Patterns and Correlates of Tobacco and Cannabis co-use by Tobacco Product Type: Findings from the Virginia Youth Survey.

BACKGROUND

Cannabis use is more common among tobacco users than nonusers, and co-use (i.e., use of both substances individually) may be increasing. Better understanding of patterns and correlates of co-use is needed. The current study aimed to compare rates and correlates of tobacco and cannabis co-use by tobacco product among youth.

METHODS

High school students who completed the 2013 Virginia Youth Survey and reported past 30-day tobacco use (cigarette, smokeless tobacco, cigar) were included (n = 1390). Prevalence of past 30-day tobacco-only and cannabis co-use was calculated. Demographic, tobacco, and other substance use characteristics were compared by co-use status. Multivariate logistic regression models examined correlates of co-use overall and by tobacco product.

RESULTS

Over half of tobacco users were co-users. Poly-tobacco use, particularly combusted tobacco, was more prevalent among co-users. Past 30-day alcohol use and lifetime other illegal drug use/prescription drug misuse were common correlates of co-use. Black Non-Hispanic (NH) race/ethnicity was associated with co-use when restricted to cigarette users. "Other" race/ethnicity was associated with co-use in the overall model and when restricted to cigar users. Past 30-day cigarette smoking was associated with co-use in all models except among cigar smoking co-users. Conclusions/Importance: Rates and correlates of tobacco and cannabis co-use were not uniform and differed by tobacco product type. Tobacco and cannabis co-users may be at greater risk for negative health effects associated with inhaled tobacco and other risky substance use. The efficacy of prevention efforts may be improved if risk factors associated with product-specific co-use are considered.