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
{"title":"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。","authors":"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","doi":"10.1136/tc-2025-059634","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"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\",\"doi\":\"10.1136/tc-2025-059634\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":23145,\"journal\":{\"name\":\"Tobacco Control\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-10-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tobacco Control\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/tc-2025-059634\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tobacco Control","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/tc-2025-059634","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
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.
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.
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.
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