Marijuana use has risen since California legalized recreational use in January of 2018, at a time when use of e-cigarettes and similar products were already on the rise. Pregnant women can be exposed to tobacco and cannabis from product use as well as from secondhand smoke and vapors. The Pregnancy Exposure to Cannabis and Tobacco (PRECATO) Study looks at the levels of cannabis and tobacco in pregnant women across races/ethnicities, and assesses the relationships to maternal demographic and neighborhood factors.
Study Objectives
Estimate levels of exposure to tobacco and cannabis in pregnant women, and find factors that relate to these exposures.
​Study Population
A sample of 1,800 women enrolled in the California prenatal screening program who self-reported as Hispanic/Latina, Black, White, Native American, Vietnamese or South Asian (i.e., from the Indian subcontinent)
Geographic Area
Eleven counties in Central and Southern California
Laboratory Methods
Serum specimens banked by the California Biobank Program were analyzed for a nicotine metabolite (cotinine) and marijuana metabolites (delta-9-THC, OH-THC, and CBN)
Principal Investigator
Martin Kharrazi, Ph.D., M.P.H.
Sequoia Foundation, Berkeley, CA
STUDY AT A GLANCE
Given the lack of data about tobacco and cannabis use during pregnancy, and the potential increase in exposures since legalization of marijuana in many states, the PRECATO study presents an important opportunity to understand who in California is exposed and to what extent.
Study Abstract
With legalization of adult marijuana use in California in January 2018, and reports of increasing use of e-cigarettes and nicotine replacement products, Californians are being exposed to tobacco and marijuana in ways as never before. It is an important time to have accurate information about these exposures and their ill effects, especially among our most vulnerable populations. Because ill effects can occur in both users of these products and those exposed to the secondhand smoke and vapors, and because it is challenging to get accurate information about these exposures from surveys, we are conducting a study of pregnant women using an objective approach to define exposure to tobacco and marijuana-containing products. We are focusing on a sample of 1800 pregnant women residing in the Southern and Central Valley regions of California from six race/ethnic groups (300 from each group) who are expected to have a range of exposures to tobacco and marijuana. These six groups are Native Americans, African Americans, South Asians, Vietnamese, Whites, and Hispanics/Latinas who provided blood in 2018-2020 during mid-pregnancy for screening of various birth defects, and who consented that their blood could be stored and used for approved research. Through laboratory analysis of the blood, we are measuring markers of tobacco and marijuana across a wide range, from high levels found in users of these products to low levels found in non-users exposed to secondhand smoke and vapors. In 2023, we will determine levels of the markers in the six race/ethnic groups. We will see whether those with high levels of the tobacco marker also have higher levels of the marijuana markers. In addition, we will assess how additional factors that may help target interventions, like age, type of medical insurance, neighborhood poverty level, and proximity to marijuana retailers, are related to the exposure markers. We expect that the findings of this study will be useful to communities, cultural groups, medical care providers and public health professionals in making focused efforts towards prevention of these exposures in pregnant women.