Cannabis Use Rose While Tobacco Fell Across All Drinking Levels in the US, 2010-2019
From 2010 to 2019, cannabis use increased significantly while tobacco use decreased across all alcohol consumption levels in the US, with the fastest cannabis increase among non-drinkers.
Quick Facts
What This Study Found
Among 395,256 US adults, tobacco use and nicotine dependence decreased while cannabis use increased across all alcohol consumption levels from 2010-2019. Cannabis use increased fastest among non-drinkers (155%) versus low-risk drinkers (77%) and high-risk drinkers (31%). Among high-risk drinkers, Black individuals were more likely than White to use cannabis and both tobacco and cannabis.
Key Numbers
395,256 participants; tobacco decreased across all groups; cannabis increased: 155% in non-drinkers, 77% in low-risk drinkers, 31% in high-risk drinkers; Black individuals at higher odds of polysubstance use among high-risk drinkers
How They Did This
Repeated cross-sectional analysis combining 2010-2019 National Survey on Drug Use and Health data for 395,256 adults aged 18+, examining tobacco and cannabis use trends across alcohol consumption levels using linear time trends and multivariable logistic regression.
Why This Research Matters
The diverging trends in tobacco (down) and cannabis (up) across all drinking levels suggest these substances are not simply substituting for each other. The faster cannabis increase among non-drinkers is particularly notable, suggesting cannabis is reaching new populations beyond those already using other substances.
The Bigger Picture
These trends reflect a fundamental shift in substance use patterns in America. The decoupling of tobacco decline and cannabis increase suggests different drivers for each, and the racial disparities in polysubstance use highlight ongoing health equity concerns.
What This Study Doesn't Tell Us
Cross-sectional design cannot track individual behavior changes. Self-reported substance use. Cannot determine causality. Cannabis legalization status not directly analyzed.
Questions This Raises
- ?Is the faster cannabis increase among non-drinkers driven by medical use, recreational normalization, or both?
- ?What explains the racial disparities in polysubstance use among high-risk drinkers?
Trust & Context
- Key Stat:
- Cannabis use increased 155% among non-drinkers from 2010 to 2019
- Evidence Grade:
- Large national dataset with a decade of trends, but cross-sectional design limits causal inference.
- Study Age:
- Published in 2024 with 2010-2019 NSDUH data.
- Original Title:
- Trends in use of tobacco and cannabis across different alcohol consumption levels in the United States, 2010-19.
- Published In:
- Alcohol and alcoholism (Oxford, Oxfordshire), 60(1) (2024)
- Authors:
- Pham, Huyen, Bui, Thanh C, Glass, Joseph E(6), Back, Sudie E, Le, Phuc
- Database ID:
- RTHC-05625
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Are people replacing tobacco with cannabis?
Not exactly. Tobacco declined and cannabis increased across all groups, but the patterns are different enough to suggest independent trends rather than simple substitution.
Who is driving the cannabis increase?
The fastest growth was among non-drinkers (155% increase), suggesting cannabis is reaching populations beyond traditional substance users.
Read More on RethinkTHC
- cannabis-dependence-physical-psychological-addiction-science
- cannabis-perception-vs-evidence-gap
- cannabis-use-disorder-test
- cross-addiction-quit-weed-start-drinking
- is-weed-addictive
- is-weed-addictive-science
- quitting-weed-and-alcohol
- rehab-for-weed-addiction-necessary
- signs-of-cannabis-use-disorder
- weed-vape-pen-addiction
Cite This Study
https://rethinkthc.com/research/RTHC-05625APA
Pham, Huyen; Bui, Thanh C; Glass, Joseph E; Back, Sudie E; Le, Phuc. (2024). Trends in use of tobacco and cannabis across different alcohol consumption levels in the United States, 2010-19.. Alcohol and alcoholism (Oxford, Oxfordshire), 60(1). https://doi.org/10.1093/alcalc/agae091
MLA
Pham, Huyen, et al. "Trends in use of tobacco and cannabis across different alcohol consumption levels in the United States, 2010-19.." Alcohol and alcoholism (Oxford, 2024. https://doi.org/10.1093/alcalc/agae091
RethinkTHC
RethinkTHC Research Database. "Trends in use of tobacco and cannabis across different alcoh..." RTHC-05625. Retrieved from https://rethinkthc.com/research/pham-2024-trends-in-use-of
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.