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Study breakdown

Cannabis use history linked to higher rates of smoking during and after pregnancy

Prospective CohortModerate evidence
The takeaway

Pregnant women with any history of cannabis use were significantly more likely to smoke cigarettes during pregnancy and postpartum, regardless of whether they had a cannabis use disorder.

Clinicians working with pregnant women and researchers studying perinatal substance use.

11x higher odds of smoking in early pregnancy with cannabis history

What the researchers found

History of cannabis use predicted cigarette smoking in early pregnancy (OR 11.12), late pregnancy (OR 6.55), and 6 months postpartum (OR 7.57). Having a cannabis use disorder diagnosis did not add additional risk beyond any cannabis use history.

Why it matters

As cannabis use among pregnant women increases, understanding its connection to cigarette smoking could improve cessation efforts during the perinatal period.

The numbers in context

252 women analyzed. 48% reported prior cannabis use, 15% met criteria for lifetime cannabis use disorder. Odds of smoking ranged from 6.55 to 11.12 times higher for those with cannabis history.

How the study worked

Prospective cohort study of 257 pregnant women with overweight/obesity in Western Pennsylvania (2012-2016), using structured clinical interviews and generalized mixed effect models adjusting for demographics, parity, and mood disorders.

What this study cannot tell us

Sample limited to women with overweight/obesity in one geographic region. Lifetime CUD was measured, not current use. Small sample size limits power to detect CUD-specific effects.

How to read the evidence

Prospective cohort with structured clinical interviews, though limited by sample size and population specificity.

When this study was published

Published in 2022 with data from 2012-2016.

The bigger picture

The finding that any cannabis use history, not just disorder-level use, predicted perinatal smoking suggests screening for cannabis history could identify women at higher risk for continued cigarette use.

Questions still open

  • Would these associations hold in a general-weight population? Does concurrent cannabis use during pregnancy further increase smoking rates?

Common questions

Did cannabis use disorder make smoking risk even higher?
No. A history of cannabis use disorder did not appear to increase perinatal cigarette use risk beyond what was seen with any cannabis use history.
How large were the smoking differences?
Women with cannabis history had 11 times higher odds of smoking in early pregnancy, 6.5 times in late pregnancy, and 7.5 times at 6 months postpartum.

Read the original research

Cohort Study of Cannabis Use History and Perinatal Cigarette Use Among Overweight and Obese Women.

Maternal and child health journal, 26(2), 389-396

Citation

De Genna, Natacha M; Germeroth, Lisa J; Benno, Maria Tina; Wang, Bang; Levine, Michele D. (2022). Cohort Study of Cannabis Use History and Perinatal Cigarette Use Among Overweight and Obese Women.. Maternal and child health journal, 26(2), 389-396. https://doi.org/10.1007/s10995-021-03246-9

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