A comparison of drug use and dependence between blunt smokers and other cannabis users.

Ethnographic studies have suggested that blunt smokers represent a subculture of cannabis users whose drug use is moderated by social norms. The objective of this study was to compare rates of cannabis dependence/abuse and nicotine dependence between blunt and other cannabis smokers. The sample included adolescents and young adults (n = 4348) who reported some form of past-month cannabis use in the 2004 National Survey on Drug Use and Health. Compared to smokers who never used blunts, blunt smokers had significantly greater odds of being dependent on cannabis and tobacco. Associations with cannabis dependence/abuse remained statistically significant with adjustment for smoking frequency and demographic characteristics. These findings highlight the need for differentiating types of cannabis users in epidemiologic studies. The study's limitations are noted.