The Association Between Sociodemographic Factors and co-Use of Cigars or Cigarillos with Cannabis

Background: Cigar/cigarillo smoking and cannabis use frequently co-occur, reflecting overlapping patterns of substance use and shared risk factors. However, little is known about how co-use of cigars/cigarillos and cannabis is associated with sociodemographic factors, as well as preferences for cannabis forms and spending patterns among co-users. Methods: We analyzed data from the second wave of a national longitudinal survey of U.S. adults who reported recreational cannabis use in January 2025 (N = 1,524). The survey included detailed information on past-30-day cigar/cigarillo use, enabling comparisons between cannabis-cigar/cigarillo co-users and cannabis-only users. We compare these two groups by applying logistic regression to examine sociodemographic correlates and product-specific cannabis preferences, and OLS regression to evaluate differences in total cannabis spending. Results: Overall, 8.26% of recreational cannabis adult users also smoke cigars/cigarillos. Compared with White, non-Hispanic cannabis users, Black, non-Hispanic users are five times (p < 0.001) more likely to smoke cigars/cigarillos. Compared with cannabis users with less than high school education, those with some college or a bachelor's degree are less likely to smoke cigars/cigarillos. Cigar/cigarillo smoking among cannabis users is associated with higher use of flowers (OR = 2.16, p < 0.05) and pre-rolls (OR = 2.05, p < 0.01). Cannabis-cigar/cigarillo co-users report significantly $72 higher monthly cannabis expenditures than cannabis-only users. Conclusions: Adult cannabis users who are Black, non-Hispanic and have less than an associate degree are more likely to smoke cigars/cigarillos. Cannabis-cigar/cigarillo co-users are more likely to consume smoking forms of cannabis such as flowers and to spend more on cannabis, suggesting possible increased risks of harm and addiction associated with co-use.