Approximately 7% of Americans and 13% of Canadians older than 25 years old use cannabis, suggesting that millions of parents across North America are users. We hypothesize that parental cannabis use may affect children in two ways: by increasing personal exposure to the substance (eg, in utero exposure) and through its impact on parenting (Figure 1). Regarding direct exposure, scientific evidence suggests that using cannabis during pregnancy is unsafe and may lead to complications at birth, such as preterm delivery, lower birth weight, lower Apgar scores, and decreased fetal growth. In addition, in one study, offspring of parents consuming cannabis were more likely to use cannabis themselves in adolescence, which was found, in a systematic review, to be associated with higher odds of depression, suicidal behavior, and psychotic illness. Paradoxically, we believe that our field is not well informed by scientific research about the effects of parental cannabis use on parenting and offspring development at early developmental periods when the child is highly sensitive to the types of parental behaviors identified at the bottom of Figure 1. Such a gap in our knowledge is of definite concern for public health and child psychiatry, particularly considering that parents and professionals have access to very conflictual information on this issue. To support our standpoint that the important gaps in our knowledge about the issue of parental cannabis use open the door for highly diverse opinions regarding the harmfulness of parental cannabis use, we reviewed the portrayal of parental cannabis use provided by three sources: the scientific literature, media (online media, print news, and print media), and publications of government and other public agencies (more information on the search strategy is provided in Supplement 1, available online).

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