Dual cigarette and e-cigarette use was the strongest predictor of marijuana vaping initiation in young adults | Research

The takeaway

In a prospective study of 2,327 college students, dual cigarette/e-cigarette use was the strongest predictor of starting marijuana vaping, while social networks with marijuana users and vape shop frequenters predicted escalation.

Substance use prevention researchers, college health professionals, and vaping policy makers.

Dual tobacco product use strongest predictor of marijuana vaping onset

What the researchers found

Among 2,327 young adults followed for one year, dual cigarette/e-cigarette use at baseline was the strongest predictor of marijuana vaping initiation among non-marijuana users. Social networks with more regular marijuana users predicted marijuana vaping initiation. Among existing e-cigarette and marijuana users, having social networks with people who frequented vape shops predicted increased marijuana vaping over time.

Why it matters

Marijuana vaping is increasing rapidly among young adults but its risk factors are poorly understood. Identifying that dual tobacco product use and social networks drive initiation helps target prevention.

The numbers in context

2,327 young adults; mean age 21.2; 54% women; 1-year follow-up (2017-2019); dual cigarette/e-cigarette use strongest predictor of initiation; vape shop social networks predicted escalation.

How the study worked

One-year prospective study of 2,327 young adults (mean age 21.2, 54% women) at 2-year and 4-year colleges in Hawaii, using validated measures of substance use, social network characteristics, and marketing exposure at baseline and follow-up.

What this study cannot tell us

Hawaii sample (unique cultural and legal context); 1-year follow-up may miss longer-term patterns; self-report measures; college students may not represent all young adults; did not assess vaping device types or THC concentrations.

How to read the evidence

Strong: large prospective design with 1-year follow-up and validated measures.

When this study was published

Published 2020.

The bigger picture

The vape shop connection is notable: social environments where nicotine vaping is normalized appear to facilitate marijuana vaping escalation. This suggests that marijuana vaping prevention may need to address the broader vaping culture, not just marijuana-specific messaging.

Questions still open

Do vape shops actively facilitate marijuana vaping adoption? Would e-cigarette regulation indirectly reduce marijuana vaping initiation?

Common questions

What predicts who will start vaping marijuana?

The strongest predictor was already using both cigarettes and e-cigarettes. Having more marijuana users in your social network also predicted initiation, but e-cigarette users and cigarette smokers in your network did not.

What makes marijuana vaping get worse over time?

Among people already using e-cigarettes and marijuana, having social networks that included people who frequented vape shops predicted increased marijuana vaping one year later.

Read the original research

Predictors of marijuana vaping onset and escalation among young adults.

Drug and alcohol dependence, 216, 108320

View on PubMed ↗Publisher’s paper ↗

Citation

Pokhrel, Pallav; Fagan, Pebbles; Kawamoto, Crissy T; Okamoto, Scott K; Herzog, Thaddeus A. (2020). Predictors of marijuana vaping onset and escalation among young adults.. Drug and alcohol dependence, 216, 108320. https://doi.org/10.1016/j.drugalcdep.2020.108320