JMIR Publications

ABSTRACT

Background:

Cannabis use during pregnancy has become an increasing public health concern amid shifting legalization policies, expanding product availability, and evolving societal attitudes toward cannabis. Understanding how the public perceives the risks of cannabis use in pregnancy is essential for informing health communication and intervention strategies. Online question-and-answer (Q&A) platforms offer a unique window into real-world conversations, capturing both lived experiences and opinions from diverse contributors.

Objective:

This study leveraged data mining from the question-and-answer social media platform Quora to explore attitudes and experiences concerning cannabis use and pregnancy. The primary aim was to identify and characterize online discourse specific to risk perceptions associated with cannabis use and pregnancy.

Methods:

Data collection encompassed two layers of Quora data: user-generated questions and answers to these questions. Keywords related to cannabis and pregnancy guided data selection and collection. Content coding was used for text analysis, and user profile metadata was reviewed to understand the roles of contributors participating in online discussions. A chi-square test was used to determine whether a significant dependent relationship existed between sentiment toward cannabis use during pregnancy and general cannabis use sentiment.

Results:

We collected 7,834 questions pertaining to cannabis use, with 6.7% (n=529) identified as relevant to topics about pregnancy. Questions spanned from January 2012-July 2023. Content analysis classified the detected themes into two stages of discussion: (a) cannabis use before pregnancy and (b) cannabis use during pregnancy, and seven sub-themes: (i) safety of cannabis use (56.6%), (ii) removal of cannabis from the body (34.6%), (iii) legal consequences of cannabis use (16.3%), (iv) cannabis use history before the pregnancy (5.1%), (v) purpose of cannabis use (4.2%), (vi) public opinion comments (4.0%), and (vii) dosing recommendations (0.4%). Among 1,916 answers to these questions, 56.1% (n=1,074) were relevant to cannabis and pregnancy topics. Among all answer contributors 78.0% (n=660) were non-expert observers (i.e., those who did not disclose professional credentials or affiliations), 6.3% (n=53) were people who had used cannabis during pregnancy, 11.3% (n=96) were expert observers (i.e., healthcare providers, researchers), and 4.4% were cannabis industry observers (n=37). Questions related to removing cannabis from the body attracted the highest engagement. Notably, sentiment analysis in answers found predominantly negative sentiment among Quora users regarding cannabis use during pregnancy.

Conclusions:

This study identified an active online community discussing cannabis and pregnancy on Quora. Results highlight a diversity of discussion topics, high frequency of non-expert observers providing advice, and generally an overall negative sentiment toward cannabis use during pregnancy but not necessarily toward general cannabis use not associated with pregnancy. Additional research is needed to understand information gaps and misinformation in cannabis and pregnancy safety discussions online and how to conduct effective outreach to pregnant women and their families.