While smoking prevalence has declined across the nation, it is still a major public health concern among adolescents and young adults. Alternative tobacco products such as smokeless tobacco and electronic cigarettes have become more popular along with an evolution in social norms surrounding marijuana use. This study looks at characteristics of young adults who use varying tobacco products and marijuana along with the first product used and total products used during lifetime, currently, and current use of each product.

Participants were 3,418 students (18-25 years) from seven colleges in Georgia. Measures included first product used, lifetime tobacco product or marijuana use, current tobacco product or marijuana use, sociodemographic measures, setting (school type), and psychosocial measures. Psychosocial measures included the adult ADHD checklist, depressive symptomology, and parental substance use.

Multivariable analyses showed that more products ever used was associated with cigarettes being first used, being older, male, White, more adverse childhood events, and parental marijuana use. They also found that more products used in the past 30 days was associated with cigarettes as the first product used. Past 30-day marijuana use was associated with the first product the participants used was marijuana but not hookah.  Another interesting finding was that those who first used e-cigarettes were the youngest of those surveyed and those first using cigarettes were the oldest. This could be correlated to different tobacco marketing techniques. These findings are important when creating early interventions strategies and knowing how first used products can predict future use in young adults.

Take Away: Alternative tobacco products have become more popular along with an evolution in social norms surrounding marijuana use. This study looks at characteristics of young adults who use varying tobacco products and marijuana along with the first product used and total products used during lifetime and current use of products. There were 3,418 college students included in the study that were asked about first product used, lifetime tobacco product or marijuana use, current tobacco product or marijuana use, sociodemographic measures, setting (school type), and psychosocial measures. More products ever used was associated with cigarettes being first used. Past 30-day marijuana use was associated with marijuana being the first product used. These findings are important when creating early interventions and knowing how first used products can predict future use in young adults.


Park, A., Vu, M., Haardörfer, R., Windle, M., & Berg, C. (2020). Initial use of tobacco or marijuana and later use profiles inyoung adults. Tobacco Prevention & Cessation, 6(March). doi:10.18332/tpc/117070