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Tobacco and cannabis use among pregnant women with prenatal opioid use
Mahabee-Gittens, E. M., Mack, N., Bann, C. M., Newman, J. E., Zhao, J., Setchell, K. D. R., Stone, L., Ambalavanan, N., Peralta-Carcelen, M., DeMauro, S. B., Lorch, S. A., Wilson-Costello, D. E., Poindexter, B. B., Limperopoulos, C., Davis, J. M., & Merhar, S. L. (2025). Tobacco and cannabis use among pregnant women with prenatal opioid use. Addictive Behaviors, 170, 108442. Article 108442. https://doi.org/10.1016/j.addbeh.2025.108442
BACKGROUND: There is a paucity of information on tobacco and cannabis use patterns in pregnant women who use opioids. Our objective was to examine sociodemographic, tobacco, and cannabis use patterns during pregnancy among pregnant women with opioid use.
METHODS: We recruited 206 pregnant women with biochemically verified opioid use during pregnancy, of whom 98 self-reported taking only medications for opioid use disorder (MOUD) and 108 reported taking other opioids during pregnancy. We examined sociodemographic characteristics and self-report of tobacco and cannabis use overall and by trimester. Chi-square and t-tests were used to assess differences between the MOUD-only vs other opioids groups. Logistic regression models were used to examine differences in factors associated with tobacco and cannabis use.
RESULTS: Mean (SD) age was 30.7 years (4.6); 81.9 % were non-Hispanic White, and 92.6 % had public insurance. Of the 91 women taking MOUD only and completing the substance use self-report, 50 (54.9 %) reported tobacco use only, 3 (3.3 %) reported cannabis use only, and 24 (26.4 %) reported both tobacco and cannabis use. Tobacco and cannabis use was similar for women taking other opioids (p = 0.98). Adjusted odds ratios indicated that there was consistent use of all tobacco products (p = 0.28) including e-cigarette products (p = 0.18) throughout all 3 trimesters of pregnancy. There was decreased use of cannabis over the course of pregnancy with 29.8 % using cannabis during the first trimester and 16.5 % during the last trimester (p = 0.0003).
CONCLUSIONS: While we observed no differences in tobacco and cannabis use between those taking MOUD only versus other opioids, we observed high rates of tobacco and cannabis use among pregnant women with opioid use. These findings underscore the need for tobacco and cannabis use education and cessation interventions throughout pregnancy for those with OUD.
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