Nearly half of Oklahoma adults reported secondhand cannabis smoke exposure, linked to respiratory symptoms | Research

The takeaway

Among 5,410 Oklahoma adults, 42% reported recent secondhand cannabis smoke exposure, which was associated with more respiratory symptoms, particularly among those who also used cannabis themselves.

People interested in secondhand cannabis smoke as a public health issue.

42% of Oklahoma adults reported secondhand cannabis smoke exposure

What the researchers found

SHCS exposure was reported by 42% of adults. Those exposed were more likely to be male, younger, non-Hispanic Black or Hispanic, lower SES, and had more respiratory symptoms. Respiratory symptoms were highest among those with both SHCS exposure and personal cannabis use. Young adulthood, Black race, and current cigarette/cannabis use were the strongest predictors of exposure.

Why it matters

As cannabis legalization expands, secondhand smoke is an emerging public health concern, particularly for populations with less ability to control their exposure environments. Oklahoma had limited smoke-free protections at the time of the study.

The numbers in context

5,410 adults surveyed. 42% reported past-30-day SHCS exposure. Exposure associated with more respiratory symptoms (p<0.01). Strongest correlates: ages 18-24, NH Black race, cigarette smoking, cannabis use.

How the study worked

Repeated cross-sectional online survey of 5,410 adults in Oklahoma (a state with legalized medical cannabis and limited smoke-free protections). Measured 30-day SHCS exposure in homes, vehicles, and indoor settings alongside harm perceptions, respiratory symptoms, and substance use.

What this study cannot tell us

Self-reported exposure and symptoms may be subject to recall bias. Oklahoma-specific findings in a medical-cannabis-only state may not generalize. Cannot separate SHCS effects from personal cannabis or cigarette smoking effects. Cross-sectional design.

How to read the evidence

Large cross-sectional survey with multiple exposure measures. Limited by self-report and inability to isolate SHCS effects from personal substance use.

When this study was published

Published in 2024 in Preventive Medicine Reports.

The bigger picture

Secondhand tobacco smoke protections took decades to develop. With cannabis legalization outpacing indoor air regulations in many states, this study highlights that secondhand cannabis smoke exposure is already common and disproportionately affects socially vulnerable populations.

Questions still open

Would extending clean indoor air laws to include cannabis smoke reduce respiratory symptoms? Are children in these households also affected? How does SHCS exposure compare to secondhand tobacco smoke in terms of health impact?

Common questions

Is secondhand cannabis smoke a health concern?

This study found that 42% of Oklahoma adults were exposed to secondhand cannabis smoke, and exposure was associated with more respiratory symptoms. The effect was strongest among people who also used cannabis themselves.

Who is most exposed to secondhand cannabis smoke?

Young adults (18-24), non-Hispanic Black individuals, and people with lower educational and financial attainment were most likely to report exposure, suggesting SHCS disproportionately affects vulnerable populations.

Read the original research

Secondhand cannabis smoke exposure and respiratory symptoms among adults living in a state with legalized medical cannabis with limited smoke-free protections.

Preventive medicine reports, 45, 102835

View on PubMed ↗Publisher’s paper ↗

Citation

Cohn, Amy M; Zaring-Hinkle, Brittany; Catino, Joshua D; Ehlke, Sarah J; Ware, Kali; Alexander, Adam; Smith, Michael A; Jewell-Fleming, Sheri; Queimado, Lurdes; Kendzor, Darla E. (2024). Secondhand cannabis smoke exposure and respiratory symptoms among adults living in a state with legalized medical cannabis with limited smoke-free protections.. Preventive medicine reports, 45, 102835. https://doi.org/10.1016/j.pmedr.2024.102835