Polytobacco, marijuana, and alcohol use patterns in college students: A latent class analysis

Abstract

Limited research has examined polysubstance use profiles among young adults focusing on the various tobacco products currently available. We examined use patterns of various tobacco products, marijuana, and alcohol using data from the baseline survey of a multiwave longitudinal study of 3418 students aged 18-25 recruited from seven U.S. college campuses. We assessed sociodemographics, individual-level factors (depression; perceptions of harm and addictiveness,), and sociocontextual factors (parental/friend use). We conducted a latent class analysis and multivariable logistic regression to examine correlates of class membership (Abstainers were referent group). Results indicated five classes: Abstainers (26.1% per past 4-month use), Alcohol only users (38.9%), Heavy polytobacco users (7.3%), Light polytobacco users (17.3%), and little cigar and cigarillo (LCC)/hookah/marijuana co-users (10.4%). The most stable was LCC/hookah/marijuana co-users (77.3% classified as such in past 30-day and 4-month timeframes), followed by Heavy polytobacco users (53.2% classified consistently). Relative to Abstainers, Heavy polytobacco users were less likely to be Black and have no friends using alcohol and perceived harm of tobacco and marijuana use lower. Light polytobacco users were older, more likely to have parents using tobacco, and less likely to have friends using tobacco. LCC/hookah/marijuana co-users were older and more likely to have parents using tobacco. Alcohol only users perceived tobacco and marijuana use to be less socially acceptable, were more likely to have parents using alcohol and friends using marijuana, but less likely to have friends using tobacco. These findings may inform substance use prevention and recovery programs by better characterizing polysubstance use patterns.

Reasons for Marijuana and Tobacco Co-use Among Young Adults: A Mixed Methods Scale Development Study

“…The items demonstrate face validity, and these subscales demonstrated convergent and discriminant validity, which is further elaborated upon below. The new measure largely reflects the literature that informed our conceptual framework (Cohn et al, 2015; Haardörfer et al, 2016; Piko et al, 2007; Ramo et al, 2013; Rath et al, 2012; Richardson et al, 2014; Schauer et al, 2015; Schauer et al, 2016; Simons et al, 2000; Sutfin et al, 2009; Wills et al, 1999), as well as the constructs and associations involved in the Social Cognitive Theory (Bandura, 1998, 2004). Moreover, it is important to note that the addition of these subscales to the regression models predicted nicotine dependence and days of marijuana use, respectively.…”

“…We also drew from the literature regarding motives for tobacco and marijuana use, respectively (Piko, Wills, & Walker, 2007; Simons, Correia, & Carey, 2000; Wills, Sandy, & Shinar, 1999), the limited literature regarding reasons for co-use (Ramo, Liu, et al, 2013; Schauer et al, 2016) as well as our qualitative findings, and the literature regarding patterns and trajectories of marijuana-tobacco use and polysubstance use more broadly (Cohn et al, 2015; Haardörfer et al, 2016; Rath, Villanti, Abrams, & Vallone, 2012; Richardson, Williams, Rath, Villanti, & Vallone, 2014; Schauer et al, 2015; Sutfin et al, 2009). In particular, outcome expectancies are a central component of Social Cognitive Theory (Bandura, 1998, 2004).…”

“…Related to the latter, environmental factors, particularly substance use among social influences, are important predictors of use (Berg, Stratton, et al, 2015). In addition, individual psychological and behavioral factors are related to substance use; specifically, the literature suggests that heavier use may be related to greater depressive symptoms (Berg, Buchanan, Grimsley, Rodd, & Smith, 2011; Berg, Wen, Cumming, Ahluwalia, & Druss, 2013) and to higher levels of other substance use, such as alcohol (Cohn et al, 2015; Haardörfer et al, 2016). …”

“…After reviewing the literature (Berg et al, 2011; Berg et al, 2015; Berg et al, 2013; Cohn et al, 2015; Haardörfer et al, 2016; Piko et al, 2007; Ramo et al, 2013; Rath et al, 2012; Richardson et al, 2014; Schauer et al, 2015; Schauer et al, 2016; Simons et al, 2000; Sutfin et al, 2009; Wills et al, 1999) and the present qualitative findings, a panel of experts that included the current author and other colleagues developed a list of 14 potential reasons for marijuana-tobacco co-use. Participants were asked, “You indicated that you have used at least one tobacco product in the past 4 months and have also used marijuana in the past 4 months.…”

UPPS-P model impulsivity and marijuana use behaviors in adolescents: A meta-analysis

“…It is likely that many of the participants in the studies reviewed here not only engaged in marijuana use, but also in a constellation of substance use and illicit behaviors. Marijuana use is associated with alcohol use (Haardörfer et al, 2016;Haas et al, 2015) and drug use (Moss et al, 2014;Palamar et al, 2015), which further suggests this might be true. It has been suggested that impulsivity is a transdiagnostic risk factor, making intervening on impulsivity of higher clinical relevance, in that interventions designed to mitigate impulsivity's effects are more likely to influence a wide range of substance-related and behavioral addictions, not just marijuana use.…”