Marijuana and Tobacco Co-Use Patterns Among African Americans | Research

The takeaway

Among African American marijuana and tobacco users, 28% used both substances, and co-users were more likely to be marijuana dependent and started using all substances at younger ages.

Read this if you use both marijuana and tobacco or work in substance use prevention for African American communities.

28% used both marijuana and tobacco; co-users had higher marijuana dependence

What the researchers found

Researchers examined 2,024 African American past-month marijuana and tobacco users from the 2013 National Survey on Drug Use and Health. Three groups emerged: 18.5% used marijuana only, 53.8% used tobacco only, and 27.7% used both.

Compared to marijuana-only users, co-users were more likely to be marijuana dependent and reported more days of marijuana use per month. Compared to tobacco-only users, co-users were less likely to be nicotine dependent but started smoking cigarettes, cigars, and marijuana at younger ages.

Co-users also reported more cigar use, suggesting a pattern of broader tobacco product experimentation alongside cannabis use.

Why it matters

African Americans face disproportionate health burdens from both tobacco and marijuana use. Understanding the co-use pattern is essential for designing prevention and treatment programs that address both substances simultaneously.

The numbers in context

2,024 participants; 18.5% marijuana only; 53.8% tobacco only; 27.7% co-users; co-users more likely marijuana dependent; co-users started all substances at younger ages; less nicotine dependent than tobacco-only users

How the study worked

Secondary analysis of 2,024 African Americans reporting past-30-day marijuana or tobacco use in the 2013 National Survey on Drug Use and Health. Compared three groups on dependence markers, frequency of use, and age of initiation.

What this study cannot tell us

Cross-sectional design cannot determine causal relationships between co-use and dependence. Self-reported use data. National survey may not capture regional variation. Did not assess blunt use (marijuana wrapped in tobacco), which is common in this population.

How to read the evidence

National survey data providing population-level estimates, but cross-sectional design and self-reported data limit conclusions.

When this study was published

Published in 2015 using 2013 data. Cannabis legalization and vaping have changed the substance use landscape considerably.

The bigger picture

Co-use of marijuana and tobacco is common and may represent a distinct pattern of substance use with unique risks and treatment needs. Interventions addressing only one substance may miss the interconnected nature of these behaviors.

Questions still open

Does the earlier age of initiation among co-users drive the increased marijuana dependence? Would integrated marijuana-tobacco treatment programs be more effective for African American co-users? How does blunt use factor into these patterns?

Common questions

Why is co-use of marijuana and tobacco a concern?

Co-users showed higher marijuana dependence and started using substances at younger ages. The combination also creates greater exposure to combustion-related health risks and complicates treatment because both dependencies need to be addressed.

Are co-users more addicted?

Co-users were more likely to be marijuana dependent than marijuana-only users but less likely to be nicotine dependent than tobacco-only users. This suggests the co-use pattern is associated with a specific dependence profile rather than simply being addicted to everything.

Read the original research

Marijuana and tobacco use and co-use among African Americans: results from the 2013, National Survey on Drug Use and Health.

Addictive behaviors, 51, 18-23

View on PubMed ↗Publisher’s paper ↗

Citation

Montgomery, LaTrice. (2015). Marijuana and tobacco use and co-use among African Americans: results from the 2013, National Survey on Drug Use and Health.. Addictive behaviors, 51, 18-23. https://doi.org/10.1016/j.addbeh.2015.06.046