Cannabis and Tobacco Product Use Classes and Psychosocial Correlates among US Young Adults

Introduction This study examined US young adults’ cannabis-tobacco use classes. Methods Latent class analysis used 2023 data among young adults (ages 18-34, purposively recruited via Facebook to represent ~50% past-month cannabis use), specifically the 2267 reporting past-month cannabis and/or tobacco use. Indicators included: cannabis, cigarette, and e-cigarette use (0 days, infrequent [1-10], frequent [11-30]) and any cigar, hookah, smokeless tobacco, and nicotine pouch use. Multivariable regressions examined sociodemographics, adverse childhood events (ACEs), mental health, and personality characteristics in relation to class. Results Five classes were identified: (#1) “primarily cannabis” (36.6%): all used cannabis (74.0% infrequent), <14% tobacco products; (#2) “frequent cannabis-cigarette” (34.2%): 86.7% cannabis (82.9% frequent), 65.9% cigarettes (51.6% frequent), 59.4% e-cigarettes (33.6% frequent), <37% other tobacco; (#3) “product-dabbling” (16.0%): 79.8% cannabis, 71.8% cigarettes, 66.7% e-cigarettes (largely infrequently used each), <40% other tobacco; (#4) “frequent poly-product” (7.7%): 93.9% cannabis, 90.9% cigarettes, 98.2% e-cigarettes (~half frequently used each), >84% other tobacco; and (#5) “primarily e-cigarette” (5.5%): all used e-cigarettes (51.0% frequent), <9% other tobacco. Correlates of class #4 membership were: being Black (vs. White) and more mental health symptoms vs. other classes; being Hispanic vs. #2 and #5; being heterosexual (vs. other) vs. classes #1-#3; being older and male and higher extraversion vs. #1 and #5; in non-legalized states vs. #1; more ACEs vs. #1, #3, and #5; and higher neuroticism and less openness vs. #1-#2. Conclusions The frequent poly-product class represented characteristics (e.g., race/ethnicity, sexual minority, mental health) implicated in substance use related disparities, underscoring the need for targeted intervention.