57% of Young Adult Cannabis Users Now Use Multiple Methods Like Smoking, Vaping, and Edibles
More than half of U.S. young adults who use cannabis employ two or more consumption methods, with recreational legalization, e-cigarette co-use, and frequent cannabis use among the strongest predictors.
Quick Facts
What This Study Found
Among 7,635 young adults (18-34) reporting current cannabis use across 23 states, 57% used multiple modes (smoking, vaping, edibles, dabbing, etc.). Dual and triple-mode use were most common. Predictors of multi-modal use included recreational legalization, sexual minority status, poor physical health, frequent cannabis use, and co-use of e-cigarettes and alcohol.
Key Numbers
n = 7,635 (weighted 7.48 million); 57% multi-modal users; dual and triple-mode most common; recreational legalization significantly associated with multi-modal use.
How They Did This
Cross-sectional analysis of 2022-2023 BRFSS data from 23 states (weighted n = 7,482,134). Multi-modal use defined as two or more administration methods in the past month. Logistic regression for predictors.
Why This Research Matters
Most cannabis research treats use as a binary (yes/no), but multi-modal use means different absorption rates, different health risks, and potentially different addiction profiles. Understanding that most young adult users are combining methods changes how we assess exposure.
The Bigger Picture
As product diversity increases in legal markets (flower, concentrates, edibles, vapes, topicals), single-mode use may become the minority. Public health surveillance and harm reduction messaging need to account for this complexity.
What This Study Doesn't Tell Us
BRFSS is self-reported via telephone. Multi-modal use definition (2+ methods in past month) does not capture frequency of each mode. Only 23 states participated in the cannabis module. Cross-sectional design.
Questions This Raises
- ?Does multi-modal use increase total cannabis exposure or harm compared to single-mode use?
- ?Which specific combinations of consumption methods carry the highest health risks?
Trust & Context
- Key Stat:
- 57% of young adult cannabis users use multiple methods
- Evidence Grade:
- Large nationally representative survey with weighted estimates, though limited by self-report and cross-sectional design.
- Study Age:
- 2025 publication with 2022-2023 BRFSS data
- Original Title:
- Multi-Modal Cannabis Use Among U.S. Young Adults: Findings from the 2022 and 2023 BRFSS in 23 States.
- Published In:
- International journal of environmental research and public health, 22(4) (2025)
- Authors:
- Kim, Nayoung(2), Flora, Sarah, Macander, Casey Elizabeth
- Database ID:
- RTHC-06832
Evidence Hierarchy
Frequently Asked Questions
How do young adults use cannabis?
Most young adult cannabis users (57%) combine multiple methods like smoking, vaping, edibles, and dabbing within the same month. Single-mode use is actually the minority among current users aged 18-34.
Does cannabis legalization change how people consume it?
Yes. Recreational cannabis legalization was significantly associated with higher odds of multi-modal use, likely because legal markets offer more product diversity than illicit sources.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-06832APA
Kim, Nayoung; Flora, Sarah; Macander, Casey Elizabeth. (2025). Multi-Modal Cannabis Use Among U.S. Young Adults: Findings from the 2022 and 2023 BRFSS in 23 States.. International journal of environmental research and public health, 22(4). https://doi.org/10.3390/ijerph22040495
MLA
Kim, Nayoung, et al. "Multi-Modal Cannabis Use Among U.S. Young Adults: Findings from the 2022 and 2023 BRFSS in 23 States.." International journal of environmental research and public health, 2025. https://doi.org/10.3390/ijerph22040495
RethinkTHC
RethinkTHC Research Database. "Multi-Modal Cannabis Use Among U.S. Young Adults: Findings f..." RTHC-06832. Retrieved from https://rethinkthc.com/research/kim-2025-multimodal-cannabis-use-among
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.