Machine learning identified different predictors of sustained cannabis vaping depending on state legalization

Using PATH Study data, machine learning found that predictors of multi-year cannabis vaping differed by legalization status: cigarette use and bullying in legal states versus heroin use and nicotine vaping in non-legal states.

Choe, Siyoung et al.·Addictive behaviors·2025·Moderate EvidenceLongitudinal Cohort
RTHC-06213Longitudinal CohortModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

In legalized states, CART split on cannabis use, cigarette use, bullying, and ethnicity; in non-legal states, split on cannabis use, heroin use, nicotine vaping, and hookah; predictors of sustained vaping differed from initiation predictors.

Key Numbers

PATH Waves 4-6 (December 2016-November 2021); five-terminal-node CART models for each legalization stratum; prior cannabis use was primary split in both.

How They Did This

Secondary analysis of PATH Study Waves 4-6 (2016-2021); two-stage ML (LASSO + CART) stratified by state recreational cannabis legalization; representative US young adult sample.

Why This Research Matters

Understanding who continues vaping cannabis over years is more relevant for intervention than who starts, and different predictor profiles by legalization status suggest policy context shapes sustained use.

The Bigger Picture

As cannabis vaping becomes the predominant consumption method among young adults, identifying who progresses to sustained use can help target prevention.

What This Study Doesn't Tell Us

ML identifies associations not causes; legalization status changed during study; self-reported measures; PATH attrition may bias results.

Questions This Raises

  • ?Why do bullying and cigarette use predict sustained vaping only in legal states?
  • ?Does the heroin-cannabis vaping connection reflect polysubstance risk?
  • ?Would post-2021 data differ?

Trust & Context

Key Stat:
Predictors of multi-year cannabis vaping differed completely between legalized and non-legalized states
Evidence Grade:
Nationally representative longitudinal data with sophisticated ML, but observational design and changing policy landscape complicate interpretation.
Study Age:
Published 2025, data from 2016-2021
Original Title:
Identifying predictors of multi-year cannabis vaping in U.S. Young adults using machine learning.
Published In:
Addictive behaviors, 160, 108167 (2025)
Database ID:
RTHC-06213

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

What predicts long-term cannabis vaping?

It depends on location. In legal states, cigarette use, bullying, and ethnicity were key. In non-legal states, heroin use, nicotine vaping, and hookah use predicted sustained vaping.

Is starting cannabis vaping the same as continuing it?

No. Predictors of multi-year cannabis vaping differed from those previously identified for vaping initiation.

Read More on RethinkTHC

Cite This Study

RTHC-06213·https://rethinkthc.com/research/RTHC-06213

APA

Choe, Siyoung; Agley, Jon; Elam, Kit; Bidulescu, Aurelian; Seo, Dong-Chul. (2025). Identifying predictors of multi-year cannabis vaping in U.S. Young adults using machine learning.. Addictive behaviors, 160, 108167. https://doi.org/10.1016/j.addbeh.2024.108167

MLA

Choe, Siyoung, et al. "Identifying predictors of multi-year cannabis vaping in U.S. Young adults using machine learning.." Addictive behaviors, 2025. https://doi.org/10.1016/j.addbeh.2024.108167

RethinkTHC

RethinkTHC Research Database. "Identifying predictors of multi-year cannabis vaping in U.S...." RTHC-06213. Retrieved from https://rethinkthc.com/research/choe-2025-identifying-predictors-of-multiyear

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.