Cannabis and Tobacco Product Use Classes and Psychosocial Correlates among US Young Adults

Authors

Morgan Speer, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Yuxian Cui, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Darcey M. McCready, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Cassidy R. LoParco, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Katelyn F. Romm, TSET Health Promotion Research Center, Stephenson Cancer Center; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences, Oklahoma City, OK, United States.
Yan Wang, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Laura C. Schubel, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Afrah Howlader, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Jessica Williams, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.
Shriya Thakkar, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Patricia A. Cavazos-Rehg, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.
Carla J. Berg, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.

Document Type

Journal Article

Publication Date

11-24-2025

Journal

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

DOI

10.1093/ntr/ntaf238

Abstract

INTRODUCTION: This study examined US young adults' cannabis-tobacco use classes. METHODS: Latent class analysis used 2023 data among young adults (ages 18-34, purposively recruited via Facebook to represent ~50% past-month cannabis use), specifically the 2267 reporting past-month cannabis and/or tobacco use. Indicators included: cannabis, cigarette, and e-cigarette use (0 days, infrequent [1-10], frequent [11-30]) and any cigar, hookah, smokeless tobacco, and nicotine pouch use. Multivariable regressions examined sociodemographics, adverse childhood events (ACEs), mental health, and personality characteristics in relation to class. RESULTS: Five classes were identified: (#1) "primarily cannabis" (36.6%): all used cannabis (74.0% infrequent), <14% tobacco products; (#2) "frequent cannabis-cigarette" (34.2%): 86.7% cannabis (82.9% frequent), 65.9% cigarettes (51.6% frequent), 59.4% e-cigarettes (33.6% frequent), <37% other tobacco; (#3) "product-dabbling" (16.0%): 79.8% cannabis, 71.8% cigarettes, 66.7% e-cigarettes (largely infrequently used each), <40% other tobacco; (#4) "frequent poly-product" (7.7%): 93.9% cannabis, 90.9% cigarettes, 98.2% e-cigarettes (~half frequently used each), >84% other tobacco; and (#5) "primarily e-cigarette" (5.5%): all used e-cigarettes (51.0% frequent), <9% other tobacco. Correlates of class #4 membership were: being Black (vs. White) and more mental health symptoms vs. other classes; being Hispanic vs. #2 and #5; being heterosexual (vs. other) vs. classes #1-#3; being older and male and higher extraversion vs. #1 and #5; in non-legalized states vs. #1; more ACEs vs. #1, #3, and #5; and higher neuroticism and less openness vs. #1-#2. CONCLUSIONS: The frequent poly-product class represented characteristics (e.g., race/ethnicity, sexual minority, mental health) implicated in substance use related disparities, underscoring the need for targeted intervention.

APA 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.; and Berg, Carla J., "Cannabis and Tobacco Product Use Classes and Psychosocial Correlates among US Young Adults" (2025). GW Authored Works. Paper 8064.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8064

Department

Prevention and Community Health