Hemp-derived tetrahydrocannabinol (THC) and kratom related health claims provided by smoke shop employees: a secret shopper study

<i>Background:</i> US smoke shop prevalence is growing and stores are diversifying products beyond nicotine vape supplies, often selling non-regulated psychoactive substances.<i>Objectives:</i> Investigate health claims and safety information provided by smoke shop employees regarding hemp-derived tetrahydrocannabinol (THC) and kratom.<i>Methods:</i> Secret shopper visits were conducted at 100 San Antonio and Austin, Texas smoke shops. Using scripted questions, shoppers assessed whether the shop sold THC and kratom, what these products could be used for, and adverse effects. Shoppers documented product availability, disease states referenced, health claims made, adverse effects mentioned, and guidance for use related to pregnancy. Descriptive statistics were calculated to characterize shopper reports.<i>Results:</i> THC (100%) and kratom (94%) were routinely stocked by smoke shops. Most employees made at least one health claim regarding THC (50%) or kratom (81%). Claims regarding pain (50%), insomnia (31%), and mental health disorders (27%) were most commonly discussed for THC, while drug withdrawal/cravings (76%), pain (69%), and mental health conditions (31%) were most frequent for kratom. When specifically asked about adverse effects, 22% and 24% of smoke shop employees, respectively, did not disclose any risks about THC or kratom; most others provided minimal information. The most common risks discussed were sedation (36%) and psychiatric (31%) adverse effects for THC, and dependence (59%) and gastrointestinal (24%) adverse effects for kratom.<i>Conclusion:</i> Efforts to develop evidence-based consumer information regarding kratom and hemp-derived THC, improve health information provided by smoke shop employees, and incentivize store owners to devote resources to employee education are needed.