ASHES, Vol. 17(6) – Prevalence and correlates of daily blunt use among a national U.S. sample


Smoking blunts (i.e., hollowed out cigars or cigarillos filled with marijuana) presents serious health risks, including exposure to carcinogens and carbon monoxide and nicotine and marijuana dependence. People who smoke blunts everyday are especially vulnerable to dependence and could benefit from interventions to help them quit or at least smoke less frequently. Learning more about the characteristics of people who tend to smoke blunts everyday is essential for developing tailored and culturally appropriate interventions. Therefore, a group of researchers led by Dale Mantey examined the characteristics of daily blunt users among a nationally representative sample. We review their study here.

What were the research questions?
Among those who smoke blunts, how prevalent is daily blunt use? Do socio-demographic characteristics, health risk behaviors, and exposure to medical marijuana laws distinguish daily blunt smokers from those who smoke blunts less often?

What did the researchers do?
The researchers used 5 years (2014–2018) of cross-sectional data collected from the (U.S.) National Survey on Drug Use and Health, a representative community survey. They included data from people who were at least 18 and reported any blunt use in the past 30 days. In addition, they only included data from people who identified as non-Hispanic White, non-Hispanic African American, or Hispanic/Latino (regardless of identified race).1 Their final sample included 10,826 people (5,781 non-Hispanic White, 2,992 non-Hispanic African American, and 2,053 Hispanic/Latino). Using logistic regression, they explored how participants who reported daily blunt use differed from those who used blunts less often.

What did they find?
Across the whole sample, 15.3% of adult blunt users reported that they smoked blunts everyday. With regard to socio-demographic predictors, the researchers found that non-Hispanic African Americans and Hispanic/Latinos were more likely to be daily blunt users, relative to non-Hispanic Whites. Additionally, people between the ages of 26 and 34 were more likely to report daily blunt use than those between 18 and 25. Education was inversely associated with daily blunt use; those without a high school diploma or GED were about 2.5 times more likely than college graduates to smoke blunts daily. In terms of health risk behaviors, cigarette smokers were more likely to be daily blunt users, but those who reported binge drinking or heavy drinking were less likely to be daily blunt users than those who didn’t drink alcohol. Finally, those who lived in states with legal medical marijuana were about 16% more likely to be daily blunt users (see Figure).

June 1 ASHES figure
Figure. Odds ratios indicating characteristics that distinguished daily blunt smokers from non-daily blunt smokers in the U.S. National Survey on Drug Use and Health. Adapted from Mantey et al. (2021). Two additional education attainment categories — (1) high school diploma/GED and (2) some college — showed the same pattern as less than high school, though to a lesser extent. Click image to enlarge.

Why do these findings matter?
This study documented that daily blunt use, a behavior associated with severe health risks, is prevalent among blunt users. Understanding, preventing, and treating daily blunt use should be public health priorities. These efforts should be concentrated on those most at risk, particularly Black and Hispanic/Latino adults in early adulthood with low educational attainment, and those who smoke cigarettes. Interventions that overcome traditional barriers to substance use treatment, including stigma, mistrust of the medical system, lack of health care coverage, lower socioeconomic status, and the absence of culturally informed treatment options are essential. For instance, one promising new study showed that it is feasible to deliver a computer-based cognitive and behavioral skills therapy within a Black church for Black adults experiencing substance use disorders.

Every study has limitations. What are the limitations of this study?
This study documented higher prevalence of daily blunt use among Black and Hispanic/Latino people, but more research is needed to understand the precipitating factors that contribute to daily blunt use. These factors might include life stress and isolation resulting from racism and economic deprivation and barriers to high-quality health care services.

For more information:
SMART Recovery offers tips for local meetings, online support groups, and online tips and other resources for people thinking about quitting or cutting back on their marijuana use. For more details about addiction, visit our Addiction Resources page.

— Heather Gray, PhD

What do you think? Please use the comment link below to provide feedback on this article.


[1] Mantey and colleagues omitted people from other racial/ethnic groups (e.g., Native American, Asian American) because there were not enough people in the sample to generate reliable estimates for these groups on their own and they did not wish to collapse them into a single “other” category.

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