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Cannabis Smoking Increasingly Seen As Safer Than Cigarette Smoking, Study Finds

By Leo Bear-McGuinness

Published: Aug 14, 2023   
Person smoking a cigarette.

Image credit: iStock

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Cannabis is slowly becoming more acceptable than cigarettes in the US, according to a new survey of over 5,000 people.

In 2017, 36.7% of the survey participants felt that daily smoking of cannabis was safer than tobacco; in 2021, this proportion jumped to 44.3%.

The participants felt similarly about the safety of second-hand cannabis smoke.

Acceptability rising

Published in JAMA Network Open, the study surveyed 5,035 people three times, in 2017, 2020, and 2021.

The respondents were asked several questions about the safety of cannabis smoking, including, “How does smoking one marijuana joint a day compare with smoking one cigarette a day?” and “How does secondhand smoke from marijuana compare to secondhand smoke from tobacco?”.

Over time, the answers to these questions were increasingly favored towards cannabis.

In 2017, 66.2% of participants considered smoking one cannabis joint as safe or safer than smoking one cigarette per day. In 2021, this proportion jumped to 74.4%.

In 2017, 70.7% of participants considered secondhand cannabis smoke just as safe if not safer than secondhand tobacco smoke. In 2021, this proportion rose to 76.9%.

“This suggests that the increasing perception of safety of cannabis may be a larger, national trend rather than a trend seen only in states with cannabis legalization,” researchers wrote in the paper.

“More participants at each time believed secondhand smoke from cannabis vs tobacco was somewhat or completely safe.”

Far fewer respondents considered cannabis smoke safe when children or pregnant women were near. These views didn’t significantly change between 2017 and 2021.

Younger, unmarried survey participants were more likely to positively view cannabis than older, married ones.

The researchers behind the study – who were principally from the University of California, San Francisco – say this growing acceptability among younger generations may be associated with the increased consumption of cannabis observed across the US. And this, according to the researchers, is a growing public health concern, given the potential harms of cannabis smoke.

“As the cannabis industry and use of cannabis continue to grow, these risk perceptions may further decrease and have the potential to shape public policy,” the researchers wrote in their conclusion.

“This may have serious health implications at individual and societal levels. Thus, more research is necessary to understand the potential risks associated with cannabis use to plan a public health and regulatory response.”

The risks of cannabis smoke

Cannabis smoke is known to contain many of the same chemicals present in tobacco smoke. Yet the effects of these chemicals may be altered when present with cannabinoids, according to some research.

One scientific review published in Cancer Epidemiology Biomarkers & Prevention in 2015 found no association between cannabis use and lung cancer despite marijuana smoke containing many known carcinogens in amounts comparable with those found in tobacco smoke. One explanation for this null association, as posited by the review, is that cannabinoids like THC counteract the carcinogens with their tumor-suppressant effects, which have been evidenced in several cell culture and animal models studies.

But other, more recent studies have documented the negative health risks second-hand cannabis smoke can pose.

A study published in Pediatric Research in 2021 found that the children of regular cannabis consumers who smoke or vape come down with viral respiratory infections more often than children whose parents don’t smoke. Other risks known to be associated with second-hand tobacco smoke, such as ear infections or asthma attacks, however, weren’t reported more frequently in the children of frequent cannabis users.

Published in 2022, a study of cannabis bongs found that, after just 15 minutes of bong smoking, the average levels of fine particulate matter in the air can be more than twice the threshold deemed hazardous by the US Environmental Protection Agency (EPA).

“There is extensive evidence of the adverse health effects of particulate matter at concentrations substantially below those measured in homes during and after bong smoking,” S. Katharine Hammond, a professor of environmental health sciences at Berkeley and co-author of the 2022 study, told Analytical Cannabis at the time.

“To quote from the recent EPA report: there are ‘consistent positive associations between short-and long-term PM exposure and respiratory and cardiovascular effects and mortality.’”


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