Table 4 Qualitative findings regarding perceptions of cannabis use and non-medical legalization among US and Israeli adults

Perceptions of cannabis use

 No concerns

‒ Children can be aware of what is happening in the world and around them. There is no need to withhold from them or conceal such information from them. (38 year-old Jewish female, Israel)

Perceived risks

 Social normalization for children

‒ Children are very impressionable. Smoking or using marijuana or getting high is not something that kids need to see and take in as a good or normal thing. I don’t think that [cannabis use] should be allowed in front of kids. (30 year-old NH White male, US)

‒ Even if it’s legal, there’s still some boundaries or respect that you still should have. I would not do that in front of others and in front of children. (24 year-old Hispanic male, US)

 Impact of byproducts on health of children

‒ I would not allow [cannabis use] in the presence of children just because I don’t think smoking, even if it's marijuana, is healthy for children. And I don’t think it should be around children. They can’t consent. (39 year-old NH Asian female, US)

‒ I would permit this from above a certain age, like 12, 13 or something, mainly because of the smoke coming out. It’s a health thing. When they’re small, they’re simply more vulnerable. I would permit it because at least a child above age 13 [can voice and take actions for themselves]. I can speak for myself as someone whose parents smoke. If the smoke would bother me, I’d move away from the smoke. (21 year-old Jewish male, Israel)

 Risks associated with use among young people

‒ I know some people that are really sort of addicted to marijuana, and that is what bothers me. And of course, use by young people is very important to me, even age 24, which is the age at which the front of the brain develops the fastest, and marijuana also has an effect on the brain, and it can harm all sorts of characteristics that we acquire during our lives. (24 year-old Jewish female, Israel)

 Cannabis serving as a gateway drug

‒ I think that [cannabis] is definitely a gateway drug. I think that most people, especially younger people, don't simply just stop at smoking marijuana. (30 year-old NH White male, US)

 Health risks of cannabis use

‒ [Cannabis use] is no different than drinking alcohol or smoking cigarettes. All these things are harmful, all these things have effects, both emotional and cognitive. (38 year-old Jewish female, Israel)

‒ I never had any interaction or, you know, exposure to [cannabis]. But to my knowledge, [cannabis] is extremely dangerous, because they may drive people crazy, you know, and the harmful effects are not clearly known. (40 year-old NH Asian male, US)

 Driving under the influence of cannabis

‒ I definitely hate the idea of people smoking a bunch of weed and then driving. That is incredibly dangerous. (44 year-old, NH White female, US)

‒ I would probably be more scared of weed because you have your legal limit of alcohol. You can go out and have dinner, and usually you’re safe to have at least like one drink and then drive. But, is there a limit on how much you're safe to drive with weed? I wouldn't trust myself to have a tiny bit of a THC gummy and get behind the wheel. (39 year-old NH White female, US)

Perceived benefits

 Medical benefits of cannabis

‒ I think marijuana has a lot of medical uses and can be used to help a lot of people. (32 year-old NH White female, US)

‒ [Cannabis] helps with pain, with sleeping, so I'm for recreational marijuana. (39 year-old NH Black male, US)

‒ I enjoy [cannabis] myself. I have chronic pain and anxiety, and it does help me. I know it helps a lot of people with chronic problems. (39 year-old NH White female, US)

‒ Marijuana has many advantages. It also has many medical advantages. It could be a mental condition or some sort of anxiety attack or things that are happen in our day-to-day lives. (24 year-old Jewish female, Israel)

 Not as dangerous as opioids

‒ I think [cannabis] is a far better alternative than the big opioid thing we have going on with people addicted to pills and stuff like that. I feel like marijuana is a far better, healthier option because it is a plant. (23 year-old NH White female, US)

‒ Peer reviewed evidence suggested that cannabis have better outcomes than traditional painkillers, which are very costly and harm your organs versus cannabis, unless you do it a little too much. (27 year-old Hispanic male, US)

 Not as dangerous as alcohol

‒ In my personal opinion, I think [cannabis] does affect you a little bit, but not at all to the extent of like alcohol or anything like that. (33 year-old NH White female, US)

‒ [Cannabis] affects everyone differently, but I think it affects the driver’s alertness. I mean the person, I won’t say they’re sober, but cannabis is not alcohol. Alcohol takes it to the extreme. Cannabis can simply slow you down. Again, it can also be harmful, causing a lack of vigilance. ([unknown age] Jewish female, Israel)

 Not as dangerous as tobacco

‒ I would authorize [cannabis] over cigarettes, just because I would find that there's less harmful ingredients or chemicals in the [cannabis] product versus traditional cigarettes. It just depends on how often or how frequently the product is being used. But I would just associate with it being a more natural product versus cigarettes. (27 year-old Hispanic male, US)

Perceptions of non-medical (i.e., ‘recreational’) cannabis legalization

 No concerns

‒ As long as [cannabis] is well regulated, I don’t have concerns. (39 year-old NH Asian female, US)

‒ I don’t see a problem with [legalizing non-medical cannabis]. I personally love it. To be honest, I don’t think it's even something that needs to be regulated by the government. (32 year-old NH Black female, US)

‒ I have no problem with [legalizing non-medical cannabis]. [Cannabis] is no different than alcohol. In my opinion, I don’t see why [cannabis] should be restricted, particularly if alcohol, let’s say, isn’t controlled. (38 year-old Jewish female, Israel)

‒ For a certain age group, I wouldn’t be against [legalizing non-medical]. I don’t think it’s harmful. (35 year-old Arab female, Israel)

Perceived risks

 Negative impact on society

‒ Laws should be very strict. Definitely, such policies would really help saving people falling in trap of these products. And if any small leverage of these [policies] occurred under the pretext of making some exemptions, it would really have a harmful effect to the society's families and communities. (40 year-old NH Asian male, US)

 Negative impact on economy and productivity

‒ I guess [cannabis] creates a society that tends to be less productive in a time where we need more people to be productive. We need more workforce, we have millions of jobs that are not being used, and you can't hire people because of drug use. So, we have a huge drug problem in this country. And I don't think that making marijuana more open and legal helps that. (30 year-old NH White male, US)

 Increased crime

‒ There has been a huge uptick of robberies of these pot stores. It's scary. People coming in with guns and stuff. (39 year-old NH White female, US)

 Inequitable economic benefit

‒ People who’ve been selling weed for forever and getting in trouble for it are going to be left out of the opportunity to make money now when it's legal. (37 year-old NH Black female, US)

‒ I think that they’re going to legalize [non-medical cannabis], and people who shouldn't be making money off of it are going to make money off of it. (37 year-old NH Black female, US)

 Increased price of cannabis products

‒ [Legalizing non-medical cannabis] will probably also increase the price. Everyone suddenly wants a share, so everyone will want a share until it reaches the store. ([unknown age] Jewish female, Israel)

 Cannabis marketing

‒ It's weird when a piece of marijuana looks like brownie, candy or like gummy bears. I disagree with that. It's not like I ever bought it or tried it, or I will ever do it. Never. But still, for me, there should be more regulations. (45 year-old NH Asian female, US)

‒ What’s bad is that, at least today, most cannabis advertising says it’s healthy. I think this is unwise because it encourages people to use, and I don’t think there’s enough knowledge available to be able to say what’s more or less healthy. I’d be pleased, for instance, if they would at least require warnings that say that this hasn’t been studied enough and there may be side effects and things. (21 year-old Jewish male, Israel)

 Insufficient regulation

‒ My concerns would just be related to lack of regulation of the products – so potential contaminants and lack of oversight in facilities where the products are processed and packaged. (38 year-old NH White female, US)

‒ I have concerns over the controls, like quality control. And there still seems to be a pretty significant black market for marijuana products. I think there’s still a lot of room for, like fly by night companies, to produce products. (39 year-old NH Black male, US)

 Driving under the influence

‒ The only concern I have is that if it were federally legal. I feel like it definitely does impact your thinking and your ability to drive and things like that. I think that would be a concern. (23 year-old NH White female, US)

‒ There should also be a prohibition on driving under the influence of marijuana just like [the government did] with alcohol. Marijuana should be treated like alcohol. (38 year-old Jewish female, Israel)

Perceived benefits

 Decriminalization

‒ [Legalizing non-medical cannabis] makes it less criminal. You're not going to jail anymore, or getting fined or arrested for having it on you. I think that's a good thing. I think it's a waste of resources to punish people for having it. (39 year-old NH Asian female, US)

‒ I support legalization for recreational use. I think it would stop crime in some urban areas and will cut down on the overt incarceration of African American and brown people, and it’ll help underserved communities recoup lost funds. (37 year-old NH Black female, US)

‒ I keep comparing [cannabis] to alcohol. Alcohol’s legal, like people celebrate with alcohol. So it just doesn't make sense that one is legal and one is super illegal. Federally, I think it's still a schedule one drug or whatever. That’s just nuts to me. (27 year-old Hispanic male, US)

‒ If you make something already happening legal, I assume this reduces criminality around the whole business. (38 year-old Jewish female, Israel)

 Facilitating medical cannabis use

‒ I think a lot of people might be able to get a lot of medicine for the medical needs, when they can't get it right now. Like a lot of kids need it for seizures and stuff like that. (42 year-old NH Black male, US)

‒ I know the government kind of thinks a little bit otherwise, but I think [legalizing non-medical cannabis] would help a lot of disabled people and people that have anxiety, you know, help them with their diseases. (32 year-old NH White female, US)

 Increased accessibility of cannabis products

‒ [Legalizing non-medical cannabis] makes [cannabis] accessible, so you don't have to go to sketchy places to get products. You can go to an easily-accessed store. (39 year-old NH Asian female, US)

‒ [Legalizing cannabis] is good, then if I buy marijuana, all the products I need to use marijuana should be accessible. (24 year-old Jewish female, Israel)

 Increased safety and regulation

‒ I think it's good that you're able to go into the store and purchase [cannabis] versus buying it on the streets, not knowing what that person has done to it. Because what I'm hearing is that it could be laced with fentanyl, and people are actually dying. I feel more comfortable with something that is approved by the government to be in a store vs. buying something on the streets. (44 year-old NH Black female, US)

‒ People wouldn’t have to go somewhere where someone could have done something to the product that could be harmful. You’d have a safe place where you can go get something legally, and feel safe. (24 year-old Hispanic male, US)

‒ Legalizing [non-medical cannabis] would allow more control versus it being sold in the shadows. So I feel like it's a good thing to be legalized and actually have more control over what's happening. (28 year-old NH Black female, US)

‒ The point is that this legal audit has advantages and disadvantages. So the advantages are that it is clean, and it undergoes an audit and not everyone can sell whatever junk they want. ([unknown age] Jewish female, Israel)

‒ Cannabis use is already happening. And when [non-medical cannabis] is legal, it's easier to monitor, and there's less room for foul play, concerning the product's quality and those who consume it. (30 year-old Arab female, Israel)

 Positive economic impact

‒ Economically, [non-medical cannabis] brings in a lot of revenue for the state. (39 year-old NH Asian female, US)

‒ Recreational marijuana brings in more money and keeps people employed. (39 year-old NH Asian female, US)

‒ [Legalizing non-medical cannabis] would stimulate the economy a little bit, because I know, people would probably go out and buy that over a cigarette. (27 year-old Hispanic male, US)

 Freedom of choice

‒ I think [legalizing non-medical cannabis] is good in that people can make the choice to use marijuana if they want to, as a way of having fun, or as a way of recreation. So, if you can do that, and you can still be a productive member of society and an upstanding citizen, then I think that’s okay. You should have the freedom to do that and make that choice. (30 year-old NH White male, US)

‒ Adults should be able to make their own choices regarding what they do with their time and their lives. (33 year-old NH White female, US)

‒ I’m in favor [of non-medical cannabis legalization], I think [non-medical cannabis] should be permitted… It feels to me that everyone should be able to do whatever they want with their body. (21 year-old Jewish male, Israel)

 Reduced use among youth

‒ Well surely, [cannabis] is all heavily regulated and it goes out to the people who it’s supposed to go out to, and not to teenagers. And so, it’s better to go that way. Again, I think it’s better when it's regulated. When it’s being done in secret, it can be very harmful to the youth because they rely on strangers to provide them with such things, and it could affect them on the long term. (27 year-old Arab female, Israel)

‒ Perhaps if [non-medical cannabis] were to be made legal, it wouldn’t be as fun for “the kids”. Or maybe [using cannabis] still would be fun anyway, since there would be an age limitation. But it would be less challenging then, perhaps. (35 year-old Arab female, Israel)