Cannabis Use During Pregnancy Was More Than Twice as Common as Cigarette Smoking in California | Research

The takeaway

In California from 2017-2019, 4.9% of pregnant women used cannabis compared to 2.1% who smoked cigarettes, with cannabis use being four times more prevalent than cigarettes in Los Angeles County.

Obstetricians, public health officials, and pregnant individuals in legalized states

4.9% cannabis vs 2.1% cigarettes

What the researchers found

Cannabis use during pregnancy (4.9%) was more than twice as common as cigarette smoking (2.1%) in California. In some counties like Los Angeles, cannabis was four times more prevalent. Overall, 7.3% of women reported cannabis use either during or soon after pregnancy. Among tobacco smokers, 73% quit before the third trimester but 33% relapsed postpartum.

Why it matters

Cannabis has overtaken tobacco as the most common combustible substance used during pregnancy in California. Since public health infrastructure for prenatal tobacco cessation is well-established but prenatal cannabis cessation programs barely exist, this shift demands attention.

The numbers in context

4.9% prenatal cannabis use vs 2.1% cigarette smoking; 4:1 ratio in Los Angeles; 7.3% used cannabis during or after pregnancy; 73% of smokers quit by third trimester; 33% postpartum tobacco relapse

How the study worked

Population-based cross-sectional analysis using California's Maternal and Infant Health Assessment survey data pooled from 35 counties with the largest birth numbers (2017-2019). Assessed tobacco and cannabis use during and after pregnancy.

What this study cannot tell us

Self-reported use likely underestimates actual prevalence. Survey methodology may miss marginalized populations. Three-year pooled data may mask trends. California's legal cannabis environment may differ from other states.

How to read the evidence

Population-based survey covering 35 California counties, but self-reported data likely underestimates true prevalence

When this study was published

2023 study

The bigger picture

The success of tobacco cessation programs during pregnancy shows that substance use in pregnancy can be addressed with proper support. Applying lessons from tobacco control to cannabis cessation could be the next frontier in prenatal public health.

Questions still open

Can tobacco cessation frameworks be adapted for prenatal cannabis use? Is the harm profile of prenatal cannabis comparable to prenatal tobacco? Will prenatal cannabis use continue to increase as legalization spreads?

Common questions

Is cannabis more common than cigarettes during pregnancy?

In California, yes. Cannabis use during pregnancy (4.9%) was more than twice as common as cigarette smoking (2.1%) from 2017-2019, and the gap was even larger in some counties.

Are pregnant women quitting cannabis like they quit cigarettes?

The study did not report cannabis quit rates, but tobacco cessation rates during pregnancy were high (73% by third trimester). Whether similar programs could work for cannabis has not been established.

Read the original research

Tobacco and Cannabis Use During and After Pregnancy in California.

Maternal and child health journal, 27(1), 21-28

View on PubMed ↗Publisher’s paper ↗

Citation

Azenkot, Tali; Dove, Melanie S; Fan, Chuncui; Valencia, Cindy V; Tong, Elisa K; Schwarz, Eleanor Bimla. (2023). Tobacco and Cannabis Use During and After Pregnancy in California.. Maternal and child health journal, 27(1), 21-28. https://doi.org/10.1007/s10995-022-03551-x