabis as a health topic when cannabis legislation appeared on state ballots and during presidential elections.

Materials and methods: We searched Google Trends for "cannabis" as a health topic. Google Trends data were extracted during the time period of May 1, 2008 to May 1, 2019 for the United States (US) and select states (18) within the US including: Alaska, Arizona, Arkansas, California, Colorado, Florida, Maine, Massachusetts, Michigan, Missouri, Nevada, North Dakota, Ohio, Oregon, Oklahoma, South Dakota, Utah, and Washington when cannabis was on the ballot. These state elections were referenda, not legislative votes. We then compared the internet search interest for cannabis before and after each election. To evaluate whether any associations with changes in the volume of cannabis internet searches were specific to the cannabis topic, or also occurred with other topics of general interest during an election year, the authors ran additional analyses of previously popular debated policies during Presidential Elections that may act as control topics. These policies included Education, Gun Control, Climate Change, Global Warming, and Abortion. We used the autoregressive integrated moving average (ARIMA) algorithm to forecast expected relative internet search interests for the 2012 and 2016 Presidential Elections. Individual variables were compared using a linear regression analysis for the beta coefficients performed in Stata Version 15.1 (StataCorp).

Results: Public internet search interest for "cannabis" increased during the voting month above the previous mean internet search interest for all 18 bills. For the US, observed internet search interest during each Presidential Election was 26.9% [95% CI, 18.4-35.4%] greater than expected in 2012 and 29.8% [95% CI, 20.8-38.8%] greater than expected in 2016. In 2016, significant state-level findings included an increase in relative internet search rates for cannabis in states with higher usage rates of cannabis in the past month (Coeff (95% CI), 3.4 (2.8-4.0)) and past month illicit drug use except cannabis rates (Coeff (95% CI), 17.4 (9.8-25.0)). Relative internet search rates for cannabis from 2008 to 2019 were also associated with increased cannabis usage in the past month (Coeff (95% CI), 3.1 (2.5-3.7)). States with higher access to legal cannabis were associated with higher relative internet search volumes for cannabis (Coeff (95% CI), 0.31 (0.15-0.46)). Of the five additional policies that were searched as topics, only two showed an increase in internet search interest during each Presidential Election. Climate Change increased by 3.5% [95% CI, - 13-20%] in 2012 and 20.1% [95% CI, 0-40%] in 2016 while Global Warming increased by 1.1% [95% CI, - 19-21%] in 2012 and 4.6% [95% CI, - 6-15%] in 2016.

Conclusion: Based on these results, we expect public interest in cannabis will spike prior to the Presidential election in 2020. Of the five selected control policies, only two showed an increase in internet search interest during both Presidential Elections and neither exceeded the internet search increase of cannabis. These results may indicate the growing awareness of cannabis in the US and mark a possible target for the timely dissemination of evidence-based information regarding cannabis and its usage/side-effects during future elections. Consequently, the results of this study may be important to physicians since they will likely receive an increased volume of questions relating to cannabis and its therapeutic uses during election season from interested patients. We recommend establishing a cannabis repository of evidence-based information, providing physician education, and a dosing guide be created to enable physicians to provide high quality care around the issue of cannabis.

Keywords: Cannabis; Elections; Google trends; Internet search; Medical marijuana; Politics.

Fig. 1

Relative internet search interest in “Cannabis” as a health topic between 2008 and 2019. Legend: Monthly trends in relative internet search volume for “Cannabis” as a health topic in the United States from 2008 to 20,019 was measured using Google Trends. Observed internet search trends (black line) vs. expected forecasts (gray line) calculated using an ARIMA model following the presidential elections of 2012 and 2016. The spike in searches for cannabis during January of 2014 is most likely due to the start of the first legal recreational cannabis sales in Colorado

Fig. 2

State-Level Associations Between Cannabis Use, Illicit Drug Use, Access To Legal Cannabis and Relative Internet Search Rates for Cannabis. Legend: State-level associations between relative internet search rates for cannabis and a cannabis use in the past month (coeff (95% CI), 3.4 (2.8–4.0)), b access to legal cannabis grade (coeff (95% CI), 0.31 (0.15–0.46)) and c illicit drug use in the past month (coeff (95% CI), 3.1 (2.5–3.7)). Relative internet search rates for cannabis were obtained using Google Trends. All cannabis and illicit drug use statistics were obtained from the National Survey on Drug Use and Health (National Institute on Drug Abuse 2019). Each state’s Access to Legal Cannabis Grade was obtained from American’s for Safe Access (Reports [Internet] 2020). The black dots represent each state, the gray line represents the 95% CI and the blue line is the regression line. All associations were made using a linear regression for the beta coefficients in Stata 15.1