White Californians Were Most Likely to Co-Use Alcohol and Cannabis | Research

The takeaway

Among over 21,000 California adults, Whites and multiracial individuals had the highest alcohol-cannabis co-use rates (17%), while Hispanic, Black, and Asian populations were less likely to co-use after adjusting for demographics.

Substance use prevention researchers, health equity researchers, public health officials

17% of White Californians co-used alcohol and cannabis, the second-highest rate among ethnic groups

What the researchers found

Alcohol-cannabis co-use was highest among Other/Two or more races (17.7%) and Whites (17.0%). After adjustment, Hispanics, Blacks, and Asians were all less likely than Whites to report alcohol use only, cannabis use only, or co-use. Among co-users, binge drinking was highest in the multiracial group (62.5%). No significant differences in illicit drug use were found across ethnic groups among co-users.

Why it matters

Co-using alcohol and cannabis carries higher risks than using either substance alone, including greater impairment and more negative consequences. Understanding which populations have the highest co-use rates can inform targeted prevention and harm reduction.

The numbers in context

21,463 participants; co-use rates: Other/Two+ races 17.7%, Whites 17.0%; Hispanics, Blacks, Asians less likely than Whites to co-use; binge drinking among co-users: Other/Two+ races 62.5%; no ethnic differences in illicit drug use among co-users; 2022 California data

How the study worked

Analysis of the 2022 California Health Interview Survey (N=21,463, 49.1% male). Multinomial logistic regression examined rates and correlates of alcohol-only use, cannabis-only use, and co-use across racial/ethnic groups.

What this study cannot tell us

California-specific results, cross-sectional design, self-reported substance use, cannot determine causation, some ethnic subgroups may have small sample sizes, 2022 single-year data

How to read the evidence

Large representative state survey with adjusted multinomial analysis; strong descriptive data but single-year cross-section

When this study was published

Published 2025

The bigger picture

As both alcohol and cannabis are legally available in California, the racial/ethnic patterns of co-use suggest that cultural factors, not just access, shape how different communities combine these substances. This has implications for how prevention messages are targeted.

Questions still open

What cultural or social factors drive higher co-use among White and multiracial populations? Does the higher binge drinking rate among multiracial co-users translate to more health consequences? Are these patterns changing over time with expanded legal access?

Common questions

How common is using alcohol and cannabis together?

In this California survey, about 17% of White and multiracial adults reported co-using alcohol and cannabis, with lower rates among Hispanic, Black, and Asian populations.

Is co-using alcohol and cannabis riskier than using either alone?

Research generally indicates higher risk with co-use. In this study, 62.5% of multiracial co-users also engaged in binge drinking, the highest rate of any group, suggesting compounded risk.

Read the original research

Alcohol and Cannabis Use and Co-Use among Ethnic Groups in California.

Journal of immigrant and minority health, 27(5), 799-808

View on PubMed ↗Publisher’s paper ↗

Citation

Caetano, Raul; Paschall, M J; Vaeth, Patrice A C; Kaplan, Zoe. (2025). Alcohol and Cannabis Use and Co-Use among Ethnic Groups in California.. Journal of immigrant and minority health, 27(5), 799-808. https://doi.org/10.1007/s10903-025-01743-5