Longitudinal transitions between combustible, non-combustible, and poly-cannabis product use from adolescence to young adulthood and intersections with nicotine use

Am J Epidemiol. 2023 Nov 17:kwad230. doi: 10.1093/aje/kwad230. Online ahead of print.


Understanding transitions across cannabis product use and poly use and how they intersect with nicotine use in young people can inform etiology and prevention. This study examined transitions across combustible and non-combustible form of cannabis use and poly-use from adolescence to young adulthood and the role of nicotine use in transitions. In a longitudinal cohort from Southern California (n=3,298; baseline mean[SD] age=16.1[0.4] years) with nine semi-annual survey waves (2015-2021), Markov multistate transition modeling estimated short (two-wave) and long-term (nine-wave) transition probabilities across five cannabis states: never use of any product, prior use with no past 6-month (P6M) use of any product, and P6M exclusive non-combustible, P6M exclusive combustible, and P6M poly product (non-combustible+combustible) use. Sizable transition probabilities from prior and exclusive P6M non-combustible or combustible cannabis use to P6M poly cannabis product use were observed in short (10.7%-38.9%) and long-term (43.4%-43.8%) analyses. P6M nicotine use increased risk of transitioning from never and prior use to exclusive P6M non-combustible and combustible cannabis use. Cannabis use in any form, even temporary use, during mid-adolescence may often be followed by poly cannabis product use. Nicotine use may amplify probability of future cannabis use onset or recurrence.

PMID:37981712 | DOI:10.1093/aje/kwad230