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.
Substance use epidemiologists, prevention program designers, policy researchers
Predictors of multi-year cannabis vaping differed completely between legalized and non-legalized states
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot tell us
ML identifies associations not causes; legalization status changed during study; self-reported measures; PATH attrition may bias results.
How to read the evidence
Nationally representative longitudinal data with sophisticated ML, but observational design and changing policy landscape complicate interpretation.
When this study was published
Published 2025, data from 2016-2021
The bigger picture
As cannabis vaping becomes the predominant consumption method among young adults, identifying who progresses to sustained use can help target prevention.
Questions still open
- 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?
Common questions
What predicts long-term cannabis vaping?
Is starting cannabis vaping the same as continuing it?
Read the original research
Identifying predictors of multi-year cannabis vaping in U.S. Young adults using machine learning.
Addictive behaviors, 160, 108167
Citation
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
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