Adolescent Simultaneous Use of Alcohol and Marijuana by Trends in Cigarette and Nicotine Vaping from 2000 to 2020

Overview

Journal Drug Alcohol Depend

Publisher Elsevier

Specialty Psychiatry

Date 2023 Jun 4

PMID 37270934

Authors

Katherine M Keyes

Victoria Joseph

Navdep Kaur

Noah T Kreski

Qixuan Chen

Silvia S Martins

Deborah Hasin

Mark Olfson

Pia M Mauro

Affiliations

Soon will be listed here.

Abstract

Background: Simultaneous alcohol and marijuana (SAM) use is associated with adverse consequences for youth. While SAM use is overall declining among youth, prior studies indicate increasing marijuana use among US adolescents who ever used cigarettes, suggesting possible moderation of the alcohol-marijuana relationship by cigarette use.

Methods: We included 43,845 12-th grade students participating in Monitoring the Future data (2000-2020). A 5-level alcohol/marijuana measure was used, including past-year SAM, alcohol-only, marijuana-only, non-simultaneous alcohol and marijuana, or no use. Multinomial logistic regressions estimated associations between time periods (categorized based on sample size: 2000-2005, 2006-2009, 2010-2014, 2015-2020) and the 5-level alcohol/marijuana measure. Models adjusted for sex, race, parental education and survey mode and included interactions of time periods and lifetime cigarette or vaped nicotine use.

Results: While overall SAM among 12th graders decreased from 23.65% to 18.31% between 2000 and 2020, SAM increased among students who never used cigarettes or vaped nicotine (from 5.42% to 7.03%). Among students who ever used cigarettes or vaped nicotine, SAM increased from 39.2% in 2000-2005-44.1% in 2010-2014 then declined to 37.8% in 2015-2020. Adjusted models controlling for demographics indicated that among students with no lifetime cigarette or vaped nicotine use, students in 2015-2020 had 1.40 (95% C.I. 1.15-1.71) times the odds of SAM, and 5.43 (95% C.I. 3.63-8.12) times the odds of marijuana-only (i.e., no alcohol use) compared to students who used neither in 2000-2005. Alcohol-only declined over time in both students who ever and never used cigarettes or nicotine vape products.

Conclusion: Paradoxically, while SAM declined in the overall adolescent US population, the prevalence of SAM increased among students who have never smoked cigarettes or vaped nicotine. This effect arises because of a substantial decline in the prevalence of cigarette smoking; smoking is a risk factor for SAM, and fewer students smoke. Increases in vaping are offsetting these changes, however. Preventing adolescent use of cigarettes and nicotine vaped products could have extended benefits for other substance use, including SAM.

References

Gfroerer J, Wright D, Kopstein A . Prevalence of youth substance use: the impact of methodological differences between two national surveys. Drug Alcohol Depend. 1997; 47(1):19-30. DOI: 10.1016/s0376-8716(97)00063-x. View

Arrazola R, Singh T, Corey C, Husten C, Neff L, Apelberg B . Tobacco use among middle and high school students - United States, 2011-2014. MMWR Morb Mortal Wkly Rep. 2015; 64(14):381-5. PMC: 5779546. View

Sun R, Mendez D, Warner K . Trends in Nicotine Product Use Among US Adolescents, 1999-2020. JAMA Netw Open. 2021; 4(8):e2118788. PMC: 8387850. DOI: 10.1001/jamanetworkopen.2021.18788. View

Terry-McElrath Y, OMalley P, Johnston L . Simultaneous alcohol and marijuana use among U.S. high school seniors from 1976 to 2011: trends, reasons, and situations. Drug Alcohol Depend. 2013; 133(1):71-9. PMC: 3786028. DOI: 10.1016/j.drugalcdep.2013.05.031. View

Silveira M, Conway K, Green V, Kasza K, Sargent J, Borek N . Longitudinal associations between youth tobacco and substance use in waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) Study. Drug Alcohol Depend. 2018; 191:25-36. PMC: 6239207. DOI: 10.1016/j.drugalcdep.2018.06.018. View

Van Etten M, Anthony J . Comparative epidemiology of initial drug opportunities and transitions to first use: marijuana, cocaine, hallucinogens and heroin. Drug Alcohol Depend. 1999; 54(2):117-25. DOI: 10.1016/s0376-8716(98)00151-3. View

Graham A, Jacobs M, Amato M . Engagement and 3-Month Outcomes From a Digital E-Cigarette Cessation Program in a Cohort of 27 000 Teens and Young Adults. Nicotine Tob Res. 2019; 22(5):859-860. PMC: 7171276. DOI: 10.1093/ntr/ntz097. View

Levy N, Mauro P, Mauro C, Segura L, Martins S . Joint perceptions of the risk and availability of Cannabis in the United States, 2002-2018. Drug Alcohol Depend. 2021; 226:108873. PMC: 8478130. DOI: 10.1016/j.drugalcdep.2021.108873. View

Keyes K, Kaur N, Kreski N, Chen Q, Martins S, Hasin D . Temporal trends in alcohol, cannabis, and simultaneous use among 12th-grade U.S. adolescents from 2000 to 2020: Differences by sex, parental education, and race and ethnicity. Alcohol Clin Exp Res. 2022; 46(9):1677-1686. PMC: 9635013. DOI: 10.1111/acer.14914. View

10.

Purcell J, Orihuela C, Elliott M, Tortolero Emery S, Schuster M, Mrug S . Examining Sex and Racial/Ethnic Differences in Co-use of Alcohol, Cannabis, and Cigarettes in a Community Sample of Adolescents. Subst Use Misuse. 2020; 56(1):101-110. PMC: 11619460. DOI: 10.1080/10826084.2020.1843056. View

11.

Miech R, Keyes K, OMalley P, Johnston L . The great decline in adolescent cigarette smoking since 2000: consequences for drug use among US adolescents. Tob Control. 2020; 29(6):638-643. PMC: 7363524. DOI: 10.1136/tobaccocontrol-2019-055052. View

12.

D Goncalves P, Gutkind S, Segura L, Castaldelli-Maia J, Martins S, Mauro P . Simultaneous Alcohol/Cannabis Use and Driving Under the Influence in the U.S. Am J Prev Med. 2022; 62(5):661-669. PMC: 9038028. DOI: 10.1016/j.amepre.2021.11.009. View

13.

Fielding-Singh P, Epperson A, Prochaska J . Tobacco Product Promotions Remain Ubiquitous and Are Associated with Use and Susceptibility to Use Among Adolescents. Nicotine Tob Res. 2020; 23(2):397-401. PMC: 8269770. DOI: 10.1093/ntr/ntaa136. View

14.

Lee C, Patrick M, Fleming C, Cadigan J, Abdallah D, Fairlie A . A Daily Study Comparing Alcohol-Related Positive and Negative Consequences for Days With Only Alcohol Use Versus Days With Simultaneous Alcohol and Marijuana Use in a Community Sample of Young Adults. Alcohol Clin Exp Res. 2020; 44(3):689-696. PMC: 7306057. DOI: 10.1111/acer.14279. View

15.

Jackson K, Sher K, Schulenberg J . Conjoint developmental trajectories of young adult substance use. Alcohol Clin Exp Res. 2008; 32(5):723-37. PMC: 2705997. DOI: 10.1111/j.1530-0277.2008.00643.x. View

16.

Liu J, Mathur Gaiha S, Halpern-Felsher B . A Breath of Knowledge: Overview of Current Adolescent E-cigarette Prevention and Cessation Programs. Curr Addict Rep. 2020; 7(4):520-532. PMC: 7661014. DOI: 10.1007/s40429-020-00345-5. View

17.

Sarvet A, Wall M, Fink D, Greene E, Le A, Boustead A . Medical marijuana laws and adolescent marijuana use in the United States: a systematic review and meta-analysis. Addiction. 2018; 113(6):1003-1016. PMC: 5942879. DOI: 10.1111/add.14136. View

18.

Hai A, Carey K, Vaughn M, Lee C, Franklin C, Salas-Wright C . Simultaneous alcohol and marijuana use among college students in the United States, 2006-2019. Addict Behav Rep. 2022; 16:100452. PMC: 9465098. DOI: 10.1016/j.abrep.2022.100452. View

19.

Spindle T, Bonn-Miller M, Vandrey R . Changing landscape of cannabis: novel products, formulations, and methods of administration. Curr Opin Psychol. 2019; 30:98-102. PMC: 7041884. DOI: 10.1016/j.copsyc.2019.04.002. View

20.

Patrick M, Kloska D, Terry-McElrath Y, Lee C, OMalley P, Johnston L . Patterns of simultaneous and concurrent alcohol and marijuana use among adolescents. Am J Drug Alcohol Abuse. 2017; 44(4):441-451. PMC: 6027645. DOI: 10.1080/00952990.2017.1402335. View