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Study breakdown

Cannabis Vaping Among High Schoolers Linked to LGB+ Identity, Mental Health, and Aggression

ObservationalModerate evidence
The takeaway

Among 2,476 9th and 10th graders, cannabis vaping was more prevalent among LGB+, Hispanic, and multiethnic adolescents, and was associated with worse mental health, alcohol use, and aggression.

school health coordinators, adolescent substance use prevention researchers, LGBTQ+ youth services

What the researchers found

Past-month vaping: 89.7% non-use, 5.9% nicotine-only, 1.0% cannabis-only, 3.4% dual use. Nicotine-only vaping was higher among females. Cannabis and dual use were associated with LGB+ identity, Hispanic/multiethnic background, and lower SES. All vaping types were associated with worse mental health, alcohol use, and aggression, with dual users showing the strongest associations.

Why it matters

Adolescent cannabis vaping is a growing concern distinct from smoking. Identifying which youth are most at risk allows for targeted prevention, and the strong association with LGB+ identity suggests inclusive prevention approaches are needed.

The numbers in context

2,476 adolescents in 9th-10th grade. Non-use: 89.7%. Nicotine-only: 5.9%. Cannabis-only: 1.0%. Dual: 3.4%. Higher risk: females (nicotine), LGB+ (cannabis, dual), Hispanic/multiethnic, low SES. All vaping linked to worse mental health, alcohol, aggression.

How the study worked

Cross-sectional survey of 2,476 9th and 10th grade adolescents in Colorado and Ohio (2021-2022). Measured vaping behaviors and psychosocial factors including substance use attitudes, alcohol use, mental health, aggression, and family/school risk and protective factors.

What this study cannot tell us

Cross-sectional design. Two states only (CO, OH). Self-reported vaping. Cannot establish causation between vaping and psychosocial factors. Low prevalence of cannabis-only vaping limits statistical power for that group.

How to read the evidence

Adequate multi-state adolescent sample with comprehensive psychosocial measures, but cross-sectional design and two-state scope limit to moderate.

When this study was published

Data from 2021-2022 school surveys in Colorado and Ohio.

The bigger picture

The fact that 4.4% of early high schoolers vaped cannabis (alone or with nicotine) and that dual users showed the worst psychosocial profiles suggests co-use prevention should be a priority in adolescent health programming.

Questions still open

  • Why is cannabis vaping more prevalent among LGB+ adolescents?
  • Do school-based programs address cannabis vaping specifically or focus mainly on nicotine?

Common questions

How common is cannabis vaping among high schoolers?
About 4.4% of 9th and 10th graders reported vaping cannabis in the past month, with 3.4% using both cannabis and nicotine and 1.0% using cannabis only.
Who is most at risk for cannabis vaping?
LGB+ adolescents, Hispanic and multiethnic youth, and those from lower socioeconomic backgrounds were more likely to vape cannabis. Dual nicotine-cannabis vapers had the worst mental health and behavioral outcomes.

Read the original research

Nicotine and cannabis vaping among early high school adolescents: Disparities of use across sociodemographic characteristics and associations with psychosocial factors.

Addictive behaviors reports, 21, 100577

Citation

Steeger, Christine M; Gust, Charleen J; Harlow, Alyssa F; Cambron, Christopher; Barrington-Trimis, Jessica; Combs, Katie Massey; Brooks-Russell, Ashley; Hill, Karl G. (2025). Nicotine and cannabis vaping among early high school adolescents: Disparities of use across sociodemographic characteristics and associations with psychosocial factors.. Addictive behaviors reports, 21, 100577. https://doi.org/10.1016/j.abrep.2024.100577

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