Aims: To evaluate how young adults perceive and compare harms and benefits of marijuana and tobacco products in the context of a legal marijuana market in Colorado.
Design: Semi-structured qualitative interviews.
Setting: Denver, CO, USA. Participants Thirty-two young adults (aged 18-26 years) who used tobacco/marijuana/vaporizers.
Measurements: Semi-structured interviews addressed perceived harms and benefits of various tobacco and marijuana products and personal experiences with these products.
Findings: Young adults evaluated harms and benefits using five dimensions: (1) combustion - smoking was considered more harmful than non-combustible products (e.g. e-cigarettes, vaporizers and edibles); (2) potency - edibles and marijuana concentrates were perceived as more harmful than smoking marijuana flower because of potential to receive too large a dose of tetrahydrocannabinol (THC); (3) chemicals - products containing chemical additives were seen as more harmful than 'pure' or 'natural' plant products; (4) addiction - participants recognized physiological addiction to nicotine, but talked primarily about psychological or life-style dependence on marijuana; and (5) source of knowledge - personal experiences, warning labels, campaigns, the media and opinions of product retailers and medical practitioners affected perceptions of harms and benefits.
Conclusions: Among young adults in Colorado, USA, perceived harms and benefits of tobacco and marijuana include multiple dimensions. Health educational campaigns could benefit from addressing these dimensions, such as the potency of nicotine and cannabis concentrates and harmful chemicals present in the organic material of tobacco and marijuana. Descriptors such as 'natural' and 'pure' in the promotion or packaging of tobacco and marijuana products might be misleading.