Using Cannabis in More Ways Dramatically Increases Risk of Addiction and Harm
Young people who used cannabis in 3+ ways (smoking, vaping, edibles, dabbing) were 5 times more likely to have cannabis use disorder and nearly 5 times more likely to drive impaired — independent of how often they used.
Quick Facts
What This Study Found
Using 3+ cannabis modes vs. one was associated with 5x higher CUD risk (aOR=5.00), 4.4x higher other SUD risk, 2x higher severe mental illness, 1.8x higher suicidal thoughts, and 4.9x higher impaired driving — even after adjusting for frequency.
Key Numbers
13,284 cannabis users; 37.5% used 3+ modes; smoking 83.9%, vaping 53.3%, edibles 47.6%, dabbing 27.3%; 3+ modes: CUD aOR=5.00, other SUD aOR=4.43, severe mental illness aOR=2.18, impaired driving aOR=4.92.
How They Did This
Analysis of 2022-2023 NSDUH data on 13,284 past-year cannabis users aged 12-25, examining associations between number of cannabis modes and adverse outcomes with multivariable adjustment including use frequency.
Why This Research Matters
Cannabis product diversification means young people can now use in many ways — this study shows the number of modes is an independent risk marker, not just a proxy for more frequent use.
The Bigger Picture
As cannabis markets diversify, simply asking 'do you use cannabis?' is insufficient — clinicians should screen for how many ways someone uses, as this independently predicts harm.
What This Study Doesn't Tell Us
Cross-sectional NSDUH data cannot establish causation; multimodal use may reflect higher engagement/severity not captured by frequency alone; self-reported adverse events.
Questions This Raises
- ?Does multimodal use lead to harm, or do higher-risk individuals gravitate toward more modes?
- ?Could screening for multimodal use improve clinical risk assessment?
Trust & Context
- Key Stat:
- Evidence Grade:
- Large nationally representative sample with adjustment for use frequency, published in a top preventive medicine journal.
- Study Age:
- Published in 2026 with 2022-2023 NSDUH data, reflecting the current diversified cannabis product landscape.
- Original Title:
- Association of Multimodal Cannabis Use with Adverse Events among Adolescents and Young Adults.
- Published In:
- American journal of preventive medicine, 108313 (2026)
- Authors:
- Bommersbach, Tanner J, Olfson, Mark(17), Rhee, Taeho Greg(2)
- Database ID:
- RTHC-08129
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does it matter how many ways you use cannabis?
Yes — using 3+ methods (smoking, vaping, edibles, dabbing) was associated with 5x higher addiction risk and nearly 5x higher impaired driving risk, even after accounting for how often someone uses.
What's the most common way young people use cannabis?
Smoking remains dominant (84%), followed by vaping (53%), edibles (48%), and dabbing (27%). Over a third of young users employ 3 or more methods.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-08129APA
Bommersbach, Tanner J; Olfson, Mark; Rhee, Taeho Greg. (2026). Association of Multimodal Cannabis Use with Adverse Events among Adolescents and Young Adults.. American journal of preventive medicine, 108313. https://doi.org/10.1016/j.amepre.2026.108313
MLA
Bommersbach, Tanner J, et al. "Association of Multimodal Cannabis Use with Adverse Events among Adolescents and Young Adults.." American journal of preventive medicine, 2026. https://doi.org/10.1016/j.amepre.2026.108313
RethinkTHC
RethinkTHC Research Database. "Association of Multimodal Cannabis Use with Adverse Events a..." RTHC-08129. Retrieved from https://rethinkthc.com/research/bommersbach-2026-association-of-multimodal-cannabis
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.