Young adults report increased pleasure from smoking cigarettes when drinking alcohol but not when using marijuana

Abstract

Background: Among young adults, cigarette smoking is strongly associated with alcohol and marijuana use. The present study compared self-reported co-use of cigarettes and alcohol versus cigarettes and marijuana among young adults using cross-sectional survey data.

Methods: Participants were young adult cigarette smokers (age 18 to 25) who also reported past month alcohol or marijuana use enrolled in a randomized trial testing a smoking cessation intervention on Facebook. Participants self-reported extent of cigarette smoking under the influence of alcohol or marijuana and differences in perceived pleasure from cigarette smoking when drinking alcohol compared to using marijuana.

Results: Among cigarette smokers who drank alcohol and used marijuana in the past month (n = 200), a similar percentage of cigarettes were smoked under the influence of alcohol (42.4% ± 31.2%) and marijuana (43.1%  ± 30.0%). Among alcohol + marijuana users, perceived pleasure from smoking cigarettes was significantly greater when drinking alcohol versus when using marijuana (t₍₁₉₉₎ = 7.05, p < .001). There was, on average, an increase in perceived pleasure from smoking cigarettes when drinking alcohol, though perceived pleasure did not differ by binge drinking frequency. In contrast, there was on average no change in perceived pleasure from smoking cigarettes when using marijuana. Results from the cigarette smokers who used alcohol + marijuana were similar to cigarette smokers who only used alcohol (n = 158) or only used marijuana (n = 54).

Conclusion: Findings highlight greater perceived reward from smoking cigarettes when drinking alcohol compared to when using marijuana, informing smoking cessation interventions that target users of multiple substances.

Keywords:

• Ethanol
• cannabis
• smoke
• tobacco
• reward
• co-use

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This study was supported by the NIH National Institute on Drug Abuse (NIDA, K23 DA032578 and P50 DA09253). The preparation of this manuscript was supported by the NIDA (T32 DA007250; F32 DA042554), and the California Tobacco-Related Disease Research Program (TRDRP, 25FT-0009). The funding sources had no involvement in the study design, in the collection, analysis and interpretation of the data, in the writing of the report, or in the decision to submit the article for publication.