Marijuana and E-cigarette Initiation Among Adolescents: A Survival Analysis

Area of Science:

• Adolescent Health
• Substance Use Research
• Public Health

Background:

• Adolescent initiation of marijuana and e-cigarettes is increasing, surpassing combustible cigarette use.
• Co-use of marijuana and nicotine products is a growing public health concern.
• Understanding initiation trajectories and product-specific impacts is crucial.

Purpose of the Study:

• To investigate the initiation trajectories of marijuana and e-cigarette use among adolescents.
• To examine how initiation of one product influences susceptibility to initiating the other.
• To analyze the relationship between prior substance use and subsequent initiation.

Main Methods:

• Utilized longitudinal data from the Population Assessment of Tobacco and Health (PATH) study (2013-2018).
• Analyzed data from 2,270 eighth graders, tracking initiation between Waves 2 and 5.
• Employed discrete-time survival analyses to model initiation likelihood and relationships between product uses.

Main Results:

• Previous marijuana initiation strongly predicted later e-cigarette initiation (OR = 6.88).
• Previous e-cigarette initiation strongly predicted later marijuana initiation (OR = 9.28).
• By Wave 5, over 42% of adolescents initiated both marijuana and e-cigarettes.

Conclusions:

• Susceptibility to marijuana and e-cigarette use begins in eighth grade and escalates.
• Initiation of one substance significantly increases the likelihood of initiating the other.
• Interventions should consider marijuana and nicotine as interconnected concerns, not separate issues.