Mississippi high schoolers who use cannabis are also more likely to vape, drink, and smoke tobacco | Research

The takeaway

Among Mississippi high school students, cannabis use was significantly associated with electronic vaping, tobacco smoking, alcohol use, and sexual behaviors after adjusting for demographics and other risk factors.

School health coordinators, youth substance prevention professionals, and state-level public health planners.

What the researchers found

In multivariable analysis adjusting for gender, race, grade, and other risk behaviors, cannabis use was significantly associated with current electronic vaping, current tobacco smoking, current alcohol drinking, and sexual behaviors. Univariate analysis also identified associations with carrying weapons on campus, suicidal attempts, and unsupervised time, but these lost significance after adjustment.

Why it matters

Cannabis rarely occurs in isolation among high schoolers. The clustering of cannabis with vaping, alcohol, tobacco, and sexual risk behaviors suggests prevention programs need to address multiple substances simultaneously rather than targeting cannabis alone.

The numbers in context

Seven risk behaviors associated with cannabis use in univariate analysis. Four remained significant in multivariable analysis: e-vaping, tobacco smoking, alcohol use, sexual behaviors. Cannabis use evenly distributed across gender and race categories.

How the study worked

Cross-sectional analysis of 2021 Mississippi Youth Risk Behavior Surveillance System (YRBS) data using survey-weighted logistic regression to examine associations between current cannabis use and other risk behaviors among high school students.

What this study cannot tell us

Cross-sectional YRBS data cannot determine temporal ordering or causation. Self-reported behaviors in a school setting may underreport. Mississippi-specific findings may not generalize to other states. 2021 data may not reflect current patterns.

How to read the evidence

Population-based survey with appropriate weighting and multivariate controls. Cross-sectional design and single-state focus limit causal and geographic generalizability.

When this study was published

2024 publication using 2021 YRBS data.

The bigger picture

The finding that cannabis use does not vary by gender or race in Mississippi challenges stereotypes about who uses cannabis. The clustering of risk behaviors supports integrated prevention approaches rather than substance-specific programs.

Questions still open

Would integrated substance prevention programs addressing vaping, alcohol, and cannabis together be more effective than single-substance approaches?
Does the gateway pattern (vaping/tobacco/alcohol preceding cannabis) hold in Mississippi's specific cultural context?

Common questions

Is cannabis a gateway drug?

This study found cannabis use clustered with other substance use, but cross-sectional data cannot determine which came first. The researchers suggest vaping, tobacco, and alcohol may precede cannabis use and should be targeted in prevention programs.

Why is the gender split equal?

Historically, males reported higher cannabis use rates. The equal distribution in Mississippi may reflect national trends toward closing the gender gap in adolescent cannabis use, driven partly by changing social norms and increased product availability.

Read the original research

Cannabis Use and Associated Risk Behavior Factors among High School Students in Mississippi: Youth Risk Behavior Surveillance System 2021.

International journal of environmental research and public health, 21(8)

View on PubMed ↗Publisher’s paper ↗

Citation

Mitra, Amal K; Zhang, Zhen; Schroeder, Julie A. (2024). Cannabis Use and Associated Risk Behavior Factors among High School Students in Mississippi: Youth Risk Behavior Surveillance System 2021.. International journal of environmental research and public health, 21(8). https://doi.org/10.3390/ijerph21081109