In focus groups with 53 pregnant individuals who used cannabis, participants described legalization as making cannabis easier to access, more socially accepted, and positioned cannabis retailers as trusted sources of information.
People interested in how cannabis legalization affects prenatal use decisions and health communication
53 pregnant participants
What the researchers found
Three major themes emerged: easier access (via retailers and delivery services), greater acceptance (reduced stigma and more willingness to discuss use with healthcare providers), and trust in cannabis retailers (perceived as knowledgeable, nonjudgmental, and caring). Responses were mixed about whether marketing influenced prenatal use and whether legalization reduced fears about Child Protective Services involvement.
Why it matters
Understanding how pregnant people perceive legalization reveals potential pathways through which policy changes affect prenatal cannabis use. The finding that pregnant users trust cannabis retailers more than health messaging suggests a disconnect in health communication.
The numbers in context
53 participants (mean age 30.3 years); 43% Black, 57% White; 30% still using at recruitment; 18 focus groups conducted November-December 2021
How the study worked
Qualitative study with 18 semi-structured focus groups conducted via video platform in Kaiser Permanente Northern California. Participants were Black and White pregnant individuals who self-reported cannabis use during early pregnancy. Thematic analysis used to identify major themes.
What this study cannot tell us
Qualitative study cannot quantify the impact of legalization on use rates. Limited to Black and White participants in Northern California. Participants were already cannabis users, so findings may not reflect perspectives of non-users. Focus groups may introduce social desirability bias.
How to read the evidence
Qualitative study providing in-depth perspectives but limited to a specific population in one health system
When this study was published
2022 study
The bigger picture
Prenatal cannabis use is increasing in legalized states. If pregnant people view cannabis retailers as trustworthy health advisors and perceive reduced barriers to use, public health messaging about prenatal cannabis risks may need to be redesigned to compete with these new information sources.
Questions still open
- Could cannabis retailers be enlisted as partners in prenatal health messaging? How do perceptions differ in states with only medical legalization? Would requiring pregnancy-specific warnings at dispensaries affect use?
Common questions
Did legalization increase cannabis use during pregnancy?
Why do pregnant people trust cannabis retailers?
Read the original research
Perceptions About Cannabis Following Legalization Among Pregnant Individuals With Prenatal Cannabis Use in California.
JAMA network open, 5(12), e2246912
Citation
Young-Wolff, Kelly C; Foti, Tara R; Green, Andrea; Altschuler, Andrea; Does, Monique B; Jackson-Morris, Melanie; Adams, Sara R; Ansley, Deborah; Conway, Amy; Goler, Nancy; Mian, Maha N; Iturralde, Esti. (2022). Perceptions About Cannabis Following Legalization Among Pregnant Individuals With Prenatal Cannabis Use in California.. JAMA network open, 5(12), e2246912. https://doi.org/10.1001/jamanetworkopen.2022.46912
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