Adverse School Outcomes and Risky Sexual Health Behaviors among High School Students with E-Cigarette and Marijuana Use

Abstract

Background

While several health risks of e-cigarette and marijuana use have been described, little is known about their associations with school-related outcomes and risky sexual behaviors in adolescents. Objectives: To determine the odds of adverse school outcomes and risky sexual behaviors among youth with single or dual use of e-cigarettes and marijuana. Methods: We used data from the 2015 and 2017 waves of the Youth Risk Behavior Survey, a nationally representative survey of high school students in the US. Participants (N = 30,389) were divided into four exposure groups for single or dual use of e-cigarettes and marijuana. We compared rates of e-cigarette and/or marijuana use for different demographic characteristics using chi-square tests and performed multivariate logistic regressions exploring associations among e-cigarette and marijuana use and adverse school outcomes and risky sexual behaviors adjusting for confounding factors. Results: Participants reported e-cigarette-only (7.7%), marijuana-only (8.5%), and dual e-cigarette/marijuana (9.2%) use. Youth in all three use categories had higher odds of reporting grades that were mostly C’s or lower than youth with no use, but no difference was found between youth with e-cigarette-only vs marijuana-only use. Increased odds of having sex without a condom were seen in youth with marijuana-only use (vs. e-cigarette-only use or no use) but not in youth with e-cigarette-only use or dual use. Conclusions: We found increased odds of adverse school-related outcomes and contrasting sexual risk profiles among youth with single or dual e-cigarette and marijuana use.

Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.1883659.

Keywords:

• Adolescent
• cannabis
• e-cigarette
• nicotine
• school
• sexual health
• student

Acknowledgements

None.

Declaration of interest

The authors declare that this article content has no conflict of interest of any kind. This work was supported by the National Institutes of Health (K23DA045085 and L40DA042434 to SEH); and the Thrasher Research Fund (Early Career Award, no grant number, to SEH). The funders had no role in the study design, in data collection, analysis or interpretation, in article development, or in the decision to submit the article for publication

Author contributions

NC was responsible for study conceptualization, interpretation of results and drafting of the initial manuscript. GL conducted statistical analyses and contributed to data analysis, manuscript conception and revisions. SEL contributed to manuscript conception and data interpretation and provided critical revisions of the manuscript. All authors reviewed and approved the final manuscript.