Nicotine Dependence among Current Cigarette Smokers Who Use E-Cigarettes and Cannabis

Dina M Jones; Mignonne C Guy; Brian J Fairman; Eric Soule; Thomas Eissenberg; Pebbles Fagan

doi:10.1080/10826084.2023.2177961

Nicotine Dependence among Current Cigarette Smokers Who Use E-Cigarettes and Cannabis

Subst Use Misuse. 2023;58(5):618-628. doi: 10.1080/10826084.2023.2177961. Epub 2023 Feb 27.

Authors

Dina M Jones¹, Mignonne C Guy^{2

3}, Brian J Fairman⁴, Eric Soule^{2

5}, Thomas Eissenberg², Pebbles Fagan¹

Affiliations

¹ Department of Health Behavior and Health Education, Center for the Study of Tobacco, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
² Department of Psychology, College of Humanities and Sciences, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.
³ Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA.
⁴ Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
⁵ Department of Health Education and Promotion, Eastern Carolina University, Greenville, North Carolina, USA.

Abstract

Background: Co-use of tobacco and cannabis and dual use of cigarettes and e-cigarettes are very common among young adults. However, it is unclear whether co-use of cigarettes, e-cigarettes, and/or cannabis is associated with higher levels of nicotine dependence than cigarette-only use. We investigated the relationship between cigarette/nicotine dependence and co-use of tobacco and cannabis among 4 groups of cigarette smokers aged 18-35: cigarette-only smokers, cigarette-e-cigarette (CIG-ECIG) co-users, cigarette-cannabis (CIG-CAN) co-users, and cigarette-e-cigarette-cannabis (CIG-ECIG-CAN) co-users.

Methods: Data were from a 2018 cross-sectional survey based on a national convenience sample of smokers aged 18-35 (n = 315). Cigarette/nicotine dependence was measured by the Fagerstrom Test of Nicotine Dependence (FTND) and e-cigarette dependence was measured by the Penn State E-cigarette Dependence Index. Bivariate analyses examined sociodemographic and tobacco/other substance use characteristics by co-use status and multivariable linear regression assessed the relationship between co-use and nicotine dependence.

Results: In the sample, 27.6% were cigarette-only smokers, 24.8% were CIG-ECIG, 27.6% were CIG-CAN, and 20.0% were CIG-ECIG-CAN co-users. Significant differences were observed in sociodemographic and tobacco/other substance use characteristics by co-use status. E-cigarette co-users had low e-cigarette dependence, but moderate FTND scores. In adjusted analyses, only CIG-ECIG co-use was associated with higher FTND scores compared to cigarette-only smoking. However, CIG-ECIG and CIG-ECIG-CAN co-use were associated with higher FTND scores compared to CIG-CAN co-use.

Conclusions: Co-use of cigarettes and e-cigarettes was associated with greater nicotine dependence among smokers aged 18-35. Additional research is needed to understand the underlying mechanisms of these relationships and inform prevention efforts.

Keywords: cannabis; cigarette; co-use; electronic cigarette; marijuana; nicotine dependence; poly-tobacco use; young adults.

Publication types

Research Support, U.S. Gov't, P.H.S.
Research Support, N.I.H., Extramural

MeSH terms

Cannabis*
Cross-Sectional Studies
Electronic Nicotine Delivery Systems*
Humans
Smokers
Tobacco Products*
Tobacco Use Disorder* / epidemiology
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding