Most pregnant women see cannabis as safer than alcohol or tobacco

Attitudes and beliefs regarding cannabis use during pregnancy compared to alcohol and tobacco: a nationwide survey of U.S. women of childbearing age.

Journal of cannabis research • • Moderately Relevant
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AI Summary

This nationwide survey of 622 U.S. women of childbearing age reveals a significant gap between public perception and medical evidence regarding cannabis safety during pregnancy. Among women who had been pregnant, 25.9% reported using cannabis during pregnancy, with most using it twice weekly, primarily in the form of joints and blunts. Strikingly, participants rated prenatal cannabis use as significantly safer (score: 3.85 out of 5) compared to alcohol (4.86) and tobacco (4.79). Common reasons for use included managing nausea, anxiety, sleep disturbance, and pain—conditions for which women sought symptom relief.

The findings expose a concerning disconnect: women of childbearing age perceive cannabis as a relatively safe option for managing pregnancy-related symptoms, positioning it favorably against alcohol and tobacco. However, this perception contradicts current medical understanding of cannabinoids' potential effects on fetal development. The study highlights that social, cultural, and emotional factors significantly influence substance use decisions during pregnancy, suggesting that healthcare providers cannot rely solely on safety warnings without understanding the real needs driving use—particularly symptom management.

These results underscore the urgent need for accurate, evidence-based messaging tailored to women's actual concerns and symptom management needs during pregnancy. Rather than simply telling pregnant women to avoid cannabis, healthcare systems must address the underlying conditions (anxiety, nausea, sleep problems) through safer alternatives while providing clear, credible information about potential risks. The research demonstrates that effective public health strategies must engage with why women use cannabis during pregnancy, not just discourage the behavior itself.

📄 Original Abstract

Cannabis use is increasing, even during pregnancy. The purpose of this study was to investigate how women of childbearing age perceive the safety of cannabis use during pregnancy compared to alcohol and tobacco use. Cloud Research recruited a national U.S. cohort of women of childbearing age (N = 622) to complete an anonymous online survey assessing cannabis, alcohol, and tobacco use during pregnancy. Validated tools measured perceptions of safety and risks to fetal, birth, and infant development. Data analyses included descriptive statistics, McNemar's tests, and repeated-measures ANOVA with post-hoc comparisons. The average age was 29.47 years (SD = 6.83, range: 18-42). Participants self-identified as White (65.9%, n = 410), Black or African American 28.1% (n = 175), Asian 5.9% (n = 37), American Indian or Alaska Native 3.9% (n = 24), or Other 4.7% (n = 29); 17.7% (n = 110) identified as Hispanic or Latino. Most participants identified as heterosexual (82.0%, n = 510). Among participants who had been pregnant (N = 351), 25.9% reported cannabis use during pregnancy, compared with 23.6% for tobacco and 8.2% for alcohol. The median frequency of prenatal cannabis use was twice weekly, with joints and blunts being the most common methods. Reported reasons for use included relief of nausea, anxiety, sleep disturbance, and pain. We used a five-point Likert scale to determine whether they thought cannabis, alcohol, and tobacco were safe to use during pregnancy, where 1 = not at all safe, and 5 = completely safe. Prenatal cannabis use was rated as safer (M = 3.85, SD = 1.46) than alcohol. (M = 4.86, SD = 0.54, p < .001) or tobacco (M = 4.79, SD = 0.63, p < .001). Findings indicate that women of childbearing age perceive cannabis as relatively safe during pregnancy, particularly for symptom management. These perceptions underscore the need for targeted education, accurate messaging, and consideration of the social, cultural, and emotional factors that influence substance use during pregnancy to safeguard maternal and fetal health.

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