Adolescents who use e-cigarettes, tobacco cigarettes, or both (dual users) are more likely than non-users to report misusing prescription drugs, alcohol, and marijuana. Â Using substances during this developmental time period is related to altered brain development, leading to developmental issues such as poor decision making and emotional regulation problems. This week, ASHES reviews a study by Sunday Azagba that explores e-cigarette, cigarette, and marijuana use among Canadian high school students.
What is the research question?
How is e-cigarette and cigarette use related to past-30-day frequency of marijuana use among high school students?
What did the researchers do?
The researchers conducted an analysis of cross sectional data reported in the 2014-2015 Canadian Student Tobacco, Alcohol and Drugs Survey. They assessed the responses of 23,429 Canadian students grades 9 through 12 about past-30-day marijuana, e-cigarette, and cigarette use. Â Participants reported the frequency with which they used marijuana in the past-30-days. Participants then responded to two questions about using e-cigarettes and cigarettes at least once in the past-30-days. The researchers used logistic regression analyses to assess whether e-cigarettes, tobacco, or dual use predicted patterns of past-30-day of marijuana use.
What did they find?
Dual users had the highest odds of reporting any past-month marijuana use, compared to non-users, e-cigarette users only, and cigarette users only. Â Dual users were the most likely to report all patterns of past-month marijuana use and were especially at high risk for using marijuana daily during the past month. (See Figure 1.)
Figure. Odds of reporting a specific pattern of past-month marijuana use among students reporting using e-cigarettes, cigarettes, or both compared to non-users.  All numbers represent significant odds ratios. Click image to enlarge.
Why do these findings matter?
Asking kids whether they’re using e-cigarettes (alone in combination with traditional cigarettes) might help identify which ones are at especially high risk for later substance use. Â
Every study has limitations. What were the limitations in this study?
The researchers did not measure which method students used to consume cannabis-based products, such as eating, smoking, or vaping. Â Method of consumption might be associated with different tobacco and e-cigarette use patterns.
For more information:
SmokeFree offers tools and tips quitting and maintaining abstinence from smoking tobacco. American Academy of Child & Adolescent Psychiatry offers parents information, tips, and tools about adolescent marijuana use behaviors. For additional tools, please visit the BASIS Addiction Resources page.
— Pat Williams
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