Cannabis and tobacco use and co-use: Trajectories and correlates from early adolescence to emerging adulthood.

BACKGROUND

Cannabis and tobacco co-use is a growing concern, yet little is known about its developmental course or associated outcomes during emerging adulthood. This study examines developmental trajectories of cannabis and tobacco co-use from adolescence to emerging adulthood, associations of co-use trajectories with four domains of functioning, and differences across racial/ethnic groups.

METHODS

Survey data come from a racially/ethnically diverse and predominantly California-based cohort that completed 10 surveys from 2008 (wave 1: mean age 11.5; n = 6,509) to 2018 (wave 10: mean age 20.7; n = 2,429). Co-use was defined as use of both cannabis and tobacco (cigarettes or smokeless tobacco) in the past 30 days. Trajectories of use were examined using latent growth modeling in a structural equation modeling framework.

RESULTS

Prevalence of cannabis and tobacco co-use increased from 0.3% at wave 1 to 9.5% at wave 10, with average probabilities of co-use higher among non-Hispanic white versus Hispanic or Asian participants. Higher average probability of co-use was associated with greater delinquency, more mental health symptoms, and poorer physical health during emerging adulthood. Higher rate of change in the probability of co-use over time was associated with greater delinquency, but better social functioning and less physical ailments. There was some evidence of racial/ethnic disparities in functioning, even at similar levels of co-use.

CONCLUSIONS

Cannabis and tobacco co-use deserves greater attention, especially regarding its effects on functioning during emerging adulthood. Results also emphasize the need for future research to focus on racial/ethnic disparities related to co-use and associated outcomes.