Survey Collects Perspectives on Warning Signs for Cannabis Use and Pregnancy
The efficacy of various warning messages on the potential risks of cannabis use during pregnancy were reviewed by cannabis users who were or had recently been pregnant.
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A recently published study examined whether signs warning of potential adverse health effects from cannabis use during pregnancy are effective (1). As the study’s abstract notes, five US states (Arizona, Colorado, Illinois, Oregon, and Washington) require mandatory warning signs (MWS) in dispensaries. However, public health policy on cannabis is lacking the public’s perspectives on the warning signs. The study, “Mandatory Warning Signs for Cannabis: Perspectives and Preferences of Pregnant and Recently Pregnant People Who Use Cannabis,” was published in January 2025 in the Journal of Studies on Alcohol and Drugs. It was funded through a grant from the California Department of Cannabis Control.
Researchers recruited participants from states with differing laws surrounding cannabis. The 34 participants in the study were ages 18–49, were either currently pregnant or had been pregnant in the past two years, and had indicated cannabis use before or during pregnancy.
The study tested 29 specific message types (abstinence based, informational, normalization, harm reduction, legal, autonomy). The messages came from various sources including existing warning signs, prenatal care providers, prior study participants, etc, and were revised according to feedback from the researchers’ community advisory board.
Examples of some of the messages used were (1):
- There is no safe level of cannabis use during pregnancy. (abstinence)
- Did you know? Cannabinoids can show up in drug tests at childbirth, even months after you stop using. (legal)
If you're pregnant, talk to your doctor before using cannabis. (normalization) - If you're pregnant, it may be safer to use edibles than to smoke or vape cannabis. (harm reduction)
Through phone interviews conducted in 2022, participants were given five of the messages, asked to imagine the messages were on a sign in a dispensary, and asked for their reactions. Overall, the participants reported negative or mixed views of the warning signs. About 40% viewed the messages as having a positive effect, though only three did not also mention a potential negative effect. The participants’ cannabis policy environment did not seem to indicate clear patterns of responses.
Three main themes emerged from the responses: perspectives that warnings can be stigmatizing, warnings should be evidence-based yet there is a lack of scientific evidence on cannabis and pregnancy to justify the warnings, and warnings are not likely to deter pregnant people from cannabis use.
Limitations to the study include underrepresentation, fewer responses from people who used cannabis during pregnancy than from those who used cannabis before pregnancy, and each message only reviewed by participants eight times at most.
Ultimately, testing messages was seen as potentially helpful for conveying health information without stigma. “This study suggests that a key reason MWS policies may not work is that people who use cannabis do not find information in MWS-cannabis believable or helpful,” the researchers concluded. “More research informed by people who use cannabis during pregnancy is needed to develop evidence-based health information that will be better received.”
Reference
- Gould, H.; Zaugg, C.; Biggs, MA.; Woodruff, K.; Long, W.; Mailman, K.; Vega, J.; Roberts, SCM. Mandatory Warning Signs for Cannabis: Perspectives and Preferences of Pregnant and Recently Pregnant People Who Use Cannabis. Journal of Studies on Alcohol and Drugs. 2025. DOI: 10.15288/jsad.23-00214.
