College Students Fall Into Five Distinct Substance Use Patterns, With Cannabis Closely Tied to Little Cigars and Hookah
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.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?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?
Trust & Context
- Key Stat:
- 77.3% of little cigar/hookah/marijuana co-users maintained that pattern consistently
- Evidence Grade:
- Large multi-campus sample with sophisticated statistical methods, but cross-sectional design and self-reported data.
- Study Age:
- Published in 2016. Vaping and cannabis legalization have likely shifted substance use patterns among college students since.
- Original Title:
- Polytobacco, marijuana, and alcohol use patterns in college students: A latent class analysis.
- Published In:
- Addictive behaviors, 59, 58-64 (2016)
- Authors:
- Haardörfer, Regine(2), Berg, Carla J(27), Lewis, Michael, Payne, Jackelyn, Pillai, Drishti, McDonald, Bennett, Windle, Michael
- Database ID:
- RTHC-01169
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
What substances do college students commonly combine with marijuana?
In this study, marijuana most commonly clustered with little cigars/cigarillos and hookah use, forming a distinct and stable polysubstance use pattern affecting about 10% of students.
How stable are these use patterns?
The marijuana/cigar/hookah cluster was the most stable of all groups, with 77.3% of members showing the same pattern whether measured over 30 days or 4 months.
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Cite This Study
https://rethinkthc.com/research/RTHC-01169APA
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
MLA
Haardörfer, Regine, et al. "Polytobacco, marijuana, and alcohol use patterns in college students: A latent class analysis.." Addictive behaviors, 2016. https://doi.org/10.1016/j.addbeh.2016.03.034
RethinkTHC
RethinkTHC Research Database. "Polytobacco, marijuana, and alcohol use patterns in college ..." RTHC-01169. Retrieved from https://rethinkthc.com/research/haardorfer-2016-polytobacco-marijuana-and-alcohol
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.