Seven medical cannabis tax preferences provide tax relief to patients
and cooperatives. After 2019 statutory changes, it is unclear how pending taxpayer
guidance may affect beneficiary savings.
The 2015 Legislature enacted seven tax preferences for medical cannabis: six
sales and use tax exemptions for medical cannabis patients and cooperatives,
and a business and occupation (B&O) tax exemption for medical cannabis
cooperatives.
The preferences vary in customer eligibility requirements, intended
beneficiaries, and qualifying purchases and activities.
The preferences have no expiration date.
Usage limited in part by availability of medically endorsed retailers
Six of the seven preferences require access to a retailer with a medical endorsement
from the Liquor and Cannabis Board. Medical endorsement is voluntary for licensed
retailers. Washington has 275 medically endorsed retailers in 32 counties. These
retailers can register eligible customers in the medical cannabis authorization
database and make tax-exempt sales. In fiscal year 2020, 205 retailers made tax-exempt
sales. Some retailers, including medically endorsed retailers, offer retail discounts
in lieu of the medical cannabis sales tax exemptions. It is unclear how often
customers make purchases with discounts instead of the preferences.
Largest tax preference subject to updated guidance
Over 87% of beneficiary savings for the medical cannabis tax preferences have been
realized under one retail sales tax preference. In 2019, the Legislature modified the
tax preference to refer to DOH-compliant products. It is unclear how pending taxpayer
guidance will affect future beneficiary savings.
Recommendations
Legislative Auditor's Recommendation: Continue
The Legislature should continue the preferences because they provide tax
relief to medical cannabis patients.
The Department of Revenue and the Department of Health should update guidance
to reflect 2019 statutory changes.
The Commission endorses the Legislative Auditor's recommendation with comment.
Testimony suggests the state should consider reviewing the definitions and guidelines
associated with medical cannabis. The Legislature may want to evaluate approaches used
in other states, such as Colorado, and consider whether and to what extent
Washington’s laws can be altered to better meet patient needs. The Legislature may
find that additional interventions may be needed to address the issues raised in
testimony. These issues largely revolve around quality and price differentials between
the regulated and unregulated market.
Committee Action to Distribute Report
On December 1, 2021 this report was approved for distribution by the Joint
Legislative Audit and Review Committee. Action to distribute this report does not
imply the Committee agrees or disagrees with Legislative Auditor recommendations.
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
REVIEW Details
1. Seven preferences for medical cannabis
Seven preferences provide tax relief for medical cannabis
purchases and cooperatives
Six preferences provide exemptions from sales and use tax on retail purchases of
cannabis and cannabis-based products, and one preference provides an exemption from the
B&O tax for medical cannabis cooperativesMedical cannabis cooperatives allow up to four medical cannabis
patients or their designated provider to grow cannabis for the patients’ personal
use.. The preferences were enacted in 2015, and have no expiration
date.
Three agencies are involved in medical cannabis regulation or taxation. The Department
of Revenue (DOR) collects retail sales and use taxes and provides guidance to taxpayers.
The Department of Health (DOH) administers the medical authorization database, licenses
and regulates the medical cannabis consultant certificate, and establishes product
quality standards for products that may be beneficial for medical use. The Liquor and
Cannabis Board (LCB) licenses and regulates cannabis producers, processors, and
retailers, and collects the marijuana excise tax.
Preferences limited to certain retailers, customers, and products
When the 2015 Legislature created the preferences, it stated its intent to provide
tax relief to medical cannabis patients and cooperatives under certain circumstances.
The preferences vary in customer eligibility requirements, intended beneficiaries, and
qualifying purchases and activities. See Section
3 for beneficiary savings for each preference.
Exhibit 1.1: Seven preferences provide exemptions to eligible cannabis sales and
medical cannabis cooperatives
Preference name
Statutes (RCW)
Tax Type
Beneficiaries
Access to
medically endorsed retailer required?
Registration in patient database required?
Qualifying activities
Medical Cannabis Sold to Qualifying Patients
82.08.9998(1)(a),
82.12.9998(1)(a)
Sales and use
Recognition cardholders
Yes, to purchase
Yes
Purchases of DOH-compliant productsProducts that meet DOH standards (Chapter 246-70 WAC)
for certain heavy metals and pesticides. (As of Jan. 1, 2020. Previously all cannabis products. See Section 3 for more detail)
Low THC Products Sold to Qualifying Patients
82.08.9998(1)(b),
82.12.9998(1)(b)
Sales and use
Recognition cardholders
Yes, to purchase
Yes
Purchases of products less than or equal to 0.3% THC
Cannabis with Low THC High CBD Ratio
82.08.9998(1)(c),
82.12.9998(1)(c)
Sales and use
All customers
Yes, to purchase
No
Purchases of DOH-compliant products appropriately labeled as Low THC, High CBD
Ratio
Topical THC Sales by Health Care Professionals
82.08.9998(1)(d),
82.12.9998(1)(d)
Sales and use
All customers
No
No
Purchases of topical products with less than or equal to 0.3% THC from health
care professionals
Medical Cannabis Produced and Used by Cooperative Members
82.08.9998(1)(e)(i),
82.12.9998(1)(e)(i)
Sales and use
Members of cooperatives
Yes, to register in patient database
Yes
Transfers of cannabis products between members of the same cooperative
Resources and Labor Contributed by Medical Cannabis Cooperative Members
82.08.9998(1)(e)(ii),
82.12.9998(1)(e)(ii)
Sales and use
Cooperatives
Yes, to register in patient database
Yes
Contributions of resources and labor by members to their own cooperative
Cannabis Cooperatives
82.04.756
B&O
Cooperatives
Yes, to register in patient database
Yes
Operations of cooperatives
Source: JLARC staff analysis.
Licensed retailers may receive medical endorsements from the Liquor and Cannabis
Board
Licensed retailers may request a medical endorsement from LCB. To hold an endorsement
in good standing (WAC 314-55-080), a retailer must, among other requirements:
Employ a cannabis consultant certified by DOH.
Demonstrate the ability to register patients in the medical cannabis patient
database.
Issue recognition cards to registered patients and their providers.
Carry a representative assortment of cannabis products for registered patients and
designated providers.
While all requirements are subject to enforcement, LCB states it only enforces the
requirement to employ certified consultants.
Patients and their designated providers may register as recognition cardholders
Exhibit 1.2 Number of retailers issuing recognition cards declining
Source: JLARC staff analysis of Department of Health data.
Five of the preferences are restricted to patients registered in the medical cannabis
authorization database or their designated provider. Collectively, these people are
called "recognition cardholders," because they are issued a recognition card when they
register in the database. To register, patients or designated providers must visit a
medically endorsed retailer and request registration from a certified consultant.
The number of retailers issuing cards and the number of cards issued have declined in
the past three years. According to state agency staff and stakeholders, the reason for
this decline is unknown.
Two preferences are available to all customers. These apply to products that do not
have significant psychoactive effects due to their low concentrations of THCThe principal psychoactive compound in
cannabis. .
Three preferences are available to cooperatives and their members. Medical cannabis
cooperatives allow up to four medical cannabis patients or their designated providers
to grow cannabis for the patients’ personal use. To register in a cooperative, a
patient or designated provider must obtain a recognition card through a medically
endorsed retailer. There are currently 12 cooperatives in six counties.
Department of Health's compliant product standards apply to two preferences
Two preferences apply to sales of products that meet DOH's compliant product
standards. These standards are optional criteria that cannabis producers and
processors test their products against, in addition to the LCB standards for all
cannabis products. Current DOH standards establish maximum allowable levels for
certain heavy metals and pesticides which are not included in the LCB testing
standards. The compliant product standards are intended to provide quality assurances
for products that may be used to address medical conditions.
DOH-compliant products fall into three categories: General Use, High THC, and High
CBD Low THC Ratio.
Exhibit 1.3: DOH-compliant products fall into three categories
Product Category
Eligible Product Types
Eligible Retailers
Eligible Customers
GENERAL USE
May be of any product type allowed by LCB. No more than 10 mg THC per
serving.
Any licensed retailer
Adults 21+ and recognition cardholders
HIGH CBD LOW THC RATIO
Concentrates: No more than 2% THC, and a ratio of at least 25:1
CBD:THC
Edibles: No more than 2 mg THC per serving, and a ratio of
at least 5:1 CBD:THC
Topicals: A ratio of at least 5:1
CBD:THC
Any licensed retailer
Adults 21+ and recognition cardholders
HIGH THC
Only capsules, tablets, tinctures, transdermal patches, and suppositories. May
be up to 50 mg THC per serving.
Only medically endorsed retailers
Recognition cardholders only
Source: JLARC analysis of Chapter 246-70 WAC.
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Review Details
2. Retailer availability limits use
Availability of medically endorsed retailers is one factor that
limits preference use
Six of the seven preferences require access to a medically endorsed retailer
Six of the seven preferences apply to sales by medically
endorsed retailersCannabis retailers meeting certain
requirements may be endorsed by the Liquor and Cannabis Board..
Cannabis retailers are not required to obtain a medical endorsement, which means these
preferences may not be available to eligible customers at all retail locations.
Medically endorsed retailers are located in 32 of 39 counties
There are 510 licensed cannabis retailers in 38 counties. Of these, 275 retailers
(54%) have medical endorsements. Seven counties have no medically endorsed retailers.
Exhibit 2.1: 32 of 39 counties have medically endorsed retailers
Source: JLARC staff analysis of Marijuana Traceability Database and Liquor and
Cannabis Board data.
Of the 275 currently medically endorsed retailers, 188 issued recognition cards in
fiscal year 2020 to patients or their designated providers. This includes the
re-issuance of lost or expired cards.
205 endorsed retailers made tax-exempt sales in calendar year 2020. Of Washington’s
38 counties with licensed retailers, 32 counties had a retailer making tax-exempt
sales.
Further information about retailers and cooperatives in each county is available in
the Appendix.
Exhibit 2.2: 205 of Washington's 510 licensed cannabis retailers made tax exempt
sales in 2020
Source: JLARC staff analysis of the Liquor and Cannabis Board's Marijuana
Traceability Database.
Some retailers offer discounts in lieu of sales tax preferences
Department of Revenue (DOR) audit records and stakeholder interviews indicate that
some retailers, including those without medical cannabis endorsements, offer discounts
to recognition cardholders for purchases eligible for tax preferences. These are
discounts to the retail sales prices, upon which sales and use tax is still collected.
However, purchases from medically endorsed retailers qualify for a sales tax
exemption, and should not be taxed. Patients paying sales and use tax on some of these
purchases may be eligible to request refunds from the retailers or DOR, in accordance
with WAC 458-20-229, if they believe the sales tax was paid in error.
Some retailers indicated they provide a discount in lieu of the tax preference due to
discomfort with handling medical records, the cost of required equipment, and
retention of qualified cannabis consultants required for a medical endorsement. It is
unclear how many retailers offer discounts rather than make tax-exempt sales and the
total value of discounts offered is unknown.
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Review Details
3. 2019 change could affect savings
Beneficiaries will save an estimated $4.9 million in the 2021-23
biennium. Most savings are realized under a recently modified preference for which
guidance is not yet updated.
Beneficiary savings in fiscal year 2020 for all seven tax preferences are $1.79
million. Over 87% of the beneficiary savings were realized under a single preference:
Medical Cannabis Sold to Qualifying Patients.
Exhibit 3.1: One preference accounts for over 87% of FY 2020 beneficiary
savings
Preference Name
Beneficiary Savings, FY 2020
Medical Cannabis Sold to Qualifying Patients
$1.57 million
Low THC Products Sold to Qualifying Patients
$83,000
Cannabis with Low THC High CBD Ratio
$113,000
Topical THC Sales by Health Care Professionals
ConfidentialThree or fewer
taxpayers deducted sales under this preference and beneficiary savings are
confidential.
Medical Cannabis Produced and Used by Cooperative Members
$8,400
Resources and Labor Contributed by Medical Cannabis Cooperative Members
$16,200
Cannabis Cooperatives
$800
Total
$1.79 million
Source: JLARC staff analysis of Department of Revenue deduction data.
2019 statute changed products eligible for the Medical Cannabis Sold to Qualifying
Patients sales tax exemption, which has the greatest beneficiary savings. Future
savings could be affected.
The 2019 Legislature passed the Marijuana Product Labeling Act (ESSB 5298). The bill
restricts cannabis product labels from making medical claims, and clarifies that the
Medical Cannabis Sold to Qualifying Patients preference applies specifically to sales
of products that meet the Department of Health’s (DOH) compliant
product standardsStandards that test cannabis products for
certain heavy metals and pesticides.. This legislation altered the
language of the cannabis tax preference with the highest beneficiary savings,
potentially affecting its use.
Preference previously applied to all recognition cardholder purchases
Prior to the 2019 statutory change, the Medical Cannabis Sold to Qualifying Patients
sales tax exemption applied to all purchases made by recognition
cardholdersMedical cannabis patients or their designated
providers who are registered in the medical cannabis authorization
database. of cannabis products identified by DOH as beneficial for
medical use.
DOH determined in 2015 that because cannabis is federally classified as a Schedule 1
controlled substance, there was insufficient evidence to identify particular products
as beneficial for medical use. Due to this lack of evidence, DOH deferred to patients
and their healthcare providers to determine which products are medically beneficial. A
2016 Department of Revenue (DOR) Special Notice to taxpayers indicated that all
cannabis products purchased by recognition cardholders from medically endorsed
retailers were presumed to be medically beneficial and exempt from sales and use tax
under this preference.
Preference administration has not changed
Effective January 1, 2020, the Marijuana Product Labeling Act specified that the
preference applies to products meeting DOH's compliant product standards. StatuteRCW 69.50.375
requires medically endorsed retailers to carry a representative assortment of
DOH-compliant products. The Liquor and Cannabis Board (LCB) stated that this
requirement has not been enforced. Beneficiary savings in fiscal year 2020 for
purchases of products labeled as DOH-compliant were $6,895, which is less than 1% of
the $1.57 million of claimed sales tax savings that year.
DOH and DOR have not updated guidance to medically endorsed retailers or the public
since the 2019 statutory change. Medically endorsed retailers have continued not to
collect sales tax on purchases by recognition cardholders, regardless of the products'
compliance with DOH standards. DOR stated that it is working with DOH, and DOH is in
the process of updating public guidance for compliant cannabis products.
Future biennial savings estimated to be $4.9 million
The estimates of future beneficiary savings shown below assumes there is no change in
guidance for the Medical Cannabis Sold to Qualifying Patients preference. However, if
new guidance limits qualifying purchases, future savings could be affected.
Exhibit 3.2: Estimates of beneficiary savings
Biennium
Fiscal Year
Estimated Beneficiary Savings
2017-2019
7/1/17 - 6/30/19
2018
$1,412,516
2019
$1,486,019
2019-21
7/1/19-6/30/21
2020
$1,794,019
2021
$2,022,628
2021-23
7/1/21-6/30/23
2022
$2,280,964
2023
$2,572,996
2021-23 Biennium
$4,853,961
Source: JLARC analysis of Department of Revenue and Liquor and Cannabis Board
data.
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
REVIEW Details
4. Optional database registration unique to WA
Optional registration in the patient database sets these
preferences apart from other preferences and states
Preferences for other medical necessities do not require beneficiaries to register
in a database
A 2013 JLARC report reviewed retail sales and use tax exemptions for medical
necessities. Medical necessities are medical products the Legislature defined as
necessary for health, or products that health professionals recommend or order for
patients. This includes menstrual products, insulin, and dialysis equipment.
Five of the seven medical cannabis tax preferences require beneficiaries to register
in the medical cannabis patient database. Tax preferences for other medical
necessities may require prescriptions or authorizations from healthcare provider, but
none require beneficiaries to register in a database.
Patients who are not registered in the database may purchase most cannabis products,
but are ineligible for the tax preferences that require registration. It is unknown
how many patients with medical cannabis authorizations from their health care provider
do not register in the database.
Unlike peer states, patient database registration is optional in Washington
JLARC staff identified eleven other statesAlaska, Arizona, California, Colorado, Illinois, Maine,
Massachusetts, Michigan, Montana, Nevada, and Oregon. that allow
sales of medical and recreational cannabis.
The eleven peer states either do not tax medical cannabis or tax it at a lower rate
than recreational cannabis. These states also vary in credentialing requirements for
cannabis retailers. Some states require medical retailers to serve only verified
medical customers, or may restrict certain types of products to verified medical
patients. Others allow for recreational and medical sales in the same location, but
may require inventories and points-of-sale to be separate.
Most of these states require medical cannabis patients to register in a database as a
condition of eligibility for medical cannabis tax preferences. Washington is the only
state in which database registration in a patient database is optional. Patients who
are not registered in Washington's database are unable to claim five of the seven tax
preferences.
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Review Details
5. Applicable statutes
RCW 82.04.756, RCW 82.08.9998, RCW 82.12.9998
Exemptions - Marijuana cooperatives
RCW 82.04.756
(1) This chapter does not apply to any cooperative in respect to growing marijuana,
or manufacturing marijuana concentrates, useable marijuana, or marijuana-infused
products, as those terms are defined in RCW 69.50.101.
(2) The tax preference authorized in this section is not subject to the provisions of
RCW 82.32.805 and 82.32.808.
Exemptions - Marijuana concentrates, useable marijuana, or marijuana-infused
products - Products containing low amounts of THC
RCW 82.08.9998
(1) The tax levied by RCW 82.08.020 does not apply to:
(a) Sales of marijuana concentrates, useable marijuana, or marijuana-infused
products, identified by the department of health in rules adopted under RCW
69.50.375(4) in chapter 246-70 WAC as being a compliant marijuana product, by
marijuana retailers with medical marijuana endorsements to qualifying patients or
designated providers who have been issued recognition cards;
(b) Sales of products containing THC with a THC concentration of 0.3 percent or less
to qualifying patients or designated providers who have been issued recognition cards
by marijuana retailers with medical marijuana endorsements;
(c) Sales of marijuana concentrates, useable marijuana, or marijuana-infused
products, identified by the department of health under RCW 69.50.375 to have a low
THC, high CBD ratio, and to be beneficial for medical use, by marijuana retailers with
medical marijuana endorsements, to any person;
(d) Sales of topical, noningestible products containing THC with a THC concentration
of 0.3 percent or less by health care professionals under RCW 69.51A.280;
(e)(i) Marijuana, marijuana concentrates, useable marijuana, marijuana-infused
products, or products containing THC with a THC concentration of 0.3 percent or less
produced by a cooperative and provided to its members; and
(ii) Any nonmonetary resources and labor contributed by an individual member of the
cooperative in which the individual is a member. However, nothing in this subsection
(1)(e) may be construed to exempt the individual members of a cooperative from the tax
imposed in RCW 82.08.020 on any purchase of property or services contributed to the
cooperative.
(2) Each seller making exempt sales under subsection (1) of this section must
maintain information establishing eligibility for the exemption in the form and manner
required by the department.
(3) The department must provide a separate tax reporting line for exemption amounts
claimed under this section.
(4) The definitions in this subsection apply throughout this section unless the
context clearly requires otherwise.
(a) "Cooperative" means a cooperative authorized by and operating in compliance with
RCW 69.51A.250.
(b) "Marijuana retailer with a medical marijuana endorsement" means a marijuana
retailer permitted under RCW 69.50.375 to sell marijuana for medical use to qualifying
patients and designated providers.
(c) "Products containing THC with a THC concentration of 0.3 percent or less" means
all products containing THC with a THC concentration not exceeding 0.3 percent and
that, when used as intended, are inhalable, ingestible, or absorbable.
(d) "THC concentration," "marijuana," "marijuana concentrates," "useable marijuana,"
"marijuana retailer," and "marijuana-infused products" have the same meanings as
provided in RCW 69.50.101 and the terms "qualifying patients," "designated providers,"
and "recognition card" have the same meaning as provided in RCW 69.51A.010.
Exemptions - Marijuana concentrates, useable marijuana, or marijuana-infused
products - Products containing low amounts of THC
RCW 82.12.9998
(1) The tax levied by RCW 82.12.020 does not apply to:
(a) Sales of marijuana concentrates, useable marijuana, or marijuana-infused
products, identified by the department of health in rules adopted under RCW
69.50.375(4) in chapter 246-70 WAC as being a compliant marijuana product, by
marijuana retailers with medical marijuana endorsements to qualifying patients or
designated providers who have been issued recognition cards;
(b) Sales of products containing THC with a THC concentration of 0.3 percent or less
to qualifying patients or designated providers who have been issued recognition cards
by marijuana retailers with medical marijuana endorsements;
(c) Sales of marijuana concentrates, useable marijuana, or marijuana-infused
products, identified by the department of health under RCW 69.50.375 to have a low
THC, high CBD ratio, and to be beneficial for medical use, by marijuana retailers with
medical marijuana endorsements, to any person;
(d) Sales of topical, noningestible products containing THC with a THC concentration
of 0.3 percent or less by health care professionals under RCW 69.51A.280;
(e)(i) Marijuana, marijuana concentrates, useable marijuana, marijuana-infused
products, or products containing THC with a THC concentration of 0.3 percent or less
produced by a cooperative and provided to its members; and
(ii) Any nonmonetary resources and labor contributed by an individual member of the
cooperative in which the individual is a member. However, nothing in this subsection
(1)(e) may be construed to exempt the individual members of a cooperative from the tax
imposed in RCW 82.08.020 on any purchase of property or services contributed to the
cooperative.
(2) Each seller making exempt sales under subsection (1) of this section must
maintain information establishing eligibility for the exemption in the form and manner
required by the department.
(3) The department must provide a separate tax reporting line for exemption amounts
claimed under this section.
(4) The definitions in this subsection apply throughout this section unless the
context clearly requires otherwise.
(a) "Cooperative" means a cooperative authorized by and operating in compliance with
RCW 69.51A.250.
(b) "Marijuana retailer with a medical marijuana endorsement" means a marijuana
retailer permitted under RCW 69.50.375 to sell marijuana for medical use to qualifying
patients and designated providers.
(c) "Products containing THC with a THC concentration of 0.3 percent or less" means
all products containing THC with a THC concentration not exceeding 0.3 percent and
that, when used as intended, are inhalable, ingestible, or absorbable.
(d) "THC concentration," "marijuana," "marijuana concentrates," "useable marijuana,"
"marijuana retailer," and "marijuana-infused products" have the same meanings as
provided in RCW 69.50.101 and the terms "qualifying patients," "designated providers,"
and "recognition card" have the same meaning as provided in RCW 69.51A.010.
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Review Details
Appendix A: Retailers by county
Interactive map of retailers and cooperatives by county
The Liquor and Cannabis Board's Marijuana Traceability Database tracks cannabis
sales, licensee status, and cooperatives. The Department of Health collects data about
recognition cards issued by medically endorsed retailers. The interactive map below
provides additional information about retailers and cooperatives in each county.
Exhibit A1: Interactive map of retailers and cooperatives by county
Source: JLARC staff analysis of Liquor and Cannabis Board and Department of Health
data.
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Recommendations & Responses
Legislative Auditor's Recommendation
Legislative Auditor recommends continuing the preferences.
The Legislature should continue the preferences because they provide tax
relief to medical cannabis patients.
The Department of Revenue and the Department of Health should update guidance
to reflect 2019 statutory changes.
Legislation Required: No
Fiscal Impact: None
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Recommendations & Responses
Letter from Commission Chair
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Recommendations & Responses
Commissioners' Recommendation
The Commission endorses the Legislative Auditor's recommendation with comment. Testimony suggests the state should consider reviewing the definitions and guidelines
associated with medical cannabis. The Legislature may want to evaluate approaches used
in other states, such as Colorado, and consider whether and to what extent
Washington’s laws can be altered to better meet patient needs. The Legislature may
find that additional interventions may be needed to address the issues raised in
testimony. These issues largely revolve around quality and price differentials between
the regulated and unregulated market.
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Recommendations & Responses
LCB Response
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Recommendations & Responses
DOR & OFM Response
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
Recommendations & Responses
DOH Response
21-06 Final Report: Medical Cannabis Tax Preferences
December 2021
More about this review
Study questions
Click image to view PDF of proposed study questions.