Most college students who co-used cannabis and tobacco stayed in the same use pattern over three years | Research

The takeaway

Among 4,448 Texas college students, four distinct cannabis-tobacco co-use patterns emerged, and most students remained in their initial pattern from 2016 to 2019, suggesting these behaviors become entrenched early.

College health professionals, substance use prevention specialists, and young adult health researchers

4,448 college students; co-use patterns stable over 3 years

What the researchers found

Four latent classes emerged: non-use (58%), general use of all substances (19%), blunt and cannabis use (13%), and concurrent/co-administration use with cigarettes, cannabis, blunts, and spliffs (10%). Most students remained in the same class from 2016 to 2019, indicating stable co-use patterns over time.

Why it matters

The stability of co-use patterns suggests that once young adults establish cannabis-tobacco co-use behaviors in college, they are unlikely to change without intervention.

The numbers in context

4,448 participants; 4 classes: non-use 58%, general use 19%, blunt/cannabis 13%, concurrent co-administration 10%; most students remained in same class 2016-2019; 64.2% female; 64.7% non-white; mean age 20.5

How the study worked

Longitudinal cohort study of 4,448 young adults (64.2% female, 64.7% non-white, mean age 20.5) at Texas colleges, assessed for past 30-day tobacco, cannabis, and co-administration use. Latent Markov models estimated class membership and transitions from 2016 to 2019.

What this study cannot tell us

Texas-specific sample may not generalize to other states; self-reported substance use; attrition over 3 years not detailed; cannot determine what drives class stability versus transition; legal context may differ across states

How to read the evidence

Large longitudinal cohort with sophisticated latent class modeling, though limited to Texas colleges and self-reported data.

When this study was published

2024 publication analyzing 2016-2019 data

The bigger picture

Cannabis-tobacco co-use is associated with worse health outcomes than either substance alone. The finding that co-use patterns solidify during college years underscores the importance of early, integrated prevention programs.

Questions still open

What distinguishes students who transition between classes from those who stay stable? Would targeted interventions during freshman year be more effective than later approaches?

Common questions

What cannabis-tobacco co-use patterns exist among college students?

Four distinct patterns emerged: most students (58%) did not use either substance; 19% used a variety of products at low levels; 13% primarily used cannabis and blunts; and 10% were heavy co-users of cigarettes, cannabis, blunts, and spliffs.

Did students change their use patterns over time?

Mostly not. Students generally stayed in the same co-use category from 2016 to 2019, suggesting these patterns become established early in college and are resistant to change without specific intervention.

Read the original research

Longitudinal patterns of cannabis and tobacco co-administration and concurrent use among young adult college students.

Addictive behaviors, 148, 107871

View on PubMed ↗Publisher’s paper ↗

Citation

Kreitzberg, Daniel S; Pasch, Keryn E; Loukas, Alexandra. (2024). Longitudinal patterns of cannabis and tobacco co-administration and concurrent use among young adult college students.. Addictive behaviors, 148, 107871. https://doi.org/10.1016/j.addbeh.2023.107871