E-cigarette and other substance use predicted which teens started vaping marijuana
Among US adolescents, current e-cigarette use, cigarette use, other marijuana use, and alcohol use all independently predicted initiating marijuana vaping.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?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?
Trust & Context
- Key Stat:
- 7.78x higher odds of marijuana vaping initiation among teens already using other marijuana products
- Evidence Grade:
- Large nationally representative longitudinal cohort with multivariable modeling and temporal ordering of exposures and outcomes.
- Study Age:
- Published in 2021 using PATH data from 2015-2018.
- Original Title:
- 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).
- Published In:
- Drug and alcohol dependence, 226, 108905 (2021)
- Authors:
- Lee, Juhan(3), Kong, Grace(4), Kassas, Bachir, Salloum, Ramzi G
- Database ID:
- RTHC-03283
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked Questions
What was the strongest predictor of starting to vape marijuana?
Already using other marijuana products was the strongest predictor, with nearly 8 times the odds compared to non-users.
Did peer influence matter?
Yes. Having peers who vaped more than doubled the odds of initiating marijuana vaping (aOR = 2.31).
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-03283APA
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
MLA
Lee, Juhan, et al. "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, 2021. https://doi.org/10.1016/j.drugalcdep.2021.108905
RethinkTHC
RethinkTHC Research Database. "Predictors of vaping marijuana initiation among US adolescen..." RTHC-03283. Retrieved from https://rethinkthc.com/research/lee-2021-predictors-of-vaping-marijuana
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.