Opinions About Cannabis Legalization From the Pregnant Cannabis User’s Perspective

The legalization of cannabis reduced obstacles to prenatal cannabis use, according to pregnant individuals.

A study published in JAMA Network Open found that pregnant individuals viewed the legalization of cannabis as reducing barriers to prenatal cannabis use.

Pregnant adults with self-reported prenatal cannabis use were recruited in 2021 from Kaiser Permanente Northern California for this study. Participants (N=53) attended 1 of 18 focus groups lasting 90 minutes which discussed drivers for prenatal cannabis use during pregnancy. The focus groups were segregated on the basis of race.

Participants had a mean age of 30.3 (SD, 5.2) years, 57% were White, 43% were Black, 36% were in their third trimester, 70% had been daily prenatal cannabis users at some point in pregnancy, and 70% had stopped cannabis use at the time of recruitment.

In general, participants thought that cannabis use during pregnancy among close contacts had been increasing in recent years. They also reported that stigma around using cannabis during pregnancy had declined since legalization.

Despite recommendations from national organizations that pregnant individuals should abstain from cannabis use during pregnancy, rates of prenatal cannabis use continue to rise in the US.

The widespread availability of cannabis tended to increase the participant’s desire to use and the increase in prenatal cannabis use was in part attributed to the availability of the many formulations of cannabis. In addition, the availability of free delivery of cannabis products made obtaining cannabis more convenient.

Many participants thought the staff at cannabis retail facilities were “experts” about cannabis use, including about use during pregnancy. Products that were endorsed by staff for use in pregnancy were trusted. One participant said about speaking with a budtender, “it’s kind of like the doctor, but not really.”

Marketing and advertisements had varying effects among participants, with some reporting that seeing advertisements enticed them to think about using whereas others reported no effects.

The participants also expressed more openness with discussing cannabis use with their health care provider due to low fears about Child Protective Services becoming involved as a result of cannabis use.

The results of this study may not be generalizable for uninsured pregnant individuals or individuals who are not Black or White.

Study authors concluded, “Legalization may have contributed to increases in prenatal cannabis use and created both challenges and opportunities for supporting the health of pregnant individuals. Despite recommendations from national organizations that pregnant individuals should abstain from cannabis use during pregnancy, rates of prenatal cannabis use continue to rise in the US.”

References:

Young-Wolff KC, Foti TR, Green A, et al. Perceptions about cannabis following legalization among pregnant individuals with prenatal cannabis use in California. JAMA Netw Open. 2022;5(12):e2246912. doi:10.1001/jamanetworkopen.2022.46912