Attitudes and beliefs regarding cannabis use during pregnancy compared to alcohol and tobacco: a nationwide survey of U.S. women of childbearing age

Abstract Background Cannabis use is increasing, even during pregnancy. The purpose of this study was to investigate how women of childbearing age perceive the safety of cannabis use during pregnancy compared to alcohol and tobacco use. Methods Cloud Research recruited a national U.S. cohort of women of childbearing age ( N = 622) to complete an anonymous online survey assessing cannabis, alcohol, and tobacco use during pregnancy. Validated tools measured perceptions of safety and risks to fetal, birth, and infant development. Data analyses included descriptive statistics, McNemar’s tests, and repeated-measures ANOVA with post-hoc comparisons. Results The average age was 29.47 years ( SD = 6.83, range: 18–42). Participants self-identified as White (65.9%, n = 410), Black or African American 28.1% ( n = 175), Asian 5.9% ( n = 37), American Indian or Alaska Native 3.9% ( n = 24), or Other 4.7% ( n = 29); 17.7% ( n = 110) identified as Hispanic or Latino. Most participants identified as heterosexual (82.0%, n = 510). Among participants who had been pregnant ( N = 351), 25.9% reported cannabis use during pregnancy, compared with 23.6% for tobacco and 8.2% for alcohol. The median frequency of prenatal cannabis use was twice weekly, with joints and blunts being the most common methods. Reported reasons for use included relief of nausea, anxiety, sleep disturbance, and pain. We used a five-point Likert scale to determine whether they thought cannabis, alcohol, and tobacco were safe to use during pregnancy, where 1 = not at all safe , and 5 = completely safe . Prenatal cannabis use was rated as safer ( M = 3.85, SD = 1.46) than alcohol. ( M = 4.86, SD = 0.54, p < .001) or tobacco ( M = 4.79, SD = 0.63, p < .001). Conclusion Findings indicate that women of childbearing age perceive cannabis as relatively safe during pregnancy, particularly for symptom management. These perceptions underscore the need for targeted education, accurate messaging, and consideration of the social, cultural, and emotional factors that influence substance use during pregnancy to safeguard maternal and fetal health.