Five Distinct Cannabis-Tobacco Use Patterns Identified Among US Young Adults
Latent class analysis of 2,267 young adults identified five cannabis-tobacco use classes, with the heaviest poly-product users disproportionately Black, Hispanic, and reporting more mental health symptoms and childhood adversity.
Quick Facts
What This Study Found
Five classes: 'primarily cannabis' (36.6%), and four other patterns. The frequent poly-product class was associated with being Black or Hispanic, heterosexual identity, older age, male sex, more ACEs, more mental health symptoms, higher neuroticism, lower openness, and living in states without cannabis legalization.
Key Numbers
2,267 past-month cannabis/tobacco users. 5 classes identified. 'Primarily cannabis': 36.6%. 'Primarily e-cigarette': 5.5%. Poly-product class correlates: Black/Hispanic, more ACEs, more mental health symptoms, non-legalized states.
How They Did This
Latent class analysis of 2023 data from 2,267 young adults aged 18-34 (purposively recruited via Facebook for ~50% past-month cannabis use). Indicators included cannabis, cigarette, and e-cigarette use frequency plus cigar, hookah, smokeless tobacco, and nicotine pouch use. Multivariable regressions tested correlates.
Why This Research Matters
Understanding distinct use patterns beyond simple 'user/non-user' categories helps target interventions. The finding that the heaviest use class overlaps with populations facing substance use disparities suggests prevention efforts need equity-focused approaches.
The Bigger Picture
The purposive sampling for high cannabis use rates limits generalizability but provides detailed characterization of use patterns that would be obscured in general population samples.
What This Study Doesn't Tell Us
Purposively recruited sample overrepresenting cannabis users. Facebook recruitment may miss some demographics. Cross-sectional design. Self-reported use. Class assignments are probabilistic, not definitive.
Questions This Raises
- ?Do these use classes predict different health outcomes over time?
- ?Would cannabis legalization change the poly-product use patterns?
Trust & Context
- Key Stat:
- Evidence Grade:
- Adequate sample with sophisticated methodology, but purposive sampling and cross-sectional design limit to moderate.
- Study Age:
- 2023 survey data from US young adults.
- Original Title:
- Cannabis and Tobacco Product Use Classes and Psychosocial Correlates among US Young Adults.
- Published In:
- Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco (2025)
- Authors:
- Speer, Morgan(10), Cui, Yuxian(13), McCready, Darcey M(11), LoParco, Cassidy R, Romm, Katelyn F, Wang, Yan, Schubel, Laura C, Howlader, Afrah, Williams, Jessica, Thakkar, Shriya, Cavazos-Rehg, Patricia A, Berg, Carla J
- Database ID:
- RTHC-07704
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
Do most young cannabis users also use tobacco?
This study found cannabis use often co-occurs with tobacco products. The largest group (36.6%) were 'primarily cannabis' users, but 84% of them also used other tobacco products.
Who uses the most substances?
The frequent poly-product class was disproportionately Black and Hispanic, had more adverse childhood experiences, more mental health symptoms, and lived in states without cannabis legalization.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-07704APA
Speer, Morgan; Cui, Yuxian; McCready, Darcey M; LoParco, Cassidy R; Romm, Katelyn F; Wang, Yan; Schubel, Laura C; Howlader, Afrah; Williams, Jessica; Thakkar, Shriya; Cavazos-Rehg, Patricia A; Berg, Carla J. (2025). Cannabis and Tobacco Product Use Classes and Psychosocial Correlates among US Young Adults.. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. https://doi.org/10.1093/ntr/ntaf238
MLA
Speer, Morgan, et al. "Cannabis and Tobacco Product Use Classes and Psychosocial Correlates among US Young Adults.." Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2025. https://doi.org/10.1093/ntr/ntaf238
RethinkTHC
RethinkTHC Research Database. "Cannabis and Tobacco Product Use Classes and Psychosocial Co..." RTHC-07704. Retrieved from https://rethinkthc.com/research/speer-2025-cannabis-and-tobacco-product
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.