More Americans now believe cannabis smoking is safer than tobacco, but science doesn't fully support that view | Research

The takeaway

From 2017 to 2021, the percentage of US adults who viewed daily cannabis smoking as safer than tobacco rose from 37% to 44%, a trend that does not fully align with existing evidence on cannabis smoke risks.

Public health communicators, tobacco/cannabis policy researchers, harm reduction advocates

44% of US adults viewed cannabis smoking as safer than tobacco in 2021

What the researchers found

Among 5,035 US adults surveyed in 2017, 2020, and 2021, the perception that daily cannabis smoking is safer than tobacco increased from 36.7% to 44.3% (P<0.001). Similar trends emerged for secondhand smoke (35.1% to 40.2%, P<0.001). Participants rated cannabis secondhand smoke as safe for adults (12.6% vs 2.4% for tobacco), children (4.8% vs 1.8%), and pregnant women (5.3% vs 1.4%). Younger and unmarried individuals were more likely to shift toward safer views of cannabis.

Why it matters

Published in JAMA Network Open, this study documents a growing divergence between public perception and scientific evidence. As more Americans view cannabis smoke as safe, they may be underestimating respiratory and other risks.

The numbers in context

5,035 participants; daily cannabis safer: 36.7% (2017) to 44.3% (2021), P<0.001; secondhand safer: 35.1% to 40.2%, P<0.001; cannabis secondhand safe for adults: 12.6% vs tobacco 2.4%; ages 18-29 aOR 1.4 (95% CI 1.1-1.8) for shifting toward safer cannabis views

How the study worked

Longitudinal survey using Ipsos KnowledgePanel, a nationally representative US panel. Same 5,035 participants completed web-based surveys in 2017, 2020, and 2021 comparing cannabis and tobacco safety perceptions. Published in JAMA Network Open.

What this study cannot tell us

Survey measures perceptions, not actual behavior or exposure. Online panel may not capture all demographics. "Safer" is relative and does not quantify absolute risk. Does not distinguish between occasional and daily use perceptions.

How to read the evidence

Nationally representative longitudinal survey published in JAMA Network Open with consistent methodology across three timepoints.

When this study was published

Published 2023 using 2017-2021 data

The bigger picture

If nearly half of Americans believe cannabis smoking is safer than tobacco, public health messaging about combustion-related risks may need to specifically address cannabis smoke rather than assuming tobacco-focused campaigns apply.

Questions still open

Is cannabis smoke truly less harmful than tobacco smoke in equivalent exposure amounts? Are changing perceptions driving increased cannabis smoking relative to other consumption methods?

Common questions

Do Americans think cannabis smoke is safer than tobacco smoke?

Yes, and increasingly so. In 2021, 44% of US adults said daily cannabis smoking was safer than tobacco, up from 37% in 2017. Similar trends were found for secondhand smoke perceptions.

Is that perception accurate?

The researchers note that these views do not reflect existing science on cannabis and tobacco smoke, as cannabis smoke contains many of the same harmful combustion products as tobacco smoke.

Read the original research

Perceptions of Safety of Daily Cannabis vs Tobacco Smoking and Secondhand Smoke Exposure, 2017-2021.

JAMA network open, 6(8), e2328691

View on PubMed ↗Publisher’s paper ↗

Citation

Chambers, Julia; Keyhani, Salomeh; Ling, Pamela M; Hoggatt, Katherine J; Hasin, Deborah; Nguyen, Nhung; Woods, Anne; Ryder, Annie; Cohen, Beth E. (2023). Perceptions of Safety of Daily Cannabis vs Tobacco Smoking and Secondhand Smoke Exposure, 2017-2021.. JAMA network open, 6(8), e2328691. https://doi.org/10.1001/jamanetworkopen.2023.28691