State-specific Prevalence and Factors Associated With Current Marijuana, ENDS, and Cigarette use Among US Adults With Asthma

Mohammad Ebrahimi Kalan; Zoran Bursac; Rime Jebai; Samane Zare; Wei Li; Prem Gautam; Abir Rahman; Kenneth D Ward; Ziyad Ben Taleb

doi:10.1177/1179173X221105783

State-specific Prevalence and Factors Associated With Current Marijuana, ENDS, and Cigarette use Among US Adults With Asthma

Tob Use Insights. 2022 May 31:15:1179173X221105783. doi: 10.1177/1179173X221105783. eCollection 2022.

Authors

Mohammad Ebrahimi Kalan^{1

2}, Zoran Bursac³, Rime Jebai⁴, Samane Zare⁵, Wei Li⁴, Prem Gautam⁴, Abir Rahman⁶, Kenneth D Ward⁷, Ziyad Ben Taleb⁸

Affiliations

¹ Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
² Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, Chapel Hill, NC, USA.
³ Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA.
⁴ Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA.
⁵ School of Medicine, Department of Social Medicine, Population, & Public Health, University of California Riverside, Riverside, CA, USA.
⁶ Cabell-Huntington Health Department, WV, USA.
⁷ School of Public Health, Memphis University, Tennessee, USA.
⁸ Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA.

Abstract

Background: The use of marijuana (MJ), combustible cigarettes (hereafter cigarettes), and electronic nicotine delivery systems (ENDS) is widespread among United States (US) adults and linked to worsening respiratory symptoms, especially among adults with asthma. This study examined state-specific prevalence and factors associated with MJ, ENDS, and cigarette use among US adults with asthma.

Methods: We analyzed data of 41 974 adults aged ≥18 years having self-reported current asthma from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). We reported weighted prevalence to account for complex survey design and performed multivariable logistic regression models to examine factors associated with current use of MJ, ENDS, and cigarettes.

Results: Overall prevalence of current MJ, ENDS, and cigarette use among adults with asthma was 14.5%, 6.6%, and 27.2%, respectively. Our results showed the US states and territories with highest and lowest use prevalence for MJ (California: 23.6% vs Guam: 3.2%), ENDS (Indiana: 12.8% vs North Dakota: 4.0%), and cigarettes (West Virginia: 42.1% vs Guam: 12.3%). Both MJ and ENDS users were more likely to be male, younger, and live in an urban area, but MJ users were more likely and ENDS users less likely to be Non-Hispanic (NH) American Indian/Alaskan Native. Cigarette users were more likely to be older, have at least 1 health condition, and were less likely to be NH Black or Hispanic and college-educated.

Conclusion: Many US adults with asthma use MJ, ENDS, and cigarettes. Our findings provide insights for clinicians about the urgent need for effective interventions to reduce tobacco and MJ use among adults with asthma.