Past-Month Tobacco and Cannabis Co-Use by Chronic Disease and Sociodemographic Factors Among U.S. Adults 65+ Years (2021-2023)

Background Tobacco and cannabis co-use prevalence is rising, with older adults disproportionately impacted. Objective Assess tobacco and cannabis co-use by health and sociodemographic characteristics among adults 65+ years. Methods Using National Survey on Drug Use and Health nationally representative data (2021-2023), we estimated past-month tobacco and cannabis co-use prevalence among adults 65+ years ( N = 15,672). Multinomial logistic regressions examined associations between health and sociodemographic characteristics with past-month co-use, tobacco-only use, and cannabis-only use (vs. former use). Results One in six reported past-month use of either cannabis or tobacco (1.7% co-used). More chronic disease diagnoses was associated with lower co-use (e.g., one vs. none: adjusted relative risk ratio [aRRR] = 0.47). Co-use was higher among people with worse self-rated health (e.g., fair/poor vs. excellent/very good: aRRR = 2.73) and past-year mental illness (aRRR = 2.07). Conclusions Clinicians working with older adults should account for cannabis co-use in tobacco cessation and disseminate evidence-based cannabis information.