College students who co-used tobacco and marijuana were more ready to quit cigarettes than marijuana, with distinct factors predicting each

A study of 721 college substance users found that tobacco-marijuana co-users rated quitting importance higher for cigarettes than marijuana but had lower quitting confidence for cigarettes, and were more likely to report readiness and actual quit attempts for cigarettes versus marijuana.

Masters, Matthew N et al.·Addictive behaviors·2018·Moderate EvidenceCross-Sectional
RTHC-01752Cross SectionalModerate Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=721

What This Study Found

Researchers studied 721 college students aged 18-25 who used cigarettes and/or marijuana: 238 cigarette-only, 331 marijuana-only, and 152 co-users.

Co-users rated the importance of quitting higher for cigarettes than marijuana, but had lower confidence in their ability to quit cigarettes versus marijuana.

Co-users were more likely to report readiness to quit cigarettes (vs. marijuana) and more likely to have made recent quit attempts for cigarettes (vs. marijuana).

Among single-product users: 41.18% of cigarette-only users reported recent quit attempts vs. 21.75% of marijuana-only users. Readiness to quit was 15.13% for cigarette-only and 23.26% for marijuana-only users.

Correlates of co-use (vs. single use) included attending public/technical colleges (vs. private), using little cigars/cigarillos, using e-cigarettes, and alcohol use.

The factors predicting readiness to quit and actual quit attempts differed for cigarettes versus marijuana, suggesting cessation programs need product-specific approaches.

Key Numbers

721 users: 238 cigarette-only, 331 marijuana-only, 152 co-users. Importance rated higher for quitting cigarettes vs marijuana (p<0.001). Confidence rated lower for quitting cigarettes vs marijuana (p<0.001). 41.18% of cigarette-only users had recent quit attempts vs 21.75% of marijuana-only users.

How They Did This

Cross-sectional study of 721 college students aged 18-25 from seven Georgia campuses. Multinomial logistic regression for user group correlates. Binary logistic regression for cessation outcomes.

Why This Research Matters

The finding that co-users prioritize quitting cigarettes over marijuana has implications for cessation programs. Co-users may benefit from sequential approaches that leverage their motivation to quit tobacco while addressing marijuana use as a related but distinct behavior.

The Bigger Picture

With many young adults using both tobacco and marijuana, cessation programs that address only one product may miss opportunities. Understanding the different motivations and barriers for each product can inform more effective interventions.

What This Study Doesn't Tell Us

Cross-sectional design from seven Georgia campuses. Self-reported substance use. College student sample limits generalizability to non-college young adults. Co-use defined broadly without dose-response data.

Questions This Raises

  • ?Does successfully quitting one substance affect the likelihood of quitting the other?
  • ?Should cessation programs address both products simultaneously or sequentially?
  • ?Why is quitting confidence lower for cigarettes than marijuana despite higher motivation?

Trust & Context

Key Stat:
Co-users rated quitting importance higher for cigarettes but had lower confidence in quitting them
Evidence Grade:
Moderate. Multi-campus study with appropriate statistical methods, but cross-sectional design and regional sample limit generalizability.
Study Age:
Published in 2018. The landscape of tobacco and marijuana use among young adults continues to evolve with vaping and legalization changes.
Original Title:
Psychosocial and cessation-related differences between tobacco-marijuana co-users and single product users in a college student population.
Published In:
Addictive behaviors, 77, 21-27 (2018)
Database ID:
RTHC-01752

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Why are co-users more motivated to quit cigarettes than marijuana?

Several factors may explain this: cigarette smoking carries greater social stigma than marijuana use in college populations, tobacco health risks are more widely known, and marijuana may be perceived as more recreational and less harmful. Co-users may see marijuana as something they choose to do and cigarettes as an addiction they want to escape.

Does quitting one affect the other?

This cross-sectional study could not answer that directly, but the finding that different factors predict quitting each substance suggests they may require separate cessation strategies. Addressing co-use is important because using one substance can trigger use of the other.

Read More on RethinkTHC

Cite This Study

RTHC-01752·https://rethinkthc.com/research/RTHC-01752

APA

Masters, Matthew N; Haardörfer, Regine; Windle, Michael; Berg, Carla. (2018). Psychosocial and cessation-related differences between tobacco-marijuana co-users and single product users in a college student population.. Addictive behaviors, 77, 21-27. https://doi.org/10.1016/j.addbeh.2017.09.007

MLA

Masters, Matthew N, et al. "Psychosocial and cessation-related differences between tobacco-marijuana co-users and single product users in a college student population.." Addictive behaviors, 2018. https://doi.org/10.1016/j.addbeh.2017.09.007

RethinkTHC

RethinkTHC Research Database. "Psychosocial and cessation-related differences between tobac..." RTHC-01752. Retrieved from https://rethinkthc.com/research/masters-2018-psychosocial-and-cessationrelated-differences

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.