Method of Use Matters: Cannabis Product Type and Polysubstance Use Among Adult Cannabis Users

BACKGROUND: Previous research suggests that cannabis users have higher odds of engaging in polysubstance use compared to non-cannabis users. More recent research has also examined cannabis product types and multimodal cannabis use following legalization. However, it remains unclear whether patterns of polysubstance use differ across different cannabis product types and multimodal use. METHODS: This study uses a large, nationally representative sample of adult cannabis users from the 2023 National Survey of Drug Use and Health to examine how eight forms of cannabis use (smoking, vaping, eating/drinking, dabbing, drops/lozenges, topical, pills, other), and a cannabis modality variety scale, are associated with the use of additional substances (cigarettes, alcohol, cocaine, heroin, methamphetamine, inhalants, hallucinogens, ecstasy). RESULTS: The results indicate that cannabis product types are differentially associated with other substance use and levels of polysubstance use, whereas using a greater number of cannabis products is consistently associated with both. CONCLUSIONS: These findings highlight meaningful differences among cannabis users and underscore the importance of considering cannabis product type and modality variety when examining patterns of polysubstance use. Future research should continue examining how cannabis product type and multimodal use relate to polysubstance use, and prevention efforts may benefit from considering these differences.