E-cigarette use tied to future cannabis use in teens

There is a strong individual-level association between adolescent electronic cigarette use and subsequent cannabis use, according to a study published online July 22 in JAMA Network Open.

Ruoyan Sun, Ph.D., from University of Alabama at Birmingham, and colleagues used data from 9,828 cannabis-naive adolescents participating in both wave 4.5 (2017-2018) and wave 5 (2018-2019) of the Population Assessment of Tobacco and Health study.

The researchers found that e-cigarette use among cannabis-naive adolescents was associated with increased likelihoods of both self-reported past 12-month and past 30-day cannabis use one year later after adjusting for sociodemographic characteristics, environmental factors, other substance use, and sensation seeking. Subsequent past 12-month cannabis use was associated with a higher risk for ever use of e-cigarettes (adjusted relative risk [aRR], 2.57), with past 12-month use of e-cigarettes (aRR, 2.62), and with past 30-day use of e-cigarettes (aRR, 2.18). Findings were similar for subsequent past 30-day cannabis use and ever use of e-cigarettes (aRR, 3.20), past 12-month use of e-cigarettes (aRR, 3.40), and past 30-day use of e-cigarettes (aRR, 2.96).

"Despite the strong association at the individual level, e-cigarette use seems to have had a minimal association with the prevalence of youth cannabis use at the population level," the authors write.

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