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Socio-demographic Correlates of Electronic Cigarette and Cannabis Co-use Among Naïve and Tobacco Adolescent Users

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Abstract

The increasing co-use of e-cigarette and cannabis among youth has become a public health challenge. The present analyses aimed to identify prevalence and correlates of past-month co-use of e-cigarettes and cannabis among adolescents with and without prior tobacco use. For this panel study, 5 years of cross-sectional data (2014–2018) were used from 8th, 10th-, and 12th-grade adolescents in the Monitoring the Future study, a nationally representative survey of U.S. students. We examined prevalence and correlates of e-cigarettes and cannabis co-use among adolescents who had ever used tobacco (n = 15,136) and among those who had never used tobacco (n = 56,525). Adolescents who had ever used tobacco showed significantly higher rates of e-cigarettes and cannabis co-use compared to adolescents who had never used tobacco (17.1% vs. 2.2%, p < 0.01). Results from adjusted multinomial regression models showed that overall, Black and Hispanic adolescents tobacco users were less likely than Whites to co-use e-cigarettes and cannabis. Black adolescents who had used tobacco previously were more likely than Whites to have used cannabis exclusively. Black and Hispanic tobacco-naïve adolescents were more likely than Whites to have used cannabis exclusively, while Black tobacco-naïve adolescents were less likely to use e-cigarettes exclusively or co-use e-cigarettes and cannabis. Overall, males and twelve graders were more likely than males and eight graders to use or co-use cannabis or e-cigarettes, respectively. Among lifetime tobacco users, higher levels of parental education were associated with co-use of cannabis and e-cigarettes. Racial/ethnic-specific patterns of e-cigarette and cannabis co-use depends on adolescents’ prior experience with tobacco. The higher rates of use and co-use of e-cigarettes and cannabis among prior tobacco users suggest that targeted interventions are needed for this group. Identified socio-demographic groups at higher risk of co-use of e-cigarettes and cannabis need to be further studied.

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Funding

Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under awards number K01DA036681 (CB) and K01DA046715 (CLQ). The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health.

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Rates of e-cigarette and cannabis co-use in adolescents who had ever used tobacco exceeded seven times the rate among tobacco naïve adolescents. The racial/ethnic patterns in co-use of these substances that emerged suggest that interventions aimed at adolescents may require race/ethnic specific attention to how these substances are paired.

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Correspondence to Cristina B. Bares.

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Bares, C.B., Sharma, V. & Lopez-Quintero, C. Socio-demographic Correlates of Electronic Cigarette and Cannabis Co-use Among Naïve and Tobacco Adolescent Users. J of Prevention 44, 457–475 (2023). https://doi.org/10.1007/s10935-023-00729-z

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  • DOI: https://doi.org/10.1007/s10935-023-00729-z

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