Usage and health perception of cannabidiol-containing products among the population in Germany: a descriptive study conducted in 2020 and 2021

Abstract

Background: Cannabidiol (CBD), a non-intoxicating substance of Cannabis sativa L., is gaining consumer attention. Yet, legal regulations in the EU are complex and questions of potential health risks remain partly unanswered. In Germany, little is known about people who use CBD products. The aim of this cross-sectional study was to gain insight into the user group of CBD, reasons for consumption and risk perception towards CBD-containing products.

Methods: The study consisted of two parts: In the first part of the study, the prevalence of CBD awareness and usage in Germany was estimated using a telephone survey and a population-representative sample of n = 1,011 respondents. Based on these results, n = 2,000 participants being aware of CBD were surveyed with an online questionnaire in the second part of the study to examine usage and perception of CBD in users and non-users.

Results: When the study was conducted at the end of 2020 and beginning of 2021, 40.2% of the German participants had already heard of products containing CBD, and 11.4% had actually used them. 42.1% of the users consumed such products regularly, at least once a week, primarily orally via oils or tinctures, and purchased them mainly online. Besides curiosity - addressed especially in young adults - anticipated health benefits including pain and stress relief were main reasons for use. More than half of the study participants perceived the health benefits of CBD use as high or very high. In contrast, the health risks were rated as low or very low by most respondents. Assumptions about official testing for safety as well as physical effects of CBD-containing products varied between users and non-users.

Conclusion: About one in nine people in Germany uses CBD-containing products. Given reasons for consumption and perception of potential health risks and benefits suggest that people are insufficiently informed about CBD-containing products. The results of the study indicate that risk communication is needed to raise awareness for the topic and to inform (potential) users.

Keywords: CBD; Cannabidiol; Consumption; Germany; Online survey; Risk perception.

Fig. 1

Study part I: Percentage of participants answering “yes”, “no” or “don’t know / no response” to the question “Have you already heard of any products that contain CBD?”, Percentage of participants subsequently answering “yes” to the question “Have you already consumed or used any products that contain CBD?”; Details in Suppl. B, Table S2. Base: All respondent (n = 1,011) and respondents who have already consumed/had used CBD (n = 116)

Fig. 2

Study part II: Percentage of all participants answering “no”, “not sure / no response”, “yes” to the question “Have you already consumed or used any products that contain CBD?”; Main demographic characteristics of the respondents that already consumed or used any products that contain CBD (details in Suppl. B, Table S3). Base: All respondents (n = 2,000) and respondents who have already consumed/had used CBD (n = 535)

Fig. 3

Study part II: Product groups containing CBD used by consumers/users; separated by gender. Base: Respondents who have already consumed/had used CBD (n = 535), male (n = 256) and female (n = 277); multiple answers possible. Respondents indicating “divers” as gender are included in the total sample

Fig. 4

Study part II: Reasons for the consumption or use of CBD-containing products (open question) separated by age groups. Base: Respondents who have already consumed/had used CBD (n = 535), 16–29 years (n = 196), 30–59 years (n = 254) and 60 years and older (n = 85)

Fig. 5

Study part II: Perception of health risks and benefits. Answers to the question “How do you rate the health risks and health benefits of products containing CBD (cannabidiol)?” on a scale from 1 = very low to 5 = very high. Base: All respondents (n = 2,000), users (n = 535) and non-users (n = 1,271)

Fig. 6

Study part II: Perceived health risks. Base: Respondents who rated health risks of CBD products as at least 3 on a scale of 1 (very low) to 5 (very high) (n = 639). Open-ended question

Fig. 7

Study part II: Perceived health benefits. Base: Respondents who rated health benefits of CBD products as at least 3 on a scale of 1 (very low) to 5 (very high) (n = 1,497). Open-ended question

Fig. 8

Study part II: Knowledge about CBD. Percentage of respondents answering “In your opinion, does each of the following statements apply or not?” Base: All respondents (n = 2,000), users (n = 535) and non-users (n = 1,271)