Recommendations From Arizona Budtenders to Mystery Callers Regarding Morning Sickness

Objective: To explore the recommendations for managing morning sickness made by Arizona budtenders, including types of products suggested and frequency of referrals to medical professionals. Design: Descriptive observational study using mystery calling. Setting: Eligible dispensaries in 12 of Arizona's 15 counties. Participants: Budtenders (N = 104) who answered the phone during regular business hours. Methods: Two researchers mystery called eligible dispensaries between February and April 2024 and documented budtender responses on a standardized form. We used counts, percentages, and 95% confidence intervals to analyze the data. Results: The response rate was 67%. Most budtenders (71.2%, n = 74) recommended cannabis products for morning sickness, especially cannabidiol and edibles. One fifth of these budtenders (18.9%, n = 14) recommended tinctures, one eighth (12.2%, n = 9) recommended inhalation products such as vapes and joints, and a few (5.4%, n = 4) recommended topicals. Most budtenders (85.6%, n = 89) encouraged a medical consultation, but relatively few (34.6%, n = 36) did so without prompting. Conclusion: Future researchers should investigate whether these trends are similar in other regions where cannabis is legal. Obstetrics and gynecology nurses should counsel patients proactively about prenatal cannabis use. Policymakers should consider mandating budtender training on cannabis risks during pregnancy as well as pregnancy-specific product warnings.