Prenatal Exposure to Tobacco and Cannabis in Six Race/Ethnicity Groups during the First Three Years after Legalization of Cannabis for Recreational Use in California

Martin Kharrazi (), Kimberly Berger, Michelle Pearl, Ying Li, Josephine DeGuzman, Paramjit Behniwal, Allison Morse, Ilya Moskalenko, Rebecca J. Williams and Jianwen She
Additional contact information
Martin Kharrazi: Sequoia Foundation, Berkeley, CA 94710, USA
Kimberly Berger: Sequoia Foundation, Berkeley, CA 94710, USA
Michelle Pearl: Environmental Investigations Branch, California Department of Public Health, Richmond, CA 94804, USA
Ying Li: Sequoia Foundation, Berkeley, CA 94710, USA
Josephine DeGuzman: Environmental Health Laboratory Branch, California Department of Public Health, Richmond, CA 94804, USA
Paramjit Behniwal: Environmental Health Laboratory Branch, California Department of Public Health, Richmond, CA 94804, USA
Allison Morse: Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA
Ilya Moskalenko: Sequoia Foundation, Berkeley, CA 94710, USA
Rebecca J. Williams: California Tobacco Prevention Program, California Department of Public Health, Sacramento, CA 95814, USA
Jianwen She: Environmental Health Laboratory Branch, California Department of Public Health, Richmond, CA 94804, USA

IJERPH, 2023, vol. 21, issue 1, 1-20

Abstract: There are known health concerns linked to prenatal tobacco and cannabis exposures. This study aims to objectively determine the level of exposure to tobacco and cannabis in pregnant individuals from six race/ethnicity groups (Black, Hispanic, Asian Indian, Native American, Vietnamese, and White) in the first three years following legalization of recreational marijuana use in 2018 in California. We used a cross-sectional sample of prenatal screening program participants (2018–2020) from southern and central California (N = 925). Exposures were estimated by a lab analysis of cotinine (tobacco) and 11-hydroxy-Δ9-tetrahydrocannabinol (OH-THC, cannabis) in banked serum. Disparities in tobacco exposure were evident, with Black subjects experiencing the highest smoking rate (16%) followed by Native American (10%) and White (8%) subjects, and ≤2% among Hispanic, Asian Indian, and Vietnamese subjects. Environmental tobacco exposure generally showed a similar pattern of exposure to tobacco smoking across race/ethnicity groups. Cannabis detection ranged from 5% among Hispanic subjects to 12% and 13% among White and Black subjects, respectively, and was higher among tobacco users and those exposed to environmental tobacco smoke than those with no cotinine detected. Tobacco and cannabis exposure were generally greatest in younger subjects and those with indices of a lower economic status; however, among Black subjects, cannabis exposure was greatest in older subjects and those with a higher socioeconomic status. Race/ethnicity, age, and socioeconomic factors can inform targeting of high-exposure groups for intervention.

Keywords: tobacco; cannabis; pregnancy; cannabis legalization; cotinine; THC; biomarker; 11-hydroxy-?9-tetrahydrocannabinol (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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