Cannabis vaping linked to increased use of other substances, study finds

By Dr. Chinta SidharthanReviewed by Susha Cheriyedath, M.Sc.Nov 26 2023

In a recent short communication published in the journal Addictive Behaviors Reports, researchers explored associations between cannabis vaping and the use of other substances. They examined if the association differed between cannabis vape users and cannabis users who did not vape.

Short Communication: The association between cannabis vaping and other substance use. Image Credit: Daisy Daisy / Shutterstock

Background

Although smoking continues to be the most prevalent form of cannabis use, with the increase in popularity of vapes, the use of cannabis vapes has increased significantly, especially among adolescents. Statistics indicate that the incidence of cannabis vaping has almost doubled among adolescents between 2017 and 2020. Surveys from 2022 show that close to 15% of the students in twelfth grade report using cannabis vapes in the past month, and the proportion of adults who use cannabis vapes has also increased in the past few years.

Vaping is the process of heating a liquid mixture containing a substance, such as nicotine or cannabis, to the point that it turns into an aerosolized vapor that can then be inhaled. Compared to smoking tobacco cigarettes or cannabis substances, vaping is perceived to be safer due to the absence of combustion-associated toxins.

Additionally, the potentially greater pharmacodynamic effects and ability to vape discretely in public add to the popularity of cannabis vaping. However, while it can be assumed that individuals who vape nicotine might naturally indulge in cannabis vaping due to their familiarity with the process, it is not clear whether cannabis vaping also increases the use of other substances.

About the study

In the present study, the researchers examined the association between cannabis vaping and the use of other substances by evaluating three potential causes for such an association. They first examined whether familiarity with vaping devices through cannabis vaping increases the tendency to use other substances.

The second potential explanation addresses the perceptions of lower health risks associated with vaping, which would imply that these individuals would be less likely to indulge in the use of other substances that could be harmful. The third potential explanation is based on the higher pharmacodynamic effects of cannabis vaping, which implies an increased use of other substances to further these effects. For the study, the researchers analyzed data from a study called Population Assessment of Tobacco and Health or PATH that surveyed tobacco use among youths and adults in a nationally representative sample set.

The self-reported use of cannabis vapes in the past year was determined using two questions about the use of electronic nicotine products and marijuana waxes, concentrates, marijuana, hash oil, or tetrahydrocannabinol (THC) in an electronic nicotine product. Individuals who answered affirmatively to both questions were considered cannabis vapers, while those individuals who used cannabis in other forms, such as eating or smoking, were categorized as non-vaping cannabis users.

Seven categories were explored for analyzing the use of other substances associated with cannabis vaping, such as the use of cigars, cigarettes, alcohol, electronic(e)-cigarettes, other tobacco products, illicit drugs, and misuse of prescription drugs. Sociodemographic characteristics such as sex, age, ethnicity and race, education levels, and household income, as well as some psychosocial variables, were considered during the analysis.

Results

The results indicated that one-third of the individuals who reported using cannabis in the past year used cannabis vapes, and the sociodemographic analysis showed that cannabis vapers were more educated, younger, and generally not of non-Hispanic black ethnicity, as compared to cannabis users who did not vape. Self-perceptions of good mental health were also lower among cannabis vapers.

Individuals who used cannabis vapes also showed a higher prevalence of using other substances such as alcohol, cigars, cigarettes, illicit drugs, e-cigarettes, and other tobacco products, as well as the tendency to misuse prescription drugs. While the prevalence of alcohol consumption was not substantially different between cannabis users who vaped and those who did not vape, the prevalence of other substance use such as cigars, illicit drugs, and other tobacco products, and misuse of prescription drugs varied significantly between cannabis vapers and individuals who consumed cannabis through other modes such as smoking or eating.

Furthermore, the prevalence of cannabis vaping was highest among adolescents between the ages of 12 and 17 years and was found to decrease with age. Among individuals between the ages of 25 and 34, cannabis vapers constituted approximately 35%, while only 8.5% of cannabis users above the age of 65 reported using cannabis vapes.

Conclusions

Overall, the findings suggested that cannabis vaping was associated with the use of other substances such as alcohol, cigars, cigarettes, other tobacco products, illicit drugs, and prescription drug misuse. The use of cannabis vapes was also higher among youths and adolescents and was observed to decrease with increasing age.