A new analysis led by Rebecca Evans-Polce at the University of Michigan, funded by the National Cancer Institute and the National Institutes of Health, used 2022–23 data from 8,722 people aged 12–34 who reported nicotine, tobacco or cannabis use in the past 30 days. On average, participants reported using about two different products in that period.
The researchers identified six distinct subgroups by typical product patterns: combustible tobacco (31%), multiple forms of cannabis (27%), vaping nicotine (18%), multiple forms and co-use of nicotine, tobacco, and cannabis (14%), cannabis edibles (5%), and multiple forms and co-use of nicotine and tobacco (5%). The largest subgroup was combustible tobacco, and several other substantial groups also reported combustible product use; the study notes combustible products are typically the most harmful.
One subgroup used many different nicotine, tobacco and cannabis types. The study warns that multiple-product use raises exposure to carcinogens and toxins and makes quitting more difficult. It also found few overall differences by sex, though combustible tobacco use was higher among males and among Black and African American youth. The authors call for continued surveillance of new product forms, appropriate regulation, and targeted prevention and cessation resources. The research appears in the American Journal of Preventative Medicine.
Difficult words
- analysis — detailed study of information or data
- subgroup — a smaller group within a larger groupsubgroups
- combustible — likely to burn and produce smoke
- co-use — simultaneous use of two or more substances
- carcinogen — a substance that can cause cancer in peoplecarcinogens
- cessation — process of stopping a harmful habit
- surveillance — systematic monitoring to detect changes or problems
- targeted — directed at a specific group or purpose
- edible — food product that contains cannabis or its extractedibles
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What are the possible challenges for public health when many people use multiple tobacco, nicotine, and cannabis products?
- How could targeted prevention and cessation resources help different subgroups identified in the study?
- Why is continued surveillance of new product forms important, and how might regulators respond?
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