Cannabis use and progression to regular tobacco use among United States youth and young adults: evidence from the Population Assessment of Tobacco and Health (PATH) study, 2017-2021.

IF 4.7 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Tobacco Control Pub Date : 2025-10-23 DOI:10.1136/tc-2025-059634

Jiayu Chen, Karen Messer, John P Pierce, David R Strong, Natalie E Quach, Yuyan Shi, Sara B McMenamin, Thet Nm Khin, Matthew D Stone, Dennis R Trinidad

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引用次数: 0

Abstract

Background: Tobacco use among United States (US) youth and young adults has declined from historic levels, but cannabis use has not. The importance of cannabis use as a risk factor for tobacco initiation is not known.

Methods: The association between past 12-month cannabis use in 2017 (study exposure; wave 4) and new-onset regular tobacco use in 2021 (study outcome; wave 6) was examined in a prospective representative US cohort aged 12-24 years who had never regularly used tobacco. Exposed respondents were propensity score matched to unexposed controls on demographics, tobacco use history, perceived harmfulness of cigarettes, mental health symptoms and other measures.

Results: Among these US youths aged 12-17 years who used cannabis, 32.7% (95% CI: 28.9% to 36.7%) progressed to regular tobacco use in 2021, an increase of 15.6 percentage points (pp) (95% CI: 11.1 pp to 20.2 pp) compared with their matched controls. Among the young adults aged 18-24 years, 14.0% (95% CI: 11.9% to 16.5%) of cannabis users reported regular tobacco use at follow-up, an increase of 5.4 pp (95% CI: 2.6 pp to 8.2 pp) over their matched controls. The matching analysis attributed 13.0% of total new regular tobacco use in the US to cannabis (the population attributable fraction), and estimated that in the absence of cannabis, 509 800 fewer US youth and young adults would have progressed to regular tobacco use in 2021.

Conclusion: Among US youth and young adults who had never regularly used tobacco, cannabis use in 2017 was associated with a large increase in current regular tobacco use in 2021.

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美国青年和青年会使用大麻并向经常使用烟草发展：来自2017-2021年烟草与健康人口评估（PATH）研究的证据。

背景：美国青年和青壮年的烟草使用已从历史水平下降，但大麻使用没有下降。大麻使用作为开始吸烟的一个危险因素的重要性尚不清楚。方法：在一个12-24岁从未经常使用烟草的前瞻性美国代表性队列中，研究了2017年过去12个月的大麻使用（研究暴露；第4波）与2021年新发病的常规烟草使用（研究结果；第6波）之间的关系。在人口统计学、烟草使用史、感知到的香烟危害、心理健康症状和其他措施上，暴露的受访者的倾向得分与未暴露的对照组相匹配。结果：在这些使用大麻的12-17岁美国青少年中，32.7% （95% CI: 28.9%至36.7%）在2021年发展为经常使用烟草，与匹配的对照组相比增加了15.6个百分点（pp）（95% CI: 11.1至20.2 pp）。在18-24岁的年轻人中，14.0%（95%可信区间：11.9%至16.5%）的大麻使用者在随访时报告经常使用烟草，比匹配的对照组增加了5.4个百分点（95%可信区间：2.6至8.2个百分点）。匹配分析将美国新增常规烟草使用总量的13.0%归因于大麻（人口归因比例），并估计在没有大麻的情况下，2021年美国青年和年轻人转为常规烟草使用的人数将减少509 800人。结论：在从未经常使用烟草的美国青年和年轻人中，2017年的大麻使用与2021年当前常规烟草使用的大幅增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tobacco Control 医学-公共卫生、环境卫生与职业卫生

CiteScore

9.10

自引率

26.90%

发文量

223

审稿时长

6-12 weeks

期刊介绍： Tobacco Control is an international peer-reviewed journal covering the nature and consequences of tobacco use worldwide; tobacco''s effects on population health, the economy, the environment, and society; efforts to prevent and control the global tobacco epidemic through population-level education and policy changes; the ethical dimensions of tobacco control policies; and the activities of the tobacco industry and its allies.