Background:
Despite insufficient evidence regarding its risks and benefits, marijuana is increasingly available and is aggressively marketed to the public.
Objective:
To understand the public's views on the risks and benefits of marijuana use.
Design:
Probability-based online survey.
Setting:
United States, 2017.
Participants:
16 280 U.S. adults.
Measurements:
Proportion of U.S. adults who agreed with a statement.
Results:
The response rate was 55.3% (n = 9003). Approximately 14.6% of U.S. adults reported using marijuana in the past year. About 81% of U.S. adults believe marijuana has at least 1 benefit, whereas 17% believe it has no benefit. The most common benefit cited was pain management (66%), followed by treatment of diseases, such as epilepsy and multiple sclerosis (48%), and relief from anxiety, stress, and depression (47%). About 91% of U.S. adults believe marijuana has at least 1 risk, whereas 9% believe it has no risks. The most common risk identified by the public was legal problems (51.8%), followed by addiction (50%) and impaired memory (42%). Among U.S. adults, 29.2% agree that smoking marijuana prevents health problems. About 18% believe exposure to secondhand marijuana smoke is somewhat or completely safe for adults, whereas 7.6% indicated that it is somewhat or completely safe for children. Of the respondents, 7.3% agree that marijuana use is somewhat or completely safe during pregnancy. About 22.4% of U.S. adults believe that marijuana is not at all addictive.
Limitation:
Wording of the questions may have affected interpretation.
Conclusion:
Americans' view of marijuana use is more favorable than existing evidence supports.
Primary Funding Source:
National Heart, Lung, and Blood Institute.
References
- 1.
Chu YW . The effects of medical marijuana laws on illegal marijuana use. J Health Econ. 2014;38:43-61. [PMID:25205609 ] doi:10.1016/j.jhealeco.2014.07.003 CrossrefMedlineGoogle Scholar - 2.
Hasin DS ,Sarvet AL ,Cerdá M ,Keyes KM ,Stohl M ,Galea S ,et al . US adult illicit cannabis use, cannabis use disorder, and medical marijuana laws: 1991-1992 to 2012-2013. JAMA Psychiatry. 2017;74:579-88. [PMID:28445557 ] doi:10.1001/jamapsychiatry.2017.0724 CrossrefMedlineGoogle Scholar - 3.
Compton WM ,Han B ,Jones CM ,Blanco C ,Hughes A . Marijuana use and use disorders in adults in the USA, 2002-14: analysis of annual cross-sectional surveys. Lancet Psychiatry. 2016;3:954-64. [PMID:27592339 ] doi:10.1016/S2215-0366(16)30208-5 CrossrefMedlineGoogle Scholar - 4. Williams J. High returns: Colorado pot sales over $100 million a month. Newsweek. 15 July 2017. Accessed at www.newsweek.com/colorado-marijuana-sales-legalization-2017-637126 on 10 July 2018. Google Scholar
- 5. Lewis M. Pot sales reach new high of $1.1 billion in 2016. KIRO7. Updated 9 January 2017. Accessed at www.kiro7.com/news/local/pot-sales-reach-new-high-of-11-billion-in-2016/482776341 on 10 July 2018. Google Scholar
- 6.
McGinty EE ,Samples H ,Bandara SN ,Saloner B ,Bachhuber MA ,Barry CL . The emerging public discourse on state legalization of marijuana for recreational use in the US: analysis of news media coverage, 2010-2014. Prev Med. 2016;90:114-20. [PMID:27373208 ] doi:10.1016/j.ypmed.2016.06.040 CrossrefMedlineGoogle Scholar - 7.
Abraham A ,Zhang AJ ,Ahn R ,Woodbridge A ,Korenstein D ,Keyhani S . Media content analysis of marijuana's health effects in news coverage. J Gen Intern Med. 2018. [PMID:29845473 ] doi:10.1007/s11606-018-4492-9 CrossrefMedlineGoogle Scholar - 8. Loria K, Welsh J. 21 medical benefits of marijuana. Business Insider. 21 April 2015. Accessed at www.businessinsider.com.au/facts-on-marijuana-and-health-2015-4 on 4 June 2018. Google Scholar
- 9. U.S. Food and Drug Administration. FDA warns companies marketing unproven products, derived from marijuana, that claim to treat or cure cancer [press release]. Silver Spring: U.S. Food and Drug Administration; 1 November 2017. Accessed at www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm583295.htm on 18 December 2017. Google Scholar
- 10. Loria K. 23 health benefits of marijuana. Business Insider. 7 March 2018. Accessed at www.businessinsider.com/health-benefits-of-medical-marijuana-2014-4/#it-can-be-used-to-treat-glaucoma-1 on 4 June 2018. Google Scholar
- 11.
Steigerwald S ,Wong PO ,Khorasani A ,Keyhani S . The form and content of cannabis products in the United States. J Gen Intern Med. 2018. [PMID:29770952 ] doi:10.1007/s11606-018-4480-0 CrossrefMedlineGoogle Scholar - 12.
Nugent SM ,Morasco BJ ,O'Neil ME ,Freeman M ,Low A ,Kondo K ,et al . The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. Ann Intern Med. 2017;167:319-31. [PMID:28806817 ]. doi:10.7326/M17-0155 LinkGoogle Scholar - 13.
Marconi A ,DiForti M ,Lewis CM ,Murray RM ,Vassos E . Meta-analysis of the association between the level of cannabis use and risk of psychosis. Schizophr Bull. 2016;42:1262-9. [PMID:26884547 ] doi:10.1093/schbul/sbw003 CrossrefMedlineGoogle Scholar - 14.
Ghasemiesfe M ,Ravi D ,Vali M ,Korenstein D ,Arjomandi M ,Frank J ,et al . Marijuana use, respiratory symptoms, and pulmonary function. A systematic review and meta-analysis. Ann Intern Med. 2018. [PMID:29971337 ]. doi:10.7326/M18-0522 LinkGoogle Scholar - 15.
Ravi D ,Ghasemiesfe M ,Korenstein D ,Cascino T ,Keyhani S . Associations between marijuana use and cardiovascular risk factors and outcomes: a systematic review. Ann Intern Med. 2018;168:187-94. [PMID:29357394 ]. doi:10.7326/M17-1548 LinkGoogle Scholar - 16.
Hasin DS . US epidemiology of cannabis use and associated problems. Neuropsychopharmacology. 2018;43:195-212. [PMID:28853439 ] doi:10.1038/npp.2017.198 CrossrefMedlineGoogle Scholar - 17.
Volkow ND ,Compton WM ,Weiss SR . Adverse health effects of marijuana use [Letter]. N Engl J Med. 2014;371:879. [PMID:25162899 ] doi:10.1056/NEJMc1407928 CrossrefMedlineGoogle Scholar - 18.
Cerdá M ,Wall M ,Keyes KM ,Galea S ,Hasin D . Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug Alcohol Depend. 2012;120:22-7. [PMID:22099393 ] doi:10.1016/j.drugalcdep.2011.06.011 CrossrefMedlineGoogle Scholar - 19.
Hasin DS ,Grant B . NESARC findings on increased prevalence of marijuana use disorders-consistent with other sources of information. JAMA Psychiatry. 2016;73:532. [PMID:27008098 ] doi:10.1001/jamapsychiatry.2015.3158 CrossrefMedlineGoogle Scholar - 20.
Azofeifa A ,Mattson ME ,Schauer G ,McAfee T ,Grant A ,Lyerla R . National estimates of marijuana use and related indicators—National Survey on Drug Use and Health, United States, 2002-2014. MMWR Surveill Summ. 2016;65:1-28. [PMID:27584586 ] doi:10.15585/mmwr.ss6511a1 CrossrefMedlineGoogle Scholar - 21.
Glantz SA ,Halpern-Felsher B ,Springer ML . Marijuana, secondhand smoke, and social acceptability. JAMA Intern Med. 2018;178:13-4. [PMID:29159409 ] doi:10.1001/jamainternmed.2017.5301 CrossrefMedlineGoogle Scholar - 22. The SMOG Readability Formula. 2018. Accessed at www.readabilityformulas.com/smog-readability-formula.php on 10 July 2018. Google Scholar
- 23. GfK. KnowledgePanel. 2017. Accessed at www.gfk.com/products-a-z/us/knowledgepanel-united-states on 18 December 2017. Google Scholar
- 24.
American Association for Public Opinion Research . Standard Definitions: Final Dispositions of Case Codes and Outcomes Rates for Surveys. Oakbrook Terrace, IL: American Association for Public Opinion Research; 2016. Google Scholar - 25.
Blanco C ,Hasin DS ,Wall MM ,Flórez-Salamanca L ,Hoertel N ,Wang S ,et al . Cannabis use and risk of psychiatric disorders: prospective evidence from a US national longitudinal study. JAMA Psychiatry. 2016;73:388-95. [PMID:26886046 ] doi:10.1001/jamapsychiatry.2015.3229 CrossrefMedlineGoogle Scholar - 26.
Koppel BS ,Brust JC ,Fife T ,Bronstein J ,Youssof S ,Gronseth G ,et al . Systematic review: efficacy and safety of medical marijuana in selected neurologic disorders: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2014;82:1556-63. [PMID:24778283 ] doi:10.1212/WNL.0000000000000363 CrossrefMedlineGoogle Scholar - 27.
Gaziano JM ,Buring JE ,Breslow JL ,Goldhaber SZ ,Rosner B ,VanDenburgh M ,et al . Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med. 1993;329:1829-34. [PMID:8247033 ] CrossrefMedlineGoogle Scholar - 28.
Berger K ,Ajani UA ,Kase CS ,Gaziano JM ,Buring JE ,Glynn RJ ,et al . Light-to-moderate alcohol consumption and the risk of stroke among U.S. male physicians. N Engl J Med. 1999;341:1557-64. [PMID:10564684 ] CrossrefMedlineGoogle Scholar - 29.
Pletcher MJ ,Vittinghoff E ,Kalhan R ,Richman J ,Safford M ,Sidney S ,et al . Association between marijuana exposure and pulmonary function over 20 years. JAMA. 2012;307:173-81. [PMID:22235088 ] doi:10.1001/jama.2011.1961 CrossrefMedlineGoogle Scholar - 30.
Hancox RJ ,Poulton R ,Ely M ,Welch D ,Taylor DR ,McLachlan CR ,et al . Effects of cannabis on lung function: a population-based cohort study. Eur Respir J. 2010;35:42-7. [PMID:19679602 ] doi:10.1183/09031936.00065009 CrossrefMedlineGoogle Scholar - 31.
Pope CA 3rd ,Burnett RT ,Krewski D ,Jerrett M ,Shi Y ,Calle EE ,et al . Cardiovascular mortality and exposure to airborne fine particulate matter and cigarette smoke: shape of the exposure-response relationship. Circulation. 2009;120:941-8. [PMID:19720932 ] doi:10.1161/CIRCULATIONAHA.109.857888 CrossrefMedlineGoogle Scholar - 32.
Brook RD ,Rajagopalan S ,Pope CA 3rd ,Brook JR ,Bhatnagar A ,Diez-Roux AV ,et al ;American Heart Association Council on Epidemiology and Prevention, Council on the Kidney in Cardiovascular Disease, and Council on Nutrition Physical Activity and Metabolism . Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation. 2010;121:2331-78. [PMID:20458016 ] doi:10.1161/CIR.0b013e3181dbece1 CrossrefMedlineGoogle Scholar - 33.
O'Neil ME ,Nugent SM ,Morasco BJ ,Freeman M ,Low A ,Kondo K ,et al . Benefits and harms of plant-based cannabis for posttraumatic stress disorder: a systematic review. Ann Intern Med. 2017;167:332-40. [PMID:28806794 ]. doi:10.7326/M17-0477 LinkGoogle Scholar - 34.
Volkow ND ,Han B ,Compton WM ,Blanco C . Marijuana use during stages of pregnancy in the United States [Letter]. Ann Intern Med. 2017;166:763-4. [PMID:28418460 ]. doi:10.7326/L17-0067 LinkGoogle Scholar - 35.
Dickson B ,Mansfield C ,Guiahi M ,Allshouse AA ,Borgelt LM ,Sheeder J ,et al . Recommendations from cannabis dispensaries about first-trimester cannabis use. Obstet Gynecol. 2018;131:1031-8. [PMID:29742676 ] doi:10.1097/AOG.0000000000002619 CrossrefMedlineGoogle Scholar - 36.
Fowler FJ Jr ,Gerstein BS ,Barry MJ . How patient centered are medical decisions?: results of a national survey. JAMA Intern Med. 2013;173:1215-21. [PMID:23712194 ] doi:10.1001/jamainternmed.2013.6172 CrossrefMedlineGoogle Scholar - 37.
Yu J ,Nagler RH ,Fowler EF ,Kerlikowske K ,Gollust SE . Women's awareness and perceived importance of the harms and benefits of mammography screening: results from a 2016 national survey. JAMA Intern Med. 2017;177:1381-2. [PMID:28654987 ] doi:10.1001/jamainternmed.2017.2247 CrossrefMedlineGoogle Scholar - 38.
Hesse BW ,Nelson DE ,Kreps GL ,Croyle RT ,Arora NK ,Rimer BK ,et al . Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey. Arch Intern Med. 2005;165:2618-24. [PMID:16344419 ] CrossrefMedlineGoogle Scholar - 39.
Bleakley A ,Jordan AB ,Hennessy M . The relationship between parents' and children's television viewing. Pediatrics. 2013;132:e364-71. [PMID:23858418 ] doi:10.1542/peds.2012-3415 CrossrefMedlineGoogle Scholar - 40.
Heeren T ,Edwards EM ,Dennis JM ,Rodkin S ,Hingson RW ,Rosenbloom DL . A comparison of results from an alcohol survey of a prerecruited Internet panel and the National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol Clin Exp Res. 2008;32:222-9. [PMID:18162076 ] CrossrefMedlineGoogle Scholar
Author, Article and Disclosure Information
University of California, San Francisco, and San Francisco Veterans Affairs Medical Center, San Francisco, California (S.K., J.I., B.E.C.)
Northern California Institute for Research and Education, San Francisco, California (S.S., M.V., C.D., S.R.Y.)
University of California, Davis, Davis, California (M.C.)
Columbia University, New York, New York (D.H.)
Disclaimer: The views expressed in this article are those of the authors and do not represent the views of the U.S. Department of Veterans Affairs or the U.S. government.
Grant Support: In part by the National Heart, Lung, and Blood Institute of the National Institutes of Health under grant R01HL130484-01A1. Dr. Keyhani's administrative funds provided by the Northern California Institute for Research and Education also supported this work. Dr. Ishida was supported by career development award K23DK103963 from the National Institute of Diabetes and Digestive and Kidney Diseases.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0810.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Reproducible Research Statement:Study protocol: Blank survey tool available from Dr. Keyhani upon request (e-mail, salomeh.
Corresponding Author: Salomeh Keyhani, MD, MPH, San Francisco VA Medical Center, 4150 Clement Street, Box 111A1, San Francisco, CA 94121; e-mail, Salomeh.
Current Author Addresses: Drs. Keyhani and Cohen, Ms. Steigerwald, Ms. Vali, Ms. Dollinger, and Ms. Yoo: San Francisco VA Medical Center, 4150 Clement Street, Box 111A1, San Francisco, CA 94121.
Dr. Ishida: San Francisco VA Medical Center, 4150 Clement Street, Box 111J, San Francisco, CA 94121.
Dr. Cerdá: Department of Emergency Medicine, University of California, Davis, 4150 V Street, Suite 2100, Sacramento, CA 95817.
Dr. Hasin: Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 228F, New York, NY 10032.
Author Contributions: Conception and design: S. Keyhani, S. Steigerwald, J. Ishida, M. Cerdá, C. Dollinger, S.R. Yoo.
Analysis and interpretation of the data: S. Keyhani, S. Steigerwald, J. Ishida, M. Vali, M. Cerdá, D. Hasin, B.E. Cohen.
Drafting of the article: S. Keyhani, S. Steigerwald, C. Dollinger, S.R. Yoo.
Critical revision for important intellectual content: S. Keyhani, S. Steigerwald, J. Ishida, M. Cerdá, D. Hasin, B.E. Cohen.
Final approval of the article: S. Keyhani, S. Steigerwald, J. Ishida, M. Vali, M. Cerdá, D. Hasin, C. Dollinger, S.R. Yoo, B.E. Cohen.
Statistical expertise: M. Vali.
Collection and assembly of data: S. Keyhani, S. Steigerwald.
This article was published at Annals.org on 24 July 2018.
Submit a Comment
Contributors must reveal any conflict of interest. Comments are moderated. Please see our information for authorsregarding comments on an Annals publication.
*All comments submitted after October 1, 2021 and selected for publication will be published online only.