Marijuana use nearly doubled among former cigarette smokers in the US between 2002 and 2016 | Research

The takeaway

Among former US cigarette smokers, past-year marijuana use nearly doubled from 5.35% to 10.09% between 2002 and 2016, while depression and binge drinking also increased, raising concerns about smoking relapse risk.

Smoking cessation specialists, public health researchers, and clinicians treating former smokers.

5.35% to 10.09% marijuana use

What the researchers found

Among former smokers, past-year marijuana use rose from 5.35% to 10.09% (2002-2016), depression increased from 4.88% to 6.04% (2005-2016), and binge alcohol use rose from 17.22% to 22.33% (2002-2016). All trends were statistically significant. Alcohol abuse/dependence did not change.

Why it matters

Former smokers now outnumber current smokers in the US. Rising marijuana use, depression, and binge drinking in this population threaten sustained cigarette abstinence, potentially undermining decades of tobacco control progress.

The numbers in context

Marijuana use: 5.35% to 10.09% (OR per year 1.08). Depression: 4.88% to 6.04% (OR 1.01). Binge drinking: 17.22% to 22.33% (OR 1.03). All p<0.05. Nationally representative data.

How the study worked

Analysis of the National Survey on Drug Use and Health (NSDUH), a nationally representative annual cross-sectional survey. Adults 18+ who smoked 100+ lifetime cigarettes but no past-year cigarettes. 2002-2016 data.

What this study cannot tell us

Cross-sectional surveys cannot track individuals over time. Self-reported data. Cannot determine whether marijuana use preceded or followed smoking cessation. Cannabis product types and potency not assessed.

How to read the evidence

Rated strong because this uses nationally representative data over 14 years with consistent methodology.

When this study was published

Published in 2019 covering 2002-2016 NSDUH data.

The bigger picture

As marijuana legalization expands and cigarette smoking declines, the population of former smokers who use marijuana is growing rapidly. Whether marijuana use undermines cigarette cessation or represents a less harmful substitution is a critical public health question.

Questions still open

Does marijuana use increase cigarette relapse risk? Is marijuana substitution for cigarettes net-positive or net-negative for health? Should smoking cessation programs address marijuana use?

Common questions

Are former smokers using more marijuana?

Yes. Past-year marijuana use nearly doubled among former US cigarette smokers from 5.35% in 2002 to 10.09% in 2016.

Does marijuana use threaten smoking cessation?

The study raises this concern. Depression and substance use are known risk factors for smoking relapse, and all three increased among former smokers during the study period.

Read the original research

Increasing Depression and Substance Use Among Former Smokers in the United States, 2002-2016.

American journal of preventive medicine, 57(4), 429-437

View on PubMed ↗Publisher’s paper ↗

Citation

Cheslack-Postava, Keely; Wall, Melanie M; Weinberger, Andrea H; Goodwin, Renee D. (2019). Increasing Depression and Substance Use Among Former Smokers in the United States, 2002-2016.. American journal of preventive medicine, 57(4), 429-437. https://doi.org/10.1016/j.amepre.2019.05.014