2026/07/21 by Qiana L. Brown, Catherine A. Cortez, Joshua R. Nugent +11
Medicine · #Cannabis and Cannabinoid Research #Prenatal Substance Exposure Effects #Maternal Mental Health During Pregnancy and Postpartum
paper · doi:10.1016/j.drugalcdep.2026.113281
OBJECTIVES: To examine joint associations between race/ethnicity and urbanicity in any cannabis use and modes of cannabis use during preconception. METHODS: In this cross-sectional study, insured pregnant patients (N = 146,166) were screened for cannabis use at prenatal care entry between February, 2020 and September, 2023 at a large integrated healthcare system in Northern California and answered questions about preconception cannabis use (any cannabis use and modes of use [smoking, blunts, edibles, vaping, dabs and topicals]). Multivariable Poisson regression models examined associations between race/ethnicity and urbanicity in preconception cannabis use. RESULTS: The prevalence of any cannabis use was 17%, smoking was the most common mode (67%). Preconception cannabis use was often highest in cities and lowest in town/rural areas. The magnitude of place-based differences was often greatest among non-Hispanic (NH) Black patients and patients from NH multi-racial/other/unknown racial/ethnic groups. For example, while the prevalence of any cannabis use and smoking was highest in cities and lowest in town/rural areas among each racial/ethnic group, the adjusted prevalence ratio (aPR) (1.55; 95% confidence interval [CI]=1.27-1.90) for any cannabis use comparing cities to town/rural areas was higher among NH Black patients; and the aPR for smoking (1.55; 95% CI=1.07-2.24) was highest for patients from NH multi-racial/other/unknown racial/ethnic groups. CONCLUSIONS: Living in cities is often associated with increased preconception cannabis use. The greater magnitude of place-based differences in use among NH Black patients and patients from NH multi-racial/other/unknown racial/ethnic groups indicates that where these patients live potentially matters more in preconception cannabis use.