Examining Use and Dual Use of Tobacco Products and Marijuana among Minnesota Adults

Abstract

Background: An increasing number of states are legalizing the medicinal and/or recreational use of marijuana. Adult perceptions of harm have decreased and marijuana use has increased. This is in contrast to declining cigarette smoking. In this article we examine independent use and dual use of marijuana and tobacco products. Methods: Data are from the 2018 Minnesota Adult Tobacco Survey (N = 6055). Estimates were calibrated on sex, race, location, and education from the American Community Survey. Results: In 2018, 15.4% of adults smoked cigarettes in the past 30 days, 7.6% used marijuana and 6.0%, 3.0%, and 1.1% used e-cigarettes, cigars, and waterpipe, respectively. Use of marijuana and cigarettes was 3.3% and use of marijuana and e-cigarettes was 2.2%. Among past 30-day marijuana users, 89.7% smoked it as a joint, blunt, or in waterpipes, 22.1% vaped it in an e-cigarette or a vaping device. Across multinomial regression models, marijuana use and dual use with tobacco products was more likely among males, younger age groups, and African Americans. Conclusions: As policies to expand the sale and use of marijuana are considered, states should anticipate the need to monitor trends and to plan surveys of sufficient sample size with specific questions on marijuana use. Understanding the proportion of the population that uses both marijuana and tobacco has implications for prevention and treatment of both substances.

Daily variation in the patterns and characteristics of adolescent ENDS use.

“…The finding that marijuana was used concurrently with ENDS on slightly more than one-quarter of ENDS use occasions is concerning, as concurrent use has been related to greater consumption of both nicotine and marijuana (Tucker et al, 2019), as well as with increased likelihood of tobacco use and dependence (Akbar et al, 2019; McClure et al, 2014). An increasing number of states legalizing or decriminalizing marijuana will likely have a compounding negative impact on this pattern of concurrent use (Boyle et al, 2021). These findings suggest future prevention research should not only focus on ENDS use alone, but on the causes and consequences of using these products together.…”

“…These findings suggest future prevention research should not only focus on ENDS use alone, but on the causes and consequences of using these products together. In addition, given the variety of modes for using nicotine and cannabis (e.g., vaping devices, blunts, little cigars or cigarillos), as well as the wide range of motivations for dual use with marijuana (e.g., convenience, concealability, extending or enhancing effects of nicotine and marijuana; McDonald et al, 2016), the context of adolescent co-use should be explored further, including assessment of the independent and concurrent use of these products across contexts (Boyle et al, 2021).…”

Review of strategies to investigate low sample return rates in remote tobacco trials: A call to action for more user-centered design research

“…This could negatively affect the collection of samples from African American smokers in current research protocols relying on CO devices. Another recent study found that cannabis use and dual use with tobacco products was more likely among African Americans [ 50 ], which may bias the results of trials relying on expired air CO for biochemical verification. High misclassification rates for biochemical verification among non-white individuals have also been noted in the most recent SRNT taskforce [ 2 ].…”