Co-Use, Simultaneous Use, and Mixing of Cannabis and Tobacco: A Cross-National Comparison of Canada and the US by Cannabis Administration Type

Alanna Chu, Michael Chaiton (), Pamela Kaufman, Renee D. Goodwin, Jodie Lin, Chandni Hindocha, Samantha Goodman and David Hammond
Additional contact information
Alanna Chu: Ontario Tobacco Research Unit, Toronto, ON M5T 3M7, Canada
Michael Chaiton: Ontario Tobacco Research Unit, Toronto, ON M5T 3M7, Canada
Pamela Kaufman: Ontario Tobacco Research Unit, Toronto, ON M5T 3M7, Canada
Renee D. Goodwin: Mailman School of Public Health, Columbia University, New York, NY 10032, USA
Jodie Lin: Ontario Tobacco Research Unit, Toronto, ON M5T 3M7, Canada
Chandni Hindocha: Division of Psychology and Language Sciences, University College London, London WC1H 0AP, UK
Samantha Goodman: School of Public Health, University of Waterloo, Waterloo, ON N2L 3G1, Canada
David Hammond: School of Public Health, University of Waterloo, Waterloo, ON N2L 3G1, Canada

IJERPH, 2023, vol. 20, issue 5, 1-11

Abstract: Introduction: Increasing cannabis legalization raises concerns that the use of tobacco, frequently used with cannabis, will also increase. This study investigated the association between the legal status of cannabis in places of residence and the prevalence of cannabis and tobacco co-use, simultaneous use, and mixing by comparing the prevalence among adults in Canada (prior to cannabis legalization) vs. adults in US states that had legalized recreational cannabis vs. US states that had not as of September 2018. Methods: Data were drawn from the 2018 International Cannabis Policy Study, conducted with respondents aged 16–65 in Canada and the US recruited from nonprobability consumer panels. Differences in the prevalence of co-use, simultaneous use, and mixing between tobacco and different cannabis products were examined using logistic regression models by legal status of place of residence among past-12-month cannabis consumers (N = 6744). Results: Co-use and simultaneous use in the past 12 months were most common among respondents in US legal states. Among cannabis consumers, co-use and simultaneous use were less common in US legal states, while mixing was less frequent in US states with both legal and illegal cannabis compared to Canada. Use of edibles was associated with lower odds of all three outcomes, while smoking dried herb or hash was associated with higher odds. Conclusions: The proportion of cannabis consumers who used tobacco was lower in legal jurisdictions despite higher prevalence of cannabis use. Edible use was inversely associated with co-use, suggesting that edible use does not appear to be associated with increased tobacco use.

Keywords: cannabis; tobacco; co-use; simultaneous use; mixing (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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