Sexual minority young adults had 2-3 times more days of combined cigarette and cannabis use | Research

The takeaway

In a 30-day daily diary study of 147 young adult smokers, sexual minority participants had about twice the odds of same-day cigarette-cannabis use and nearly 3 times the odds of using all three substances (cigarettes, alcohol, cannabis) on the same day.

LGBTQ+ health researchers, substance use treatment providers, and anyone interested in polysubstance use patterns among young adults.

2.79x odds of using cigarettes, alcohol, and cannabis on the same day

What the researchers found

Sexual minority young adults had significantly greater odds of same-day cigarette and cannabis use (AOR 2.05, 95% CI 1.04-4.01) and all three substances combined (AOR 2.79, 95% CI 1.51-5.14) compared to heterosexuals. Of 2,891 daily assessments, 18.1% included same-day cigarette and cannabis use, and 15.0% included all three substances.

Why it matters

Same-day use of multiple substances compounds health risks beyond what each substance poses individually. Identifying that sexual minority young adults are at elevated risk for this pattern helps target interventions for maximum impact.

The numbers in context

147 participants; 2,891 daily assessments; 30 days; cigarettes+cannabis AOR 2.05; all 3 substances AOR 2.79; 18.1% of days included cigarettes+cannabis

How the study worked

Daily diary data from 147 young adult smokers (aged 18-26, 51.7% female, 41.5% sexual minority) using smartphone-based surveys over 30 consecutive days, analyzed with generalized estimating equations.

What this study cannot tell us

All participants were smokers, limiting generalizability. 30-day window may not capture longer-term patterns. Self-reported daily diary data. Specific reasons for polysubstance use not assessed.

How to read the evidence

Ecologically valid daily diary design with appropriate statistical methods, though smoker-only sample limits generalizability.

When this study was published

Published in 2021.

The bigger picture

The daily diary method captures patterns of use that standard surveys miss. The elevated polysubstance use among sexual minority young adults likely reflects the cumulative stress of minority status and the social contexts in which substance use occurs.

Questions still open

What drives the elevated polysubstance use among sexual minority young adults? Would interventions addressing minority stress reduce same-day multiple substance use? Does the health impact of combined use exceed the sum of individual substance effects?

Common questions

Do sexual minority young adults use more substances on the same day?

Yes. In this study, sexual minority participants had about twice the odds of using cigarettes and cannabis together, and nearly 3 times the odds of using all three substances (cigarettes, alcohol, cannabis) on the same day.

How common was same-day multiple substance use?

Across all participants, 18.1% of daily assessments included same-day cigarette and cannabis use, and 15.0% included use of all three substances.

Read the original research

Same-day use of cigarettes, alcohol, and cannabis among sexual minority and heterosexual young adult smokers.

Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 35(2), 215-223

View on PubMed ↗Publisher’s paper ↗

Citation

Nguyen, Nhung; McQuoid, Julia; Neilands, Torsten B; Dermody, Sarah S; Holmes, Louisa M; Ling, Pamela M; Thrul, Johannes. (2021). Same-day use of cigarettes, alcohol, and cannabis among sexual minority and heterosexual young adult smokers.. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 35(2), 215-223. https://doi.org/10.1037/adb0000678