OBJECTIVES: To assess perceptions and knowledge of health effects of smoking tobacco, blunts, and marijuana among adult African American (AA) men aged 19-30 in five Black Belt counties of rural Alabama. METHODS: Cross-sectional study using interviewer-administered oral surveys. RESULTS: Four hundred and fifteen participants completed surveys. Cigarettes were the most common initial and current product used (40%) and there were more current than initial users of marijuana and blunts. Significantly more cigarette users (80%) felt that smoking cigarettes was harmful to health compared with marijuana (33%) and blunt (53%) users (p < .001). Many marijuana smokers (71%) and blunt smokers (48%) believed smoking their product was safer than cigarettes for reasons including more natural and less addictive. CONCLUSIONS: When compared with cigarettes, knowledge of the health-related effects of smoking marijuana-containing products among young African American men is poor. Intervention strategies focusing on the adverse health effects of smoking marijuana are needed.