Most Tobacco-Cannabis Co-Users Started With Nicotine E-Cigarettes Before Cannabis
Among 6,131 co-users, about 71% tried tobacco first, with nicotine e-cigarettes the most common gateway product, especially among younger users.
Quick Facts
What This Study Found
38.4% of participants co-used tobacco and cannabis. Among co-users, 70.9% tried tobacco first, with e-cigarettes being the first tobacco product for ~60% of those who started with tobacco.
Key Numbers
6,131 participants. 38.4% co-used. 70.9% tried tobacco first. ~60% started with e-cigarettes.
How They Did This
Cross-sectional national survey of 6,131 participants aged 13-40 reporting use of 17 tobacco and cannabis products.
Why This Research Matters
Understanding the sequence from e-cigarettes to cannabis can help design prevention programs targeting the most common entry point.
The Bigger Picture
For today's generation, nicotine e-cigarettes may serve as initial substance exposure preceding cannabis, a different sequence from previous generations.
What This Study Doesn't Tell Us
Cross-sectional with retrospective recall. Does not establish causation.
Questions This Raises
- ?Would reducing e-cigarette access decrease cannabis initiation?
- ?Is the sequence causal or reflecting shared risk factors?
Trust & Context
- Key Stat:
- 71% of co-users tried tobacco first; ~60% started with nicotine e-cigarettes
- Evidence Grade:
- Large national survey with detailed product data, but cross-sectional design limits causal inference.
- Study Age:
- Published in 2024.
- Original Title:
- Products and patterns through which adolescents, young adults, and adults initiate co-use of tobacco and cannabis.
- Published In:
- Addictive behaviors, 158, 108105 (2024)
- Authors:
- McCauley, Devin M, Liu, Jessica(3), Gaiha, Shivani Mathur(2), Halpern-Felsher, Bonnie
- Database ID:
- RTHC-05534
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Do people start with tobacco or cannabis first?
About 71% of co-users tried tobacco first, with e-cigarettes the most common first product among younger users.
Are e-cigarettes a gateway to cannabis?
Most co-users vaped nicotine before cannabis, but this does not prove causation.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-05534APA
McCauley, Devin M; Liu, Jessica; Gaiha, Shivani Mathur; Halpern-Felsher, Bonnie. (2024). Products and patterns through which adolescents, young adults, and adults initiate co-use of tobacco and cannabis.. Addictive behaviors, 158, 108105. https://doi.org/10.1016/j.addbeh.2024.108105
MLA
McCauley, Devin M, et al. "Products and patterns through which adolescents, young adults, and adults initiate co-use of tobacco and cannabis.." Addictive behaviors, 2024. https://doi.org/10.1016/j.addbeh.2024.108105
RethinkTHC
RethinkTHC Research Database. "Products and patterns through which adolescents, young adult..." RTHC-05534. Retrieved from https://rethinkthc.com/research/mccauley-2024-products-and-patterns-through
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.