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

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.

Chambers, Julia et al.·JAMA network open·2023·Strong EvidenceLongitudinal Cohort
RTHC-04454Longitudinal CohortStrong Evidence2023RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Strong Evidence
Sample
N=5,035

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
44% of US adults viewed cannabis smoking as safer than tobacco in 2021
Evidence Grade:
Nationally representative longitudinal survey published in JAMA Network Open with consistent methodology across three timepoints.
Study Age:
Published 2023 using 2017-2021 data
Original Title:
Perceptions of Safety of Daily Cannabis vs Tobacco Smoking and Secondhand Smoke Exposure, 2017-2021.
Published In:
JAMA network open, 6(8), e2328691 (2023)
Database ID:
RTHC-04454

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked 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 More on RethinkTHC

Cite This Study

RTHC-04454·https://rethinkthc.com/research/RTHC-04454

APA

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

MLA

Chambers, Julia, et al. "Perceptions of Safety of Daily Cannabis vs Tobacco Smoking and Secondhand Smoke Exposure, 2017-2021.." JAMA network open, 2023. https://doi.org/10.1001/jamanetworkopen.2023.28691

RethinkTHC

RethinkTHC Research Database. "Perceptions of Safety of Daily Cannabis vs Tobacco Smoking a..." RTHC-04454. Retrieved from https://rethinkthc.com/research/chambers-2023-perceptions-of-safety-of

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.