Mixed Policy, Mixed Perception: Attitudes Towards Marijuana and Electronic Cigarettes in a Landscape of Changing Policy

Background and Purpose: Marijuana is the most widely used illicit drug in the United States, and more recently, electronic cigarettes emerged as the most common electronic nicotine delivery system (Romijnders et al., 2018). With the policy landscape changing over the past 20 years in the United States, research is needed to better understand current perceptions about marijuana, and electronic cigarettes. Furthermore, extant research is limited to certain regions in the country and the general US population (Keyes et al., 2016; Berg et al., 2014). The purpose of this research is to 1) describe perceptions of marijuana and electronic cigarettes among a diverse group of participants who reside in the southwestern region of the United States, and 2) identify gaps in knowledge about marijuana and electronic cigarette use.

Methods: Analyses were conducted using data from the Maricopa County Community Health Needs Assessment project. Purposive sampling was used to recruit individuals (n=457) who were 13 to 75 years old living in Maricopa County, Arizona, from diverse demographic backgrounds. Data were analyzed from focus groups, which averaged 90 minutes and 10 participants per group. A total of 49 focus groups were recorded using note-takers and audio recording devices and then transcribed. Focus group data were analyzed using Grounded Theory developed by Corbin and Strauss (1990). Themes and sub-themes were conceptualized following comparative analytic processes to account for data patterns.

Results: The majority of participants identified as female (n=284, 62%) and were Hispanic or Latino (n=132, 26%), Black/African American (n=108, 22%), or American Indian/Alaska Native (n=91,18%). Three themes emerged from the analyses specific to marijuana: 1) perceptions of marijuana as a medicinal substance, 2) perceptions of marijuana as an illicit and/or addictive substance, and 3) perceptions of marijuana as a nuisance to community health. Underscoring these themes, were three sub-themes relating to gaps in knowledge specific to 1) public education about the health benefits of marijuana, 2) clarification about marijuana legalization, and 3) limited insurance coverage for medical marijuana. Although data about participants’ perceptions of electronic cigarettes were limited, two preliminary themes surfaced: 1) health safety concerns of electronic cigarettes, and 2) access to electronic cigarettes.

Conclusions and Implications: Findings from this study suggest that while participants’ perceptions about marijuana centered on its medical use, illicitness, and community influences, gaps in knowledge exist about the health benefits of marijuana, marijuana legalization, and insurance coverage. Regarding electronic cigarettes, preliminary findings suggest that participants perceive electronic cigarettes as harmful yet accessible. Further research is needed to explore the beliefs about marijuana and electronic cigarettes under distinct policy environments, and future research should examine how differences in policies affect individuals’ perceptions about these substances.