What are the effects of second-hand smoke from cannabis (marijuana) on children?

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DS

Dainyal Siddiqui, MD

Internal Medicine

MJ

Manuel Jimenez, MD

Cardiology

FP

Franz Pierre-Louis, MD

Infectious Disease

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Last updated: March 22, 2025 • View editorial policy

From the Guidelines

Secondhand marijuana smoke is harmful to children and should be completely avoided. Children exposed to marijuana smoke can experience negative health effects similar to those from tobacco smoke, including respiratory problems, increased risk of asthma attacks, ear infections, and potential cognitive impacts 1. THC (the psychoactive component in marijuana) can be detected in the blood of non-smoking individuals exposed to secondhand marijuana smoke, meaning children could absorb these chemicals. The developing brains of children are particularly vulnerable to these substances, potentially affecting attention, memory, and learning.

Key Recommendations

  • Parents and caregivers who use marijuana should never smoke it inside homes, cars, or any enclosed spaces where children are present or will be present later, as smoke particles can linger on surfaces and in the air for hours or days (known as thirdhand smoke) 2.
  • If adults choose to use marijuana, they should do so outdoors, away from children, and change clothes and wash hands thoroughly before interacting with children.
  • Comprehensive smoking bans should be enacted to protect children from secondhand smoke exposure, including in public places and vehicles 2.

Rationale

  • The evidence suggests that secondhand smoke exposure can have serious health consequences for children, including increased risk of respiratory problems and cognitive impacts 1, 2.
  • Protecting children from exposure to secondhand smoke remains essential for their health and development, even in states where marijuana is legal.
  • Pediatricians should inquire about tobacco use and tobacco smoke exposure as part of health supervision visits and visits for diseases that may be caused or exacerbated by tobacco smoke exposure, and provide counseling and guidance to parents and caregivers on how to protect children from secondhand smoke exposure 1.

From the Research

Effects of Second-Hand Smoke from Cannabis on Children

  • The effects of second-hand smoke from cannabis on children are not well understood, but studies suggest that exposure to second-hand marijuana smoke may be associated with increased risk of respiratory infections, such as viral respiratory infections (VRIs) 3.
  • A study found that caregivers who used marijuana reported an increased rate of VRIs in their children compared to caregivers with no marijuana use 3.
  • Another study found that approximately half of the children who qualified for the study had biological evidence of exposure to marijuana, and children with positive results for marijuana metabolites were more likely to have parents who use marijuana daily and smoke marijuana in the home 4.
  • Second-hand smoke exposure, including exposure to marijuana smoke, has been correlated with many adverse disease processes in children, including sudden infant death syndrome (SIDS), asthma, altered respiratory function, infection, cardiovascular effects, behavior problems, sleep difficulties, increased cancer risk, and a higher likelihood of smoking initiation 5.
  • A study found that more students with asthma were exposed to second-hand marijuana smoke than students without asthma, highlighting the need to examine marijuana second-hand smoke as a public health issue 6.

Health Risks Associated with Second-Hand Smoke Exposure

  • Second-hand smoke exposure has been linked to a range of health problems in children, including respiratory infections, asthma, and other respiratory diseases 3, 5, 6.
  • Exposure to second-hand smoke, including marijuana smoke, may exacerbate existing health conditions, such as asthma, and increase the risk of developing new health problems 5, 6.
  • The health risks associated with second-hand smoke exposure are particularly concerning for children, as their developing lungs and immune systems may be more vulnerable to the effects of second-hand smoke 7, 5.

Need for Further Research

  • Further research is needed to fully understand the effects of second-hand smoke from cannabis on children and to develop effective strategies for reducing exposure to second-hand smoke 3, 4, 6.
  • Studies should investigate the relationship between second-hand marijuana smoke exposure and health outcomes in children, including respiratory infections, asthma, and other diseases 3, 6.
  • Research should also focus on developing and evaluating interventions to reduce second-hand smoke exposure in children, including education and counseling programs for parents and caregivers 7, 5.

References

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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