Among US adolescents, current e-cigarette use, cigarette use, other marijuana use, and alcohol use all independently predicted initiating marijuana vaping.
Parents, educators, public health professionals, and anyone interested in adolescent substance use patterns.
7.78x higher odds of marijuana vaping initiation among teens already using other marijuana products
What the researchers found
Adolescents who already used other marijuana products had nearly 8 times the odds of initiating marijuana vaping, while e-cigarette users had about twice the odds.
Why it matters
Marijuana vaping exposes youth to higher THC concentrations and has been linked to vaping-related lung injuries. Identifying which teens are most likely to start helps target prevention efforts.
The numbers in context
7,821 adolescents; other marijuana use aOR = 7.78; ENDS use aOR = 2.16; cigarettes aOR = 2.65; alcohol aOR = 1.98; vaping peers aOR = 2.31
How the study worked
Researchers analyzed data from 7,821 adolescents across Waves 3 and 4 of the PATH Study (2015-2018), using multivariable logistic regression to identify baseline predictors of marijuana vaping initiation among those who had never vaped marijuana at Wave 3.
What this study cannot tell us
Self-reported data subject to recall and social desirability bias. Data from 2015-2018 may not reflect current patterns. Cannot establish causation from observational data.
How to read the evidence
Large nationally representative longitudinal cohort with multivariable modeling and temporal ordering of exposures and outcomes.
When this study was published
Published in 2021 using PATH data from 2015-2018.
The bigger picture
This study underscores how substance use rarely happens in isolation. Teens who used any substance were substantially more likely to add marijuana vaping to their repertoire, suggesting gateway-style patterns of escalation.
Questions still open
- Have risk factors shifted since the EVALI outbreak? Do interventions targeting e-cigarette use also reduce marijuana vaping initiation? What role does THC potency play in sustaining use after initiation?
Common questions
What was the strongest predictor of starting to vape marijuana?
Did peer influence matter?
Read the original research
Predictors of vaping marijuana initiation among US adolescents: Results from the Population Assessment of Tobacco and Health (PATH) study Wave 3 (2015-2016) and Wave 4 (2016-2018).
Drug and alcohol dependence, 226, 108905
Citation
Lee, Juhan; Kong, Grace; Kassas, Bachir; Salloum, Ramzi G. (2021). Predictors of vaping marijuana initiation among US adolescents: Results from the Population Assessment of Tobacco and Health (PATH) study Wave 3 (2015-2016) and Wave 4 (2016-2018).. Drug and alcohol dependence, 226, 108905. https://doi.org/10.1016/j.drugalcdep.2021.108905
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