Smoking Marijuana Increasingly Seen As Safer Than Cigarettes, American Medical Association Journal Study Finds

People increasingly view smoking marijuana or being exposed to secondhand cannabis smoke as safer than smoking or being near tobacco smoke, according to a new study published by the American Medical Association (AMA).

Researchers surveyed 5,035 U.S. adults three times—in 2017, 2020 and 2021—about how they perceive the risks of both substances, and they found a “significant shift” over time as more people expressed that they felt cannabis smoke was generally safer than tobacco smoke.

The survey—results of which were published in the Journal of the American Medical Association (JAMA) Substance Use and Addiction on Friday—asked people whether they felt smoking one marijuana joint per day was much less safe, somewhat less safe, just as safe, somewhat safer or much safer than smoking one cigarette per day.

“Daily cannabis smoking or smoke exposure was perceived to be safer than tobacco,” the authors wrote. And over time, “views increasingly favored the safety of cannabis vs tobacco smoke.”

“Regarding the safety of daily smoking of cannabis vs tobacco, there was a significant shift from 2017 to 2021 toward a more favorable perception of cannabis.”

For example, in 2017, 33.7 percent of respondents said that smoking marijuana once a day was either much or somewhat more dangerous than smoking a daily cigarette, compared to 36.6 percent who said cannabis was safer. About 30 percent said they carried equal risks.

By 2021, just 25.5 percent still believed that smoking cannabis was more dangerous than smoking tobacco, while 44.3 percent said marijuana was safer than cigarettes—a 21 percent increase from four years earlier.

Similar trends were observed when respondents were asked about the relative dangers of being exposed to secondhand cannabis and cigarette smoke.

In 2017, 29.2 percent of people said that secondhand marijuana smoke was more dangerous than cigarette smoke exposure, whereas 35.1 percent said that the opposite was true. Another 35.6 percent said that neither was safer nor more dangerous.

Four years later, in 2021, 25.5 percent said that secondhand cannabis smoke was worse than tobacco smoke, and 40.1 percent said that exposure to marijuana was safer than being around cigarette smoke.

There was “a significant shift toward a more favorable view of cannabis from 2017 to 2021.”

The survey also asked people to rate the relative safety of secondhand marijuana and tobacco smoke for different groups.

For adults, 12.6 percent said cannabis was somewhat or completely safe, versus 2.4 percent who said the same about tobacco. For children, 4.8 percent said secondhand cannabis smoke was completely or somewhat safe, compared to 1.8 percent for tobacco. And 5.3 percent said that exposure to marijuana smoke was generally safe for pregnant women, while 1.4 percent said that was true of cigarettes.

“US adults have a more favorable view of the safety of primary and secondhand cannabis smoke exposure than tobacco smoke exposure,” the paper says.

Notably, the “legality of cannabis in the participants’ state of residence was not independently associated with change over time,” the authors wrote. “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.”

That finding seems to partly contradict a part of the paper’s concluding discussion where the authors predict that as more states enact legalization, “risk perception may decrease further, which may be associated with increased consumption of cannabis and exposure to secondhand cannabis smoke.”

“The perceived relative safety of cannabis smoke increased over time.”

The authors appear concerned about the change in attitudes towards marijuana’s relative safety, saying that “public health efforts may be necessary to educate the public on potential risks and curb the increasing social acceptance of cannabis smoke exposure, similar to past education about secondhand tobacco smoke.”

The release of the new study comes days after Gallup came out with a new poll showing that fully half of Americans have tried marijuana—and more people now actively smoke cannabis than tobacco cigarettes. Additionally, a majority say they are not especially concerned about the effects of adults regularly using marijuana.

Meanwhile, a poll released by the American Psychiatric Association in June found that Americans consider marijuana to be significantly less dangerous than cigarettes, alcohol and opioids—and they say cannabis is less addictive than each of those substances, as well as technology.

Last year, a survey also showed that Americans believe that cannabis is less dangerous than alcohol or tobacco. And a separate poll released last year found that more Americans now openly admit that they smoke marijuana or eat cannabis-infused edibles than say they’ve smoked cigarettes in the past week.

Also, a study published in May found that state-level legalization is associated with a “small, occasionally significant longer-run declines in adult tobacco use.”

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Photo courtesy of Martin Alonso.