Smoking cigarettes can lead to a variety of adverse health events including cancer, lung disease, and heart disease. It can also cause a variety of cognitive, attention, and mood deficits in adolescents and young adults. With the development of electronic nicotine delivery systems (ENDS), many are concerned that this may lead to young adults to combustible cigarette use, nicotine dependence, polysubstance use, or co-use of ENDS and cannabis. Co-use of nicotine and cannabis can have a synergistic effect which has been associated with higher dependence of both substances. This study examines the characteristics and age of nicotine and cannabis use and co-use among young adults.
The study’s sample consisted of 32,072 young adults between the ages of 18 and 24 who participated in the Population Assessment of Tobacco and Health (PATH) longitudinal study. Participants were asked to report if they had ever used nicotine or cannabis products and if they had co-used nicotine and cannabis. They were also asked at what age they first used nicotine or cannabis products, when they began using the products regularly. Demographic information was also assessed. Data was analyzed using Rao-Scott chi-square statistics and Pearson chi-square tests.
Results of the data analysis showed that males were more likely than females to report having ever used nicotine or cannabis. Ever-use of nicotine was associated with a 13-fold increase in the likelihood of using cannabis. Among those who reported nicotine use, 68.1% reported initial use prior to 18 years of age and 27.1% reported initial use during ages 18-24. Among those who reported cannabis use, 57.3% reported initial use prior to 18 years of age and 34.9% reported initial use during ages 18-24. Among cannabis users, 96.4% also had used nicotine products. Those who started using nicotine at ages 18-24 were twice as likely as those who started using nicotine at less than 18 to have ever used cannabis.
Takeaway: Adolescents and emerging adulthood is a critical period of initiation of nicotine and cannabis use and may impact use of other substances in the future.