Cannabis and Nicotine Substance Use Coercion During the Perinatal Period

Perinatal intimate partner violence (IPV) and perinatal cannabis and nicotine product use are common and associated with negative maternal-infant health outcomes. Substance use coercion (SUC), which involves abusive partners' controlling behaviors related to substance use, has not been studied for cannabis and nicotine products. Perinatal individuals may be particularly vulnerable to SUC, and this study aims to explore how cannabis and nicotine SUC manifests among perinatal survivors.

We conducted virtual, semi-structured, 45-minute retrospective interviews with 19 IPV advocates and 15 perinatal IPV survivors. Participants were recruited through local IPV agencies and an online recruitment repository. Audio-recorded interviews were transcribed and analyzed using a deductive-inductive thematic analysis approach. Two research team members individually coded each transcript and met to resolve discrepancies.

Key themes emerged relating to survivors' use, interpersonal coercive tactics, and systems-level control. Specific findings included (1) survivors using substances to cope; (2) abusive partners coercing survivors through withholding, controlling, and punishing substance use; (3) shame and stigma are key drivers of coercion; (4) partners hinder cessation efforts; and (5) child protective services and health care are systems used by abusive partners to control and manipulate perinatal survivors of IPV.

The findings demonstrate that cannabis and nicotine products are used to coerce and control survivors of IPV. Future work should focus on developing survivor-centered interventions within systems to better support perinatal IPV survivors using cannabis and nicotine products. This study highlights the impact of cannabis and nicotine SUC on perinatal individuals and underscores the need to consider SUC when providing resources or treatment.