Cannabis and electronic cigarettes are two of the most frequently used substances in the United States. Cannabis popularity has evolved significantly in the past two decades, leading state-by-state decriminalization and legalization campaigns. While traditional forms of tobacco consumption have generally decreased over time, electronic cigarette use remains popular in the United States. While the literature concerning the use of these substances/products continues to develop, very little research has been conducted on dual use behaviors. This study evaluates cannabis and electronic cigarette dual use, and how this consumption pattern may affect general consumption patterns and consequences.
The study’s sample was organized from a participant pool of psychology students at a large undergraduate university in the United States. Of the participants who responded to an introductory survey concerning personal substance use, 315 were identified as current cannabis users, and 156 were identified as current electronic nicotine delivery system (ENDS) users. The combination of these two user groups composed the final sample. Participants then completed questionnaires which measured the following variables: ENDS use (via the Electronic Cigarette Smoking History Questionnaire, cannabis use (via the Marijuana Use Form), ENDS use problems, cannabis problems (via the Marijuana Problems Scale), depression & anxiety (via the Depression Anxiety Stress Scale), and combustible smoking history (via the Smoking History Questionnaire). Data analysis was performed using a series of two analysis of covariance (ANCOVA) tests.
Results of the analysis found ENDS use to be significantly related to increased cannabis use, increased cannabis problems and increased depression & anxiety scores. In turn, cannabis use was related to increased ENDS use, increased ENDS problems, and increased anxiety scores (not significantly related to depression).
Takeaway: the use of cannabis and electronic nicotine delivery systems together may interact in fashions that increase the risk of health consequences, both physiologically and psychologically. Interventions designed to treat the use of either of these substances may benefit from a design which can address concurrent substance use.