Marijuana use and subsequent cigarette use among U.S. adolescents: A longitudinal study

The extant literature on the relationship between marijuana and tobacco among youth is mixed. The present study examined the temporal association of marijuana use with subsequent cigarette use in a nationally representative sample of U.S. adolescents.

We used data from Waves 1, 2 and 3 of the Population Assessment of Tobacco and Health. A propensity score method was used to address imbalance between marijuana ever and non-ever users. Logistic regressions were used to examine the temporal associations of marijuana ever use at Wave 1 on cigarette use at Waves 2 and 3 among youth that were classified as never cigarette users at Wave 1.

Among the 422 youth marijuana ever users at Wave 1, 15.5% reported subsequent past 12-month (P12M) cigarette use and 8.2% reported subsequent past 30-day (P30D) cigarette use at Wave 2. Of the 7924 youth never marijuana users at Wave 1, 3.5% reported P12M cigarette use and 1.4% reported P30D cigarette use. Youth marijuana ever users at Wave 1 were more likely to report P12M cigarette use (aOR = 5.11; 95% CI 2.91-8.95) and P30D cigarette use (aOR = 6.14; 95% CI 2.89-13.04) at Wave 2.

Our findings suggest that youth marijuana ever users were more likely to report subsequent P12M cigarette use and P30D cigarette use. Given the known health effects related to both products, findings suggest there is a need for continued monitoring of both marijuana and cigarette use among adolescents, especially in a rapidly changing regulatory environment.