Young Adults Who Used Both Marijuana and Tobacco Were Less Likely to Plan Quitting Tobacco | Research

The takeaway

Among young adult tobacco users, 53% also used marijuana in the past month, and marijuana co-use was associated with more tobacco use and 25% lower odds of planning to quit tobacco permanently.

Read this if you use both tobacco and marijuana and are thinking about quitting either one.

53% co-use rate with 25% lower odds of planning to quit tobacco permanently

What the researchers found

An online survey of young adult tobacco users (ages 18-25) found that over half (53%) had also used marijuana in the past 30 days. Marijuana co-users were younger, had higher income, were more likely to be male and multiethnic, and were more commonly nondaily smokers compared to tobacco-only users.

Days of marijuana use in the past month was associated with multiple measures of tobacco use intensity. However, among all the tobacco-related cognitions assessed (outcome expectations, desire, self-efficacy, difficulty, pros/cons, stage of change), only one significant association emerged: co-users had 25% lower odds of planning to quit tobacco permanently (OR=0.75, 95% CI: 0.58-0.98).

Why it matters

Marijuana and tobacco co-use is extremely common among young adults. The finding that co-users are less likely to plan quitting tobacco is clinically important: tobacco cessation interventions for young adults should assess and address marijuana use as a potential barrier to quit motivation.

The numbers in context

53% of young adult tobacco users also used marijuana in past 30 days. Co-users: younger, higher income, more male, more nondaily smokers. OR=0.75 for planning to quit tobacco permanently. Other tobacco cognitions: no significant differences.

How the study worked

Cross-sectional online survey. Participants ages 18-25 reporting past-month tobacco use. Assessed tobacco use patterns, marijuana use, tobacco-related cognitions and quit plans. Multivariable analysis.

What this study cannot tell us

Online convenience sample may not represent all young adult smokers. Cross-sectional design cannot determine whether marijuana use causes lower quit intentions. Self-reported substance use. The single significant finding among many comparisons could be a chance result.

How to read the evidence

Cross-sectional survey with appropriate analysis; moderate evidence for co-use patterns and quit intentions.

When this study was published

Published in 2013. Marijuana-tobacco co-use research has expanded, especially as cannabis normalization continues.

The bigger picture

The 53% co-use rate underscores how intertwined these substances are among young adults. That co-users differ from tobacco-only users in their quit intentions but not other cognitions suggests marijuana may specifically undermine the commitment to permanent cessation rather than broadly altering attitudes toward tobacco.

Questions still open

Does quitting marijuana improve tobacco cessation rates? Should tobacco cessation programs address marijuana co-use? Do young adults who use both substances see them as a single behavior or separate habits?

Common questions

Why do marijuana users smoke more tobacco?

This study found that days of marijuana use correlated with tobacco use intensity, but the reasons are not fully clear. Possibilities include: blunt smoking (tobacco wraps for marijuana), social contexts where both are used, shared neurobiological pathways, and marijuana reducing motivation to cut back on tobacco. The two substances often reinforce each other's use.

Should you quit marijuana and tobacco at the same time?

This study does not directly answer this, but the finding that marijuana co-users are less likely to plan quitting tobacco suggests the substances are linked in terms of quit motivation. Some treatment approaches recommend addressing both simultaneously, while others prioritize one at a time. What is clear is that tobacco cessation programs should assess marijuana use as a relevant factor.

Read the original research

Marijuana and tobacco co-use in young adults: patterns and thoughts about use.

Journal of studies on alcohol and drugs, 74(2), 301-10

View on PubMed ↗

Citation

Ramo, Danielle E; Delucchi, Kevin L; Hall, Sharon M; Liu, Howard; Prochaska, Judith J. (2013). Marijuana and tobacco co-use in young adults: patterns and thoughts about use.. Journal of studies on alcohol and drugs, 74(2), 301-10.