Tobacco and cannabis co-use by route of administration in the United States, 2022/2023.

Given recent increases in cannabis and tobacco co-use, alongside the rapidly evolving cannabis and tobacco use landscapes in the United States (US), updated national estimates of current co-use that account for route of administration are needed. Using data from Wave 7 (2022/2023) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study (N = 39,947), this study estimates the prevalence of current co-use among US youth and adults aged 12 years and older and examines the specific routes (e.g., combustible, vaping, oral) through which individuals co-use both substances. Data were weighted to produce representative estimates. An estimated 8.2 % of US youth and adults reported current (past 30-day) co-use between 2022 and 2023. Co-use of combustible tobacco and combustible cannabis products was the most common form of co-use, accounting for nearly one third of all co-using individuals. Co-use involving combustible tobacco and combustible cannabis was most common among co-using individuals aged 25-39 and 40+, while co-use involving nicotine vaping was most common among those aged 12-24. Use of multiple tobacco and/or cannabis administration routes was also common. These findings provide the first nationally representative estimates of co-use that account for specific administration routes for both tobacco and cannabis. Findings highlight the need for surveillance and intervention strategies that account for the full range of tobacco and cannabis administration routes available today.