Black/African American adults with low socioeconomic status or mental health conditions had up to five times higher odds of blunt use compared to non-Black adults with higher SES, with disparities growing with age.
Public health researchers, health equity advocates, substance use counselors, and policy makers addressing tobacco-cannabis co-use.
What the researchers found
Compared to non-Black adults with high SES, those identifying as Black/African American with low SES had 5.1 times higher odds of blunt use (aOR=5.10, 95% CI=4.16-6.26), with similar magnitudes for those with internalizing (aOR=4.83) or externalizing conditions (aOR=4.74).
Why it matters
Blunts combine tobacco and cannabis health risks, and these stark disparities highlight how intersecting identities create compounding vulnerability that single-factor analyses miss.
The numbers in context
N=30,516 US adults; 8.4% of young adults (18-34) and 1.4% of adults 35+ used blunts; B/AA + low SES aOR=5.10; B/AA + high internalizing aOR=4.83; B/AA + externalizing aOR=4.74; disparities larger in 35+ age group
How the study worked
Analysis of Wave 6 (2021) Population Assessment of Tobacco and Health (PATH) Study data from 30,516 US adults, using weighted multivariable logistic regression examining blunt use by race, mental health, and SES intersections, stratified by age group.
What this study cannot tell us
Cross-sectional design limits causal inference; self-reported data; binary race categorization (B/AA vs non-B/AA) masks heterogeneity; blunt use definition may vary; 2021 data collected during COVID-19 pandemic.
How to read the evidence
Large nationally representative sample with intersectional analysis, but cross-sectional design and self-reported measures limit causal conclusions.
When this study was published
Published 2026; uses 2021 PATH Study data.
The bigger picture
Addressing blunt use requires understanding how racial, economic, and mental health factors intersect — single-axis interventions may miss the populations at highest risk.
Questions still open
- What drives the increasing disparity with age? Would interventions targeting economic factors reduce blunt use? How does cannabis-only use compare across the same intersections?
Common questions
Who uses blunts the most in the US?
Are blunts more harmful than other cannabis methods?
Read the original research
Inequities in blunt use across multiple socio-demographic intersections among US adults.
Drug and alcohol dependence, 279, 113019
Citation
Glasser, Allison M; Jensen, Jessica K; Sterling, Kymberle L; Villanti, Andrea C. (2026). Inequities in blunt use across multiple socio-demographic intersections among US adults.. Drug and alcohol dependence, 279, 113019. https://doi.org/10.1016/j.drugalcdep.2025.113019
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