Youth and Young Adult Blunt Use Predicts Progression to Other Nicotine Product Use in the United States

Abstract

Background

Little cigars or cigarillos (LCCs) are frequently modified to smoke cannabis (“blunts”) by youth and young adults. This study investigated whether young blunt users who are otherwise nicotine-naïve are more likely to initiate other tobacco products compared to never blunt users.

Methods and Materials

Data were from four waves of the Truth Longitudinal Cohort (TLC), a national probability-based sample of youth and young adults (aged 15-24 years) in the United States (Wave 1: January—April 2017; Wave 2: February—May 2018; Wave 3: February—May 2019; Wave 4: September—December 2019). The sample was restricted to nicotine naïve respondents at Wave 1 with possible ever use of blunts (N = 5,284). Logistic regression analyses tested whether ever blunt use at Wave 1 predicted initiation of nicotine products by Wave 4, controlling for established risk factors.

Results

Compared to never-blunt users, ever users of blunts at Wave 1 had significantly higher odds of ever using cigars (OR: 4.74; 95% CI: 1.80-12.47; p = 0.002), e-cigarettes (OR: 4.66; 95% CI: 2.42-8.95; p < 0.001), cigarettes (OR: 3.02; 95% CI: 1.17-7.84, p = 0.023), or hookah (OR: 3.47; 95% CI: 1.07-11.29, p = 0.039) by Wave 4. Cannabis (never blunt) use by Wave 1 predicted ever use of e-cigarettes (OR: 3.45, 95% CI: 2.38-5.02, p < 0.001), cigarettes (OR: 3.81; 95% CI: 2.26-6.43, p < 0.001), or hookah (OR: 2.13; 95% CI: 1.12-4.05, p = 0.021) by Wave 4.

Discussion

Blunts are a point of nicotine initiation that places users at increased risk of progression to cigars, while the same relationship was not found for cannabis alone.

Keywords:

• Blunts
• initiation
• cigars
• social media
• youth

Declaration of interest

The authors declare there no conflicts of interest for this study.

Declaration of interest statement

All authors declare no conflicts of interest.

Additional information

Funding

This study was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA248871. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.