What topics does this cannabis study cover?

This study covers research on: Mental Health.

Where was this research published?

Published in Addictive behaviors on May 15, 2026.

Mental Health

Cannabis overtakes tobacco in pregnant women for the first time

Cannabis surpasses tobacco among pregnant women: national trends and predictors of use in the U.S., 2015-2023.

Addictive behaviors • May 15, 2026 • Moderately Relevant

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AI Summary

This landmark national study reveals a striking shift in substance use patterns among pregnant women in the United States, with cannabis use surpassing tobacco for the first time in 2022. Analyzing data from the National Survey on Drug Use and Health between 2015-2023, researchers found that tobacco-only use among pregnant individuals dropped dramatically from 12.0% to 3.9%, while cannabis-only use more than doubled during the same period, peaking at 6.3% in 2022. This reversal occurred alongside expanding cannabis legalization, raising significant concerns about prenatal exposure during a critical period of fetal development.

The research identified important sociodemographic disparities in these trends. Before the pandemic, lower education, unmarried status, lower income, and public insurance were strong predictors of substance use during pregnancy. Post-pandemic patterns became more complex, with education becoming a key factor in cannabis-only use—a shift that differs markedly from historical tobacco use patterns. Notably, Hispanic women showed consistently lower likelihoods of all substance use patterns compared to non-Hispanic White women, while uninsured status emerged as newly associated with higher cannabis-only use.

These findings underscore the urgent need for updated clinical screening and public health responses. As cannabis becomes increasingly normalized and legally accessible, healthcare providers must adapt their prenatal counseling practices to address this evolving risk landscape. The data suggests that previous health interventions successfully reduced tobacco use in pregnancy, but emerging cannabis legalization may be creating new challenges for protecting fetal health that require targeted prevention and education strategies.

📄 Original Abstract

Rapid cannabis legalization in the United States has heightened concern about prenatal exposure as social acceptance increases. While tobacco use during pregnancy has steadily declined, emerging evidence suggests cannabis use may be rising. We examined national trends in tobacco-only use, cannabis-only use, and co-use among pregnant individuals from 2015 to 2023 and identified associated sociodemographic factors. We analyzed nationally representative 2015-2023 National Survey on Drug Use and Health data restricted to pregnant women ages 15-44 (N = 6,099). Outcomes were self-reported past-30-day tobacco-only use, cannabis-only use, and co-use. Weighted prevalence was estimated for 2015-2019, 2020, and 2021-2023. Multivariable logistic regressions for 2015-2019 and 2021-2023 assessed predictors relative to non-use, reporting adjusted odds ratios and average marginal effects. Regressions were not estimated for 2020 due to limited sample size. Tobacco-only use declined from 12.0% in 2015 to 3.9% in 2023. Cannabis-only use more than doubled pre-pandemic and peaked at 6.3% in 2022, surpassing tobacco before converging in 2023. Co-use declined to 0.8% by 2023. Pre-pandemic, lower education, unmarried status, lower income, and public insurance were associated with higher tobacco-only use and co-use. Hispanic individuals had lower likelihoods of all use patterns relative to non-Hispanic White individuals. Post-pandemic, educational gradients in cannabis-only use emerged, while Medicaid and Medicare coverage remained associated with higher tobacco-only use and uninsured status became associated with higher cannabis-only use. Prenatal substance use patterns are shifting, with cannabis surpassing tobacco in recent years. Updated screening, counseling, and policy responses are needed to address evolving prenatal exposure risks.

Paper Type

📄 Research

Publication

Journal: Addictive behaviors
Published: May 15, 2026
PMID: 42143410
DOI: 10.1016/j.addbeh.2026.108740

Authors (2)

Joanne Constantin Department of Health Policy and Management, School of Public Health, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, United States. Electronic address: Joanne.Constantin@downstate.edu.
Jayani Jayawardhana Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY, United States. Electronic address: jayani.jayawardhana@uky.edu.