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.
tobacco/cannabis co-use researchers, health equity researchers, substance use prevention specialists
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot 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.
How to read the evidence
Adequate sample with sophisticated methodology, but purposive sampling and cross-sectional design limit to moderate.
When this study was published
2023 survey data from US young adults.
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.
Questions still open
- Do these use classes predict different health outcomes over time?
- Would cannabis legalization change the poly-product use patterns?
Common questions
Do most young cannabis users also use tobacco?
Who uses the most substances?
Read the original research
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
Citation
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
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