Characterizing Online Questions and Answers About Cannabis Use and Pregnancy on the Social Media Platform Quora: Data Mining and Qualitative Content Analysis.

Abstract

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. 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. Manual content coding was used for text analysis, with coding conducted by multiple coders, and interrater reliability assessed. Publicly available user profile metadata was reviewed to understand the roles of contributors participating in online discussions. A chi-square test was used to examine potential associations between sentiment toward cannabis use during pregnancy and sentiment toward general cannabis use. We collected 7834 questions pertaining to cannabis use, with 6.8% (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: (1) cannabis use before pregnancy and (2) cannabis use during pregnancy, and seven subthemes: (a) safety of cannabis use (608/1074, 56.6%), (b) removal of cannabis from the body (372/1074, 34.6%), (c) legal consequences of cannabis use (175/1074, 16.3%), (d) cannabis use history before the pregnancy (27/529, 5.1%), (e) purpose of cannabis use (22/529, 4.2%), (f) public opinion comments (21/529, 4.0%), and (g) dosing recommendations (2/529, 0.4%). Among 1916 answers to these questions, 56.1% (n=1074) were relevant to cannabis and pregnancy topics. Among all answer contributors, 78.0% (660/846) were nonexpert observers (ie, users who did not publicly disclose professional credentials or affiliations on their Quora profiles), 6.3% (53/846) were people who had used cannabis during pregnancy, 11.3% (96/846) were expert observers (ie, health care providers, researchers), and 4.4% (37/846) were cannabis industry observers. Questions related to removing cannabis from the body attracted the highest engagement. Notably, analysis of answers found predominantly negative sentiment among Quora users regarding cannabis use during pregnancy. This study identified an active online community discussing cannabis and pregnancy on Quora. Results highlight a diversity of discussion topics, high frequency of nonexpert 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.