A study of 3,418 college students identified five polysubstance use profiles, with a distinct cluster of students who co-used little cigars, hookah, and marijuana as their primary pattern.
Read this if you want to understand how marijuana use fits into broader patterns of substance use among college students.
77.3% of little cigar/hookah/marijuana co-users maintained that pattern consistently
What the researchers found
Researchers used latent class analysis to identify distinct patterns of substance use among 3,418 college students across seven US campuses. Five groups emerged.
Abstainers made up 26.1%, alcohol-only users were the largest group at 38.9%, heavy polytobacco users comprised 7.3%, light polytobacco users 17.3%, and a distinctive group of little cigar/cigarillo, hookah, and marijuana co-users accounted for 10.4%.
The little cigar/hookah/marijuana cluster was the most stable over time, with 77.3% of members showing the same pattern across both 30-day and 4-month timeframes. This suggests this is a deeply entrenched use pattern, not just experimentation.
Relative to abstainers, heavy polytobacco users perceived tobacco and marijuana as less harmful. Alcohol-only users perceived tobacco and marijuana use as less socially acceptable but were more likely to have friends using marijuana.
Why it matters
Substance use among college students is rarely limited to one product. Understanding the specific clusters of co-use helps prevention programs target the right combinations and the risk factors associated with each pattern. The stability of the marijuana/cigar/hookah cluster is particularly important for intervention design.
The numbers in context
Five classes: Abstainers (26.1%), Alcohol only (38.9%), Heavy polytobacco (7.3%), Light polytobacco (17.3%), LCC/hookah/marijuana co-users (10.4%). The LCC/hookah/marijuana cluster was the most stable (77.3% consistent across timeframes). Sample: 3,418 students, ages 18-25, seven US campuses.
How the study worked
Baseline data from a multiwave longitudinal study of 3,418 students aged 18-25 from seven US college campuses. Latent class analysis identified use patterns across tobacco products, marijuana, and alcohol. Multivariable logistic regression examined correlates of class membership.
What this study cannot tell us
Cross-sectional baseline data cannot capture how use patterns evolve over time. Self-reported use may be underreported. Seven campuses may not represent all college environments. The study cannot determine whether the clustering reflects shared social contexts, pharmacological interactions, or both.
How to read the evidence
Large multi-campus sample with sophisticated statistical methods, but cross-sectional design and self-reported data.
When this study was published
Published in 2016. Vaping and cannabis legalization have likely shifted substance use patterns among college students since.
The bigger picture
This study challenges the approach of treating each substance in isolation. The strong clustering of little cigars, hookah, and marijuana suggests these products share social contexts and risk factors. Prevention programs may be more effective by addressing these products as a bundle rather than individually.
Questions still open
- Why do little cigars, hookah, and marijuana cluster together so strongly? Does this cluster persist beyond college years? Would addressing the social contexts where these products are co-used be more effective than substance-specific prevention?
Common questions
What substances do college students commonly combine with marijuana?
How stable are these use patterns?
Read the original research
Polytobacco, marijuana, and alcohol use patterns in college students: A latent class analysis.
Addictive behaviors, 59, 58-64
Citation
Haardörfer, Regine; Berg, Carla J; Lewis, Michael; Payne, Jackelyn; Pillai, Drishti; McDonald, Bennett; Windle, Michael. (2016). Polytobacco, marijuana, and alcohol use patterns in college students: A latent class analysis.. Addictive behaviors, 59, 58-64. https://doi.org/10.1016/j.addbeh.2016.03.034
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