Cannabis use modalities are associated with sociodemographic characteristics and patterns of cannabis use among US adults: A latent class analysis.

BACKGROUND

Cannabis consumption modalities such as smoking, vaping, and consumption of edibles differ in pharmacokinetics and potency, and vary by demographic characteristics. Data linking real-world consumption modality patterns to use frequency and cannabis use disorder (CUD) remain limited.

METHODS

Latent class analysis (LCA) was applied to identify modality-based classes using data from 17,732 adults reporting past 30-day cannabis use on the 2022-2023 National Survey on Drug Use and Health. Multinomial logistic regression delineated associations of class membership with demographic characteristics, cannabis use frequency, and the presence/severity of CUD.

RESULTS

LCA yielded four classes based on each modality likelihood: primary smoking (48.2 %), smoking and vaping (20.5 %), mainly edibles (16.9 %), and polymodal use (14.4 %). Compared to adults aged ≥ 50, those aged 18-25 years were more likely to belong to the smoking and vaping (aRRR = 2.52, 95 % CI: 1.77-3.61) or polymodal classes (aRRR = 3.58, 95 % CI: 2.48-5.18). Females were more likely to be in the mainly edibles class (aRRR = 1.78, 95 % CI: 1.48-2.13). Daily cannabis use was more likely among polymodal (aRRR = 2.67, 95 % CI: 2.25-3.17) and less likely among mainly edibles (aRRR = 0.49, 95 % CI: 0.35-0.68) classes, relative to the primary smoking class. Compared to the primary smoking class, risk of having CUD was higher among people in the smoking and vaping class, and in the polymodal class, but lower in the mainly edibles class.

CONCLUSIONS

Cannabis use modalities were associated with differences regarding demographic characteristics and severity of use. Future interventions could account for route-specific use to improve prevention and harm reduction efforts.