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

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.

Steeger, Christine M et al.·Addictive behaviors reports·2025·Moderate EvidenceObservational
RTHC-07721ObservationalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Moderate Evidence
Sample
N=2,476

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

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

Trust & Context

Key Stat:
Evidence Grade:
Adequate multi-state adolescent sample with comprehensive psychosocial measures, but cross-sectional design and two-state scope limit to moderate.
Study Age:
Data from 2021-2022 school surveys in Colorado and Ohio.
Original Title:
Nicotine and cannabis vaping among early high school adolescents: Disparities of use across sociodemographic characteristics and associations with psychosocial factors.
Published In:
Addictive behaviors reports, 21, 100577 (2025)
Database ID:
RTHC-07721

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked 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 More on RethinkTHC

Cite This Study

RTHC-07721·https://rethinkthc.com/research/RTHC-07721

APA

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

MLA

Steeger, Christine M, et al. "Nicotine and cannabis vaping among early high school adolescents: Disparities of use across sociodemographic characteristics and associations with psychosocial factors.." Addictive behaviors reports, 2025. https://doi.org/10.1016/j.abrep.2024.100577

RethinkTHC

RethinkTHC Research Database. "Nicotine and cannabis vaping among early high school adolesc..." RTHC-07721. Retrieved from https://rethinkthc.com/research/steeger-2025-nicotine-and-cannabis-vaping

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.