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Using an intersectional framework to explore cannabis and tobacco co-use patterns: Protocol for a descriptive study.

Bethany Shorey Fennell1,2, Cherell Cottrell-Daniels3, Kory Heier4

  • 1Department of Family & Community Medicine, College of Medicine, University of Kentucky, 2195 Harrodsburg Road, Lexington, KY, USA 40502.

Methodsx
|September 11, 2025
PubMed
Summary

Cannabis and tobacco co-use is common among U.S. adults, varying by product type and demographics. Understanding these patterns is crucial for developing effective cessation strategies for both substances.

Keywords:
Cannabis and tobacco co-useCannabis useSubstance useTobacco use

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Area of Science:

  • Public Health
  • Addiction Science
  • Behavioral Science

Background:

  • Cannabis and tobacco co-use presents a significant public health challenge, associated with higher dependence and lower success rates for quitting both substances.
  • Limited research exists on how co-use patterns differ based on product type, user motivations, and demographic factors.

Purpose of the Study:

  • To characterize the frequency, type, and context of cannabis and tobacco co-use among U.S. adult tobacco users.
  • To utilize an intersectional framework to examine co-use patterns across diverse populations.
  • To inform the development of targeted cessation interventions for co-using populations.

Main Methods:

  • Cross-sectional study protocol involving a national sample of 3,777 U.S. adults who used tobacco in the past 30 days.
  • Data collection via CloudResearch Prime Panels, including detailed measures of tobacco and cannabis use, co-use behaviors, motivations, expectancies, health behaviors, and sociodemographics.
  • Stratified sampling to ensure representation across geographic regions, racial/ethnic groups, and socioeconomic strata, with robust data validation protocols.

Main Results:

  • Analysis of nuanced patterns in tobacco use, cannabis use, and co-use across various product types.
  • Examination of co-use behaviors in relation to sociodemographic and psychosocial factors.
  • Identification of specific populations disproportionately affected by co-use patterns.

Conclusions:

  • Findings will guide the creation of tailored public health messaging and cessation interventions for cannabis and tobacco co-users.
  • Addressing co-use is essential for improving cessation success rates and mitigating associated health risks.
  • The study highlights the need for interventions that consider the complex interplay of substance use, motivations, and demographics.