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?
Who is most at risk for cannabis vaping?
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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