Elizabeth L Seaman1, Kerry M Green2, Min Qi Wang2, Sandra C Quinn3, Craig S Fryer4. 1. Department of Behavioral and Community Health, University of Maryland School of Public Health, 4200 Valley Drive College Park, MD 20742, United States. Electronic address: eseaman@terpmail.umd.edu. 2. Department of Behavioral and Community Health, University of Maryland School of Public Health, 4200 Valley Drive College Park, MD 20742, United States. 3. Department of Family Science, University of Maryland School of Public Health, 4200 Valley Drive College Park, MD 20742, United States; Center for Health Equity, University of Maryland School of Public Health, 4200 Valley Drive College Park, MD 20742, United States. 4. Department of Behavioral and Community Health, University of Maryland School of Public Health, 4200 Valley Drive College Park, MD 20742, United States; Center for Health Equity, University of Maryland School of Public Health, 4200 Valley Drive College Park, MD 20742, United States.
Abstract
BACKGROUND: Prior research has documented a strong association between cigarette and marijuana use among young adults; it is critical to study patterns and risk factors for co-use. METHODS: Appended, cross-sectional National Health and Nutrition Examination Survey (NHANES) data were used to assess prevalence and correlates of cigarette and marijuana co-use among young adults (ages 21-30) over a 10-year period (2005-2014). Respondents (unweighted sample = 4,948) were classified into four categories regarding past-month behavior: neither use, cigarette-only use, marijuana-only use, and co-use of both. Regression models were computed to predict these categories using three waves of NHANES (unweighted sample = 3,073). RESULTS: Prevalence of past-month cigarette use decreased from 30.9% in 2005-2006 to 23.7% in 2013-2014 (p = 0.024) while past-month marijuana use (average 18.0%) and past-month co-use (average 9.8%) remained stable during this time. Co-use differed significantly by gender (p < 0.001; average 12.9% men, 6.8% women). Co-users were less likely to be married, more likely to endorse non-Hispanic black racial identity, more likely to have engaged in non-marijuana drug use in their lifetime and more likely to drink alcohol monthly than cigarette-only users. Co-users were more likely to have depressive symptoms, ever use non-marijuana drugs, live with a smoker, and initiate marijuana at a younger age than marijuana-only users. CONCLUSIONS: Co-use of cigarettes and marijuana remained stable but high over a ten-year period; understanding the unique characteristics, living situations, experiences, and substance use behaviors of co-users can contribute to more effective, tailored prevention and education strategies to reduce the burden of comorbid cigarette and marijuana use.
BACKGROUND: Prior research has documented a strong association between cigarette and marijuana use among young adults; it is critical to study patterns and risk factors for co-use. METHODS: Appended, cross-sectional National Health and Nutrition Examination Survey (NHANES) data were used to assess prevalence and correlates of cigarette and marijuana co-use among young adults (ages 21-30) over a 10-year period (2005-2014). Respondents (unweighted sample = 4,948) were classified into four categories regarding past-month behavior: neither use, cigarette-only use, marijuana-only use, and co-use of both. Regression models were computed to predict these categories using three waves of NHANES (unweighted sample = 3,073). RESULTS: Prevalence of past-month cigarette use decreased from 30.9% in 2005-2006 to 23.7% in 2013-2014 (p = 0.024) while past-month marijuana use (average 18.0%) and past-month co-use (average 9.8%) remained stable during this time. Co-use differed significantly by gender (p < 0.001; average 12.9% men, 6.8% women). Co-users were less likely to be married, more likely to endorse non-Hispanic black racial identity, more likely to have engaged in non-marijuana drug use in their lifetime and more likely to drink alcohol monthly than cigarette-only users. Co-users were more likely to have depressive symptoms, ever use non-marijuana drugs, live with a smoker, and initiate marijuana at a younger age than marijuana-only users. CONCLUSIONS: Co-use of cigarettes and marijuana remained stable but high over a ten-year period; understanding the unique characteristics, living situations, experiences, and substance use behaviors of co-users can contribute to more effective, tailored prevention and education strategies to reduce the burden of comorbid cigarette and marijuana use.
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