Marijuana Vaping in U.S. Adults: Evidence From the Behavioral Risk Factor Surveillance System

As of February 18, 2020, states have reported 2,807 cases of e-cigarette, or vaping, product use-associated lung injury to the Centers for Disease Control and Prevention. Most cases involved cannabinoids. This study identifies current risk factors for adult marijuana vaping by analyzing 2017 and 2018 Behavioral Risk Factor Surveillance System data.

Data on 8,255 people who recently used marijuana were analyzed in September 2019. Sample-weighted multivariate logistic regressions considered a binary indicator for vaping as the primary method of marijuana use. Adjusting for demographic controls, regressions assessed the association between marijuana vaping and marijuana use for medical purposes (versus nonmedical only), current conventional cigarette use, current nicotine e-cigarette use, and 2 mental health variables. Demographic controls were binary indicators for female sex, Hispanic ethnicity, race, and having completed ≥1 year of college.

Odds of marijuana vaping were higher among those who reported using for medical purposes (AOR_{age18-24years}=3.8, 95% CI=1.91, 7.67; AOR_{age25-54years}=1.8, 95% CI=1.02, 3.08; AOR_{age55-64years}=2.3, 95% CI=0.75, 7.07) and lower among people who smoked combustible cigarettes (AOR_{age18-24years}=0.2, 95% CI=0.06, 0.65; AOR_{age25-54years}=0.2, 95% CI=0.10, 0.26; AOR_{age55-64years}=0.1, 95% CI=0.05, 0.34). Vaping nicotine e-cigarettes was associated with greater odds of vaping marijuana for adults aged 25-54 years (AOR=4.6, 95% CI=2.70, 7.78) but not those aged 18-24 years (AOR=0.9, 95% CI=0.33, 2.26).

Among people who use marijuana, adults reporting medical marijuana use were more likely to vape as their primary mode of consumption, whereas conventional cigarette smokers were less likely to do so. Use of nicotine e-cigarettes was associated with a greater likelihood of vaping marijuana for adults aged 25-54 years.