Cigarette, little cigars, smokeless tobacco, and hookah uses among young adults have decreased in the past few years. Still, the prevalence of electronic nicotine delivery systems (ENDS) and cannabis has increased or remained stable. Co-use of both has been shown to increase the adverse health effects associated with tobacco use, including poor lung functioning and increased dependence on nicotine. Previous studies have stated that 30-60% of college students who use cannabis also concurrent tobacco product use. The goal of the study is to determine the latent classes of concurrent use and co-administration of cannabis and tobacco and analyze the transition between latent classes of concurrent use and co-administration of cannabis and tobacco products across three years, from 2016 to 2019, among young adult college student.  

 The Marketing and Promotion Across Colleges in Texas (M-PACT) project was a rapid-response study that measured tobacco and nicotine product use, correlates of use, and the trajectories of use among young adult college students. There was a total of 4,448 students in this study. The average age of each participant was 20.5 years. This study measured past 30-day use of cigarettes, hookah, cigars, smokeless tobacco, ENDS, and marijuana, each measured via a single question. Cannabis and Tobacco co-administration was also measured. The most used tobacco product was cigarettes, followed by ENDS, hookah, cigars, and smokeless tobacco.  

 This study found that 82.5% of students remained in the same use class from baseline to the three-year follow-up. 8.5% decreased their use behavior, and 7.8% increased their use behavior from baseline. This study also created four distinct classes of use behavior among college students. Those in the class with a high probability of past 30-day cannabis use had high chances of co-administration. This supports previous studies that many college students who use cannabis are exposed to nicotine through co-administration of tobacco and cannabis products. 

Takeaway: Most students that use cannabis are exposed to nicotine through co-administration of both tobacco and cannabis products. Co-use of both has shown to increase the negative health effects associated with tobacco use such as including poor lung functioning and increased dependence on nicotine. 

Daniel S. Kreitzberg, Keryn E. Pasch, Alexandra Loukas, Longitudinal patterns of cannabis and  tobacco co-administration and concurrent use among young adult college students, Addictive Behaviors, Volume 148, 2024, 107871, ISSN 0306-4603, https://doi.org/10.1016/j.addbeh.2023.107871