Grant: Team Grant: Cannabis Research in Priority Areas - Indigenous Peoples' Health

The legalization of non-medical cannabis in 2018 has raised many questions about the health effects associated with the drug's use. For instance, emerging evidence associates smoking cannabis with several oral diseases, including oral cancers. However, the effects of cannabis use on the oral health of Indigenous youth and adults are unknown. This study addresses stakeholder priorities and the impact increased cannabis use has on the already disproportionate burden of illness borne by Indigenous Peoples. Self-identified cannabis users and non-users, ages 18 to 44 years, will be recruited from partnering Indigenous communities and neighboring non-Indigenous communities, with each group followed for three years. Baseline and yearly comprehensive oral health examinations will be conducted by calibrated dentists. Saliva samples will be collected to monitor salivary constituents. Saliva and urine analyses will assess cannabis exposure. Non-invasive sensory tests will measure pain sensitivity in the orofacial region. Oral health outcomes will include: oral mucosal lesions, periodontitis, dental caries, changes in oral microbial composition, and abnormal sensory function. We hypothesize cannabis use in Indigenous and non-Indigenous populations is associated with: 1) a shift in the oral inflammatory signature that promotes the progression of pre-malignant lesions to oral cancers; 2) a distinctive salivary bacterial fingerprint; 3) a shift in the proteins in saliva reflecting a higher incidence of periodontitis and early-stage oral cancers, and; 4) oral and facial somatosensory changes dependent on drug use. The Indigenous Learning Circle model will be used throughout to share knowledge around the oral health risks of cannabis consumption and the drug's impact on Indigenous communities. The Circles will also be used to evaluate the research outcomes through the lens of the community so as to inform policy and recommend measures that promote cessation and harm reduction.