The concurrent use of tobacco and cannabis among young adults is a prevalent behavior in the United States, widely acknowledged for its profound adverse effects on physical, mental, and social health. Of particular concern is the same-day co-use of these substances, which exposes individuals to the compounded harmful effects of both tobacco and cannabis within a condensed timeframe, thereby significantly exacerbating the associated risks. Despite the growing recognition of this issue, comprehensive research examining the underlying motivations and behavioral patterns of same-day co-use remains limited. The current study seeks to address this critical gap by exploring the specific motivations and behavioral patterns underlying same-day co-use, as well as to analyze the differing motivational factors associated with tobacco and cannabis use.
This study was conducted in February 2024 through an online survey targeting 303 young adults aged 18 to 30 years residing in the United States. Eligibility criteria required participants to have prior experience using tobacco products, although cannabis use was not a prerequisite. However, the study specifically sought to include individuals who engaged in same-day use of both tobacco and cannabis, focusing on an in-depth analysis of the patterns and motivations associated with this co-use behavior. The survey collected data on participants’ demographic characteristics, co-use behaviors, and motivations for tobacco, cannabis and their same-day co-use. The collected data were analyzed using paired two-sample t-tests to compare the motivations for tobacco and cannabis use.
The findings reveal that 58.7% of participants reported co-using tobacco and cannabis within the preceding 30 days, with 94% of these individuals engaging in same-day co-use. The primary motivations for same-day co-use were identified as nicotine cravings (60%), cannabis cravings (54.4%), and stress relief (48.8%). Among participants who engaged in same-day co-use, motivations for cannabis use were rated more favorably than those for tobacco, particularly regarding the intensity of effects, satisfaction, product purity and variety, duration of effects, and control over consumption. In contrast, tobacco was more strongly associated with convenience and as a coping mechanism for emotions such as anger or discomfort. Additionally, most participants indicated that they learned co-use behaviors through self-experimentation (60.2%) or from friends (58%), understanding the pivotal role of social and experiential factors in shaping co-use behavior. These findings highlight that same-day co-use is predominantly driven by cravings, stress, and social influences, with discernible differences in the underlying motivations for using tobacco and cannabis.
Takeaway: Young adults are more likely to engage in same-day use of tobacco and cannabis driven by cravings and stress, with differing motivations for each substance, highlighting the need for tailored intervention strategies that address these distinctions.