Cannabis Consumers’ Understanding of New York State’s Required Cannabis Product Labeling

Abstract

The label content on consumer products is important for communicating health-related information and promoting safety, which is especially important for psychoactive products such as legal cannabis. New York State (NYS) legalized cannabis for adult use in 2021 and implemented packaging and labeling requirements, including requiring NYS symbols and a Certificate of Analysis (COA). We conducted an online survey exploring consumer recognition of the required NYS symbols and the comprehension and utilization of information provided in COAs. Participants (N = 195) had low recognition of required NYS symbols, most frequently selecting a symbol required in California as being required in NYS. Most participants did not know what proportion of the products that they used had a required NYS symbol on them. Half of the participants did not know how often they viewed COAs, and those who did viewed them less than half of the time they purchased products on average. Participants’ perceptions of the clarity of COAs and the impact of a COA on product safety were mixed. Additionally, 14.9% of respondents reported not using a product because of the information contained in the COA, and 13.8% reported not using a cannabis product because it did not have a COA. These results demonstrate the need for consumer education regarding cannabis product labeling and safety.

1. Introduction

This study examines consumer understanding of required cannabis product label information in New York State. Cannabis is the most used federally illegal drug in the United States; over 50 million people used it at least once in 2021 [1]. In April 2026, the U.S. Department of Justice and Drug Enforcement Agency officially moved U.S. Food and Drug Administration-approved cannabis products and state-regulated medical cannabis to Schedule III of the Controlled Substances Act, though cannabis otherwise remains on Schedule I. As of April 2026, cannabis was legal for medical use in 40 U.S. states and legal for adult use in 24 U.S. states. The U.S. National Academies of Sciences, Engineering, and Medicine (NASEM) assessed available evidence and determined that cannabis or cannabinoids are effective for treating chronic pain, chemotherapy-induced nausea and vomiting, and multiple sclerosis spasticity, and are likely effective for treating some sleep disturbances [2]. NASEM also concluded that there is substantial evidence that acute cannabis intoxication is associated with a greater risk of motor vehicle crashes, that cannabis consumption during pregnancy is associated with lower birth weight, and that those predisposed to develop schizophrenia or other psychoses are more likely to experience such conditions [2]. For example, research found dysregulation of the hypothalamus–pituitary–adrenal axis in chronic schizophrenic patients whose illness started after cannabis exposure, but not in those without cannabis exposure [3]. Cannabis products containing THC could have additional adverse effects such as dizziness, disorientation, sedation, and addiction potential [4,5,6].

People who use cannabis have low to moderate knowledge regarding cannabinoid content and dosages of THC and CBD [7] and the risks of cannabis [8], as well as the practices that can reduce the risks of such harms [9]. People who use cannabis rarely obtain their cannabis-related information from healthcare providers; their information generally comes from personal experiences, Internet searches, friends, and family members [9]. Cannabis-related information on the Internet is only moderately related to conclusions in the emerging scientific literature and contains considerable levels of misinformation [10]. Thus, it is critical to provide accurate information to consumers of cannabis.

Packaging and labeling are important for communicating product information to consumers; this is especially important for psychoactive products such as legal cannabis [11,12,13]. Cannabis product labels ensure safety, transparency, and regulatory compliance. In states that have legalized adult-use cannabis, regulatory authorities have established requirements for health warnings, product contents, standardized symbols, and other means to inform consumers about the product [11]. Pictorial cannabis labels may have greater salience for consumers than text-based information [14].

New York State (NYS) legalized adult-use cannabis for sale and consumption on 31 March 2021, and the first adult-use dispensary opened on 29 December 2022. Approximately 2 million adults in NYS reported consuming cannabis in 2023 [15]. In NYS, all legal adult-use cannabis products must meet packaging and labeling requirements [16,17]. Each product must display the Universal Cannabis Symbol—a bright yellow equilateral triangle with a black stylized cannabis leaf and the letters “THC!” boldly displayed in black on the main panel of the packaging, to alert consumers to the presence of Tetrahydrocannabinol (THC). All NYS cannabis products must include two additional symbols, including a clear “21+” in a red circle age restriction label to indicate that the product is intended exclusively for adults aged 21 and over. This label reinforces the legal age limit for purchasing and consuming cannabis. Additionally, an outline image of NYS and the words “New York State” appear on all packages, emphasizing that the product is a legal cannabis product produced and sold within New York State. These symbols are often displayed within and on the front of dispensary stores, including the entrance doors.

Labels must also clearly state the total THC and Cannabidiol (CBD) content per serving and per package, along with the number of servings, net weight or volume, and the complete list of ingredients, including any allergens. A scannable Quick Response (QR) code must also be included to provide access to the product’s Certificate of Analysis (COA), which is a laboratory-issued document that verifies the contents of a cannabis product. It typically includes detailed information on cannabinoid potency (such as THC and CBD levels), terpene profile, and results of safety tests for contaminants like pesticides, heavy metals, mold, residual solvents, and microbial pathogens. The primary purpose of a COA is to ensure consumer safety and provide transparency about the product quality and regulatory compliance. In New York State, COAs are required for each batch of cannabis products before they reach dispensary shelves, and QR codes linking to the COA are required on product labels to promote transparency.

Although the availability of COAs increases the transparency of product contents, the usability of these documents can vary widely. Some COAs are full of technical details, scientific jargon, small fonts, and complex tables, and may be difficult for the average consumer to interpret. Other COAs present information in a more user-friendly format, with visual summaries and clear labeling of “pass” or “fail” results for safety tests. New York regulations require that the COA be easily accessible, but they do not yet mandate a standardized, consumer-friendly format. As a result, although COAs promote transparency in theory, their practical utility depends on the accessibility of the COA and how clearly the information is presented by the testing labs and product manufacturers. Yet, little is known about consumer awareness, access, and understanding of cannabis product COAs.

This study explored consumer understanding of NYS cannabis product labeling. We investigated consumer recognition of the required NYS symbols as well as the utilization and comprehension of the information provided in COAs on NYS cannabis products. We examined symbol recognition by demographic characteristics and sources of cannabis and cannabis products. We predicted that participants reporting acquiring their cannabis from authorized dispensaries would have greater recognition of NYS symbols.

2. Materials and Methods

2.1. Participant Recruitment

The research team recruited respondents using multiple methods, including cards with recruitment scripts and QR codes at licensed cannabis dispensaries in New York State (NYS); emails sent from NYS cannabis dispensaries to their contact lists; providing iPads loaded with the survey at NYS cannabis dispensaries; and posting recruitment scripts with survey links on 39 cannabis-related Reddit communities. Participants were recruited between 2 August and 20 December 2024, nearly two years after the initiation of sales at adult-use cannabis dispensaries. Individuals 18 years of age or older who used cannabis or cannabis products in the past 12 months and currently reside in New York State were eligible to participate. The survey was anonymous and the survey program did not collect meta-data such as IP addresses, which could be used to identify participants. Informed consent was obtained and respondents were not compensated for their participation. Items assessed demographics, reasons for using cannabis, medical cannabis authorization status, sources of cannabis products, knowledge of NYS’s required cannabis labels, proportion of cannabis products consumed with the NYS label, and consumer use and understanding of COAs. The study was reviewed by the University at Buffalo Institutional Review Board prior to data collection. All procedures were performed in compliance with relevant laws and institutional guidelines.

2.2. Measures

Respondents completed a 15-item section on a cannabis use questionnaire. The first three items assessed age, gender, and whether respondents lived in New York State. Respondents indicated their frequency of cannabis use in the past 30 days (see

Table 1. Participant demographics and descriptives.

Characteristic	N = 195
Age in years (M, SD, range)	35, 14, 18–80
Gender
Woman	49.2%
Man	43.6%
Non-binary	4.1%
I don’t want to answer	1.0%
Transgender man	1.0%
Transgender woman	0.5%
Other identity	0.5%
What races/ethnicities do you identify with? (inclusive)
White	61.0%
Hispanic/Latino	20.5%
Black/African American	19.0%
American Indian or Alaska Native	2.1%
Asian	1.5%
Native Hawaiian/Pacific Islander	1.0%
Other	5.1%
In the past 30 days, how frequently have you used cannabis or cannabis products?
Not in the past 30 days	10.8%
Once	5.1%
2 to 3 times	8.7%
Once a week	4.6%
2 to 3 days per week	9.2%
4 to 6 days per week	9.2%
Once or twice a day	28.2%
Three or more times per day	24.1%
For what reasons do you use cannabis? (inclusive)
Fun/recreational activities	72.8%
Improve general well-being	64.1%
As an escape	35.4%
Treat medical condition(s)	29.7%
Spiritual growth	25.6%
Curiosity	21.0%
Reduce or end the use of prescription medications	15.4%
Reduce or end the use of substances(s) other than prescription medications	10.8%
Social/peer pressure	8.7%
Other	12.3%
Do you have a Medical Cannabis Card?
Yes	9.2%
In the past, but not currently	12.8%
No	77.9%
Sources of cannabis and cannabis products (inclusive)
Dispensaries with products for both medical and adult (recreational) use	75.1%
A dealer, someone who regularly sells cannabis without a license	22.9%
Non-dispensary retailers (head shops, gas stations, grocery stores, etc.)	17.9%
Informal sources, like a friend or neighbor	16.9%
Stores on Native American Reservations (Seneca Nation Territory, etc.)	13.9%
Flower that I grow myself	10.4%
Home delivery/Online	10.0%
Dispensaries that only sell to people with medical authorization	8.0%
Products that I make myself (like home-made edibles)	6.0%
Other	4.5%
Bars or restaurants	3.5%
Legally designated grower or caregiver	1.5%

). Next, respondents were asked “Where do you get your cannabis or cannabis products? (Select all that apply)” and were provided a checklist with 12 options (see Table 1). Respondents were asked, “How often do you scan the Certificate of Analysis QR code for your products?” and were provided a labeled 0% (“Never”) to 100% (“Always”) scale with a “Don’t Know” checkbox response option. Follow-up questions about the COA included having respondents rate the clarity of information in the COA on a 5-point Likert-type scale (extremely unclear to extremely clear, with a “Don’t Know” response option), and whether having a COA influences perceived product safety (less safe, no impact, more safe). Finally, respondents were asked if COA results have ever caused them to not use a cannabis product (yes/no), and if a product not having a COA has ever caused them to not use a cannabis product (yes/no).

In the next section, respondents were asked “Which of these should be on cannabis products sold in New York State?” and were allowed to select multiple options from six symbol images (three from NYS, one each from Colorado, California, and Michigan) that appeared in a randomized order across respondents. The question on the next survey page asked, “What proportion of the cannabis products you use had the New York State symbol on them?” with an image of the NYS symbol and a labeled 0% (“Never”) to 100% (“Always”) scale with a “Don’t Know” response option. On the three following survey pages respondents were asked, “For what reasons do you use cannabis? (Please select all that apply)” with a checklist with 10 options, “Do you currently have a medical cannabis (marijuana) card or certification?” and “What races/ethnicities do you identify with? (Please check all that apply.)” (see Table 1).

2.3. Analyses

Completed surveys were screened for participants who lived in New York State, were 18 years of age or older, and used cannabis or cannabis products. Descriptive statistics were conducted on the recognition of required symbols on labels for cannabis products sold in New York State and items related to Certificates of Analysis (COA). We repeated the analysis of the perceived clarity of information in COAs for participants who provided an estimate for the proportion of the times they scan COAs when purchasing cannabis products, excluding participants who reported never scanning COAs. A forward stepwise linear regression predicted the total number of required symbols correctly identified. Candidate predictors included demographic characteristics (age, gender, race/ethnicity), sources of cannabis, whether respondents had an active medical cannabis approval, whether respondents had an expired medical cannabis approval, whether respondents were recruited through dispensaries or social media, and frequency of cannabis use in the past 30 days.

3. Results

The analytical sample included 195 adults in New York State who used cannabis or cannabis products. The median completion time was seven minutes. About half of the participants were recruited through cannabis dispensaries (49.2%) and half were recruited through social media (50.8%). Participant demographics and descriptives are reported in Table 1.

3.1. Knowledge of Required Cannabis Product Labels

Three-quarters of participants (77.4%) incorrectly selected the symbol required in California when asked to identify the labels required on NYS-regulated cannabis products (see Figure 1). This was the label selected by the highest proportion of respondents. The required New York State outline symbol was correctly selected by the lowest proportion of respondents (37.9%). Only 7.2% of respondents correctly categorized all symbols. The majority (61.0%) of respondents did not know what proportion of the cannabis products that they used had the required NYS outline symbol on them; only 10.8% selected 100% of products. A total of 22.4% indicated that more than half of their products (including 100%) had the required NYS symbol, and 16.2% indicated half or fewer of their products had the required NYS symbol. Younger participants and those who reported obtaining their cannabis or cannabis products from dispensaries with products for both medical and adult (“recreational”) use had greater recognition of required NYS labels. Participants who identified as Black or African American (compared to those who did not identify as Black or African American) and those who reported obtaining their cannabis or cannabis products online and/or from home delivery had less recognition of required NYS labels (See

Table 2. Factors predicting recognition of required label symbols for cannabis products sold in New York State in a forward stepwise linear regression.

	Unstandardized Coefficients		Standardized Coefficients
	B	SE	Beta	t	p
(Constant)	3.91	0.30		13.10	<0.001
Black/African American	−0.83	0.23	−0.250	−3.64	<0.001
Age	−0.02	0.01	−0.199	−2.86	0.005
Home delivery/online as a source	−0.71	0.31	−0.158	−2.31	0.022
Adult-use dispensaries as a source	0.44	0.20	0.146	2.17	0.031

). Gender identities, participant source (dispensary vs. social media), whether respondents had an active medical cannabis approval, whether respondents had an expired medical cannabis approval, and frequency of cannabis use in the past 30 days were not significantly associated with label recognition.

3.2. Certificate of Analysis Utilization

When asked how often they accessed Certificates of Analysis (COAs), about half of respondents (49.7%) selected “Don’t know,” 31.3% scanned QR codes or otherwise accessed COAs less than half of the time (including 16.4% who reported never accessing QR codes), and only 18.7% reported accessing the COAs half of the time or more. Participants who provided an estimate scanned COAs an average of 31.9% of the time when they purchased cannabis products (SD = 35.6). When asked about the clarity of information in COAs, the plurality of participants responded, “Don’t Know” (46.2%); others selected “Extremely clear,” (12.8%), “Somewhat clear” (24.1%), “Neither clear or unclear,” (8.2%), “somewhat unclear” (6.7%), and “extremely unclear” (2.1%). We interpret “Don’t Know” responses as indicating a lack of understanding. We interpret “Neither clear or unclear,” as a neutral response. Participants who reported accessing COAs (n = 66; excluding participants who did not know how often they accessed COAs or reported never accessing them), reported that they considered the information provided in COAs to be “Extremely clear,” (24.2%), “Somewhat clear” (42.4%), “Neither clear or unclear,” (7.1%), and “somewhat unclear” (12.1%), with 15.2% responding “Don’t Know.” Regarding COAs and perceived product safety, almost half (48.2%) of respondents selected “It makes me believe the product is safer,” 46.2% selected “It has no impact on my perception of safety,” and 4.6% selected “It makes me believe the product is less safe.” Additionally, 14.9% of respondents reported not using a cannabis product because of the information contained in the COA, and 13.8% reported not using a cannabis product because it did not have a COA.

4. Discussion

There is an increasing need for a comprehensive program of risk reduction research and regulation regarding cannabis. Population representative surveys in the U.S. estimate that both non-medical and medical/therapeutic cannabis use are increasing in prevalence among adults [18]. In the current sample, 37.9% of participants used cannabis for therapeutic purposes, treating medical conditions or reducing their use of pharmaceuticals or other substances. This study assessed awareness and comprehension of state-required cannabis labeling (i.e., Universal Cannabis Symbol, 21+, New York State outline logo) and content reporting (i.e., Certificate of Analysis; COA) information among a convenience sample of cannabis consumers in New York State (NYS). Cannabis consumers were generally unable to identify required symbols on legal NYS cannabis products and more frequently selected symbols from other states (e.g., California) than those from NYS. This suggests that despite the legal availability of cannabis for adults in NYS, there remains a considerable illicit supply of cannabis products originating from other states or mimicking the properties of products from other states. Another study conducted in NYS found that the NYS cannabis symbol was only included on 13% of products at unlicensed dispensaries and 3% of products at unlicensed smoke shops [19]. Unlicensed cannabis products often had legal from other states, including California symbols with unclear meanings [19]. The same project documented that licensed cannabis products were more likely to include label information on health warnings and safety features [19], consistent with our finding of more label recognition among consumers who purchase products from licensed dispensaries.

Most consumers also did not know how often these symbols appeared on their cannabis product packaging, suggesting a lack of engagement with these regulatory symbols. The use and understanding of COAs showed complementary findings, with almost half of the respondents reporting “Don’t know” regarding the frequency of accessing COAs and the clarity of information on COAs. Together, these results suggest that regulatory efforts to denote the legal and safety status of legal cannabis products may be poorly understood or overlooked by consumers.

Cannabis product labeling is essential for determining the legitimacy and legality of products. Previous research has also demonstrated similar challenges that consumers experience regarding cannabis product labeling. A focus group in Denver, which included both cannabis consumers and non-consumers, indicated that only around 10% of individuals had previously seen the Universal Symbol, despite its requirement on products in Colorado [20]. Additionally, most non-consumers were surprised that there was no indication that the product contained cannabis, suggesting a misunderstanding of the Universal Symbol [20]. Of course, understanding these symbols is valuable for both consumers and non-consumers—ensuring that consumers can verify the legitimacy of a product, and ensuring that non-consumers do not accidentally consume a cannabis product. Although the current study did not include non-consumers, recognition of regulatory symbols was low among cannabis consumers in NYS, with 61% not knowing how frequently the symbol appears on their product and only 21% reporting the symbol appearing on over half of purchased products.

Similar findings were observed for COAs, with less than 20% of the sample accessing a COA on at least half of their purchased products and about 37% believing COA information to be somewhat or extremely clear. Although almost half indicated that a COA increases their perceived safety of the product, a similar proportion of the sample indicated no impact on their perception. Fewer respondents (less than 15%) indicated that COA results, or the lack of a COA, have led them not to use a cannabis product. To our knowledge, no other studies have assessed awareness and comprehension of COAs; however, studies on cannabis product labeling demonstrate converging results. Few Canadian youth and young adults properly understand quantitative THC labeling on edible cannabis products, with 28% reporting the accurate serving size based on THC content and 44% reporting “don’t know” [21]. Dosing and potency information were better understood when participants were provided with servings per package or a pictorial label (e.g., traffic light) to indicate product potency, though this may not easily apply across all cannabis product types [21]. U.S. cannabis consumers overestimated levels for high-THC, high-CBD, low-THC, low-CBD, and strains of cannabis, and most did not know effective dosages of THC or CBD [7].

Additionally, a focus group in Seattle found that cannabis consumers were unfamiliar with the meaning of Δ9 [20], the main psychoactive form of THC occurring in cannabis plants. Thus, it is not surprising that consumers may struggle to understand COAs and therefore fail to utilize them. Regulatory agencies must consider ways to increase engagement with and understanding of product labeling and reporting, such as exploring the value of using both numerical and non-numerical/pictorial labeling strategies [22]. However, further research is necessary to validate non-numerical labeling to ensure it is properly understood and does not mislead consumers about product risks and safety. COAs could make use of a color gradient graph (e.g., from green to red), indicating the relative risks for specific analytic results.

Our results imply the need for educational campaigns highlighting the importance of purchasing licit products from licensed dispensaries. This campaign could emphasize the importance of the required NYS symbols as an indicator of products that are regulated and tested for safety standards. Messaging could emphasize the importance of knowing what individuals are consuming to prevent illness, injury, and adverse events. These messages could be broadcast as public service announcements on television and radio and distributed through smartphone-friendly social media. Point-of-sale interventions could place educational materials in cannabis dispensaries.

African American and White adults in New York State have similar proportions reporting cannabis use [23]. It is notable that African Americans had lower recognition of NYS symbols. We included an assessment of cannabis product sources; however, there may still be residual differences in the proportion of products consumed from illicit supplies. It is apparent that culturally tailored educational programs are necessary to reduce disparities in knowledge of cannabis safety indicators. Partnering with members of the focus community, i.e., African Americans who use cannabis, on educational programs may help optimize the effectiveness of these messages.

A notable limitation of the current study is the recruitment of a convenience sample of cannabis consumers from a single state. Our sample has somewhat more women than men, whereas the prevalence of cannabis use in the U.S. is higher for men than for women [24]. There are some differences in preferences for cannabis administration methods; women are more likely to consume edibles, drink beverages, and apply lotions than men, whereas men are more likely to smoke or vape cannabis than women [25]. However, we did not see a gender difference in the recognition of required NYS symbols for cannabis products.

Given the self-selected sample, which is more likely to be cannabis-engaged than the average NYS adult consumer and the fact that the NYS symbols are displayed on the entrance door to the dispensary where participants were recruited, the study’s conclusions may be more conservative than they would be from a population-representative assessment, where recognition of required NYS symbols may be even lower. This study is cross-sectional and does not examine how results may change over time.

Future studies may benefit from assessing potential differences by state or country to determine if specific cannabis product labeling strategies may facilitate consumer utilization and comprehension. Cannabis labeling requirements vary considerably across U.S. states [11,12]. Similarly, assessing other factors that may be implicated in label understanding, such as health literacy and numeracy may be beneficial to understand how to make labels that are functional for all consumers [25,26,27]. An additional limitation is subjective reporting regarding product labeling symbols and COA comprehension. Objective assessments, such as having respondents upload product pictures or providing a COA for interpretation, may help assess the validity of these self-reports.

5. Conclusions

In summary, there was low awareness of required label symbols on cannabis products sold in NYS, and most consumers do not seem to attend to these symbols on products. Certificates of Analysis (COAs), which report on both the psychoactive (e.g., THC) and potentially harmful constituents (e.g., metals, pesticides) of a cannabis product, are regularly accessed by, understood by, and impact the product choice of a minority of cannabis consumers in NYS. These regulatory labeling and reporting requirements exist to protect public health and minimize the harms of illicit or unsafe cannabis products. Providing safety information for cannabis products is necessary, but not sufficient to protect the health of consumers if consumers are not aware of, do not access, and do not utilize this information. States with legal adult-use and/or medical cannabis should consider public education and outreach opportunities to ensure consumers are aware of proper labeling practices and understand the meaning and implications of COA results. Similarly, continued research is necessary to determine optimal strategies for communicating cannabis product information to both experienced and naïve consumers.