Alcohol Use Predicts Escalating Cannabis Vaping Among Youth

Summary: A recent study highlights alcohol as the strongest predictor of cannabis vaping initiation and experimentation among youth and young adults, regardless of demographic factors. Conducted over three years, the research found that alcohol consumption increased the likelihood of transitioning from non-use to cannabis vaping.

Depression also emerged as a predictor for specific racial and ethnic groups, emphasizing the need for tailored interventions. Researchers suggest incorporating prevention strategies targeting alcohol, cannabis, and mental health into school-based substance use programs to mitigate risks.

Key Facts:

  • Alcohol use is a significant predictor of cannabis vaping initiation and experimentation in youth.
  • Depression was linked to cannabis vaping initiation among Hispanic and non-Hispanic Black youth.
  • Preventative strategies addressing alcohol, cannabis, and mental health issues could reduce substance dependence risks.

Source: UT Houston

Alcohol use was the most common predictor of escalating cannabis vaping among youth and young adults, independent of demographic factors, according to research by UTHealth Houston published this month in the journal Social Science & Medicine

Cannabis vaping is the use of electronic cigarette delivery of liquid tetrahydrocannabinol (THC), a concentrated form of cannabis that has been extracted and diluted into a liquid solution.Vaping cannabis has grown in popularity among young people in the U.S., according to the Substance Abuse and Mental Health Services Administration

“A decade ago, 10% of cannabis users vaped it. Now, the number is about 75%, at least for youth and young adults,” said Dale Mantey, PhD, assistant professor of health promotion and behavioral sciences at UTHealth Houston School of Public Health.

“That is a major public health concern for many reasons.”

Cannabis vaping in youth and early adulthood can affect cognitive development and performance, including learning, memory, and attention; lead to the onset of chronic pulmonary damage from black market liquid THC products, as well as an increase in dependence on the drug; and result in incarceration due to federal prohibitions, which list cannabis as a Schedule I drug.

In this study, researchers focused on identifying the predictors of behavior of cannabis users and nonusers. The data included middle to high school students in Dallas/Fort Worth, San Antonio, Austin, and Houston.

The students were surveyed from 2019 to 2021 and asked two questions: “Have you ever smoked marijuana or liquid THC from an electronic cigarette?” And “During the past 30 days, how many days did you smoke marijuana from an electronic cigarette?”

The students were also asked to self-report their racial and ethnic identity, gender, nicotine usage, and alcohol consumption. Researchers also investigated two indicators of mental health among the student population: anxiety and depression.

“If we know what predicts that behavior, those are the things we can try to target for addressing and preventing cannabis vaping among youth,” Mantey said.

At the beginning of the study , 72.7% reported never cannabis vaping, 12.7% reported ever cannabis vaping, and 14.5% reported current cannabis vaping. Through the three-year duration of the study, the risk for cannabis vaping experimentation (never to current) was significantly higher among non-Hispanic Blacks relative to non-Hispanic whites and non-Hispanic other groups. 

Alcohol proved to be a consistent factor in those who had never vaped cannabis to begin or experiment. Researchers referred to alcohol as a “gateway” to cannabis vaping.

“The ultimate goal is to delay initiation of substances in youth because the later someone initiates a substance, the less likely they are to become addicted to it,” Mantey said.

“Since alcohol was shown to be a strong predictor, we need more comprehensive interventions. When we go into schools and talk about nicotine, vaping, or tobacco prevention, we need to make sure we are incorporating cannabis prevention and alcohol prevention, not just one substance.”

Depression predicted cannabis vaping initiation among Hispanics and non-Hispanic Blacks groups. The authors said more research is needed to understand the impact depression and other mental health problems may have on cannabis vaping among various demographics so public health intervention can target the most at-risk groups.

Additional UTHealth Houston authors included Stephanie L. Clendennen, DrPH, MPH; Baojiang Chen, PhD; Sana Amin, MPH; and Melissa B. Harrell, PhD, MPH.

About this addiction and neurodevelopment research news

Author: Sydney Lowther
Source: UT Houston
Contact: Sydney Lowther – UT Houston
Image: The image is credited to Neuroscience News

Original Research: Open access.
Cannabis vaping use in emerging adulthood: Characterizing transitions between stages of vaping among a diverse cohort in Texas” by Dale Mantey et al. Social Science & Medicine


Abstract

Cannabis vaping use in emerging adulthood: Characterizing transitions between stages of vaping among a diverse cohort in Texas

Objective

To characterize and compare transitions in cannabis (THC) vaping by sociodemographic and other risk factors among a diverse cohort of youth and young adults observed between Spring 2019 and Fall 2021.

Methods

We analyzed six (6) waves of panel data from n = 2605 youth transitioning into young adulthood via the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system; participants provided N = 13,974 observations (i.e., completed surveys).

The TATAMS sample was 37.7% Hispanic, 31.7% NH-White, 14.5% NH-Black, and 16.1% among NH-Other. We applied a three-state Markov model to estimate cannabis vaping initiation (never→ever), experimentation (never→current), escalation (ever→current), and de-escalation (current→ever).

First, we compared transitions in THC vaping by race/ethnicity, with non-Hispanic (NH) Black as the referent. Second, we stratified the Markov models by race/ethnicity to identify common and unique predictors of cannabis vaping transitions, examining differences by: sex, age, alcohol use, depression (PHQ-9), anxiety (GAD-7) and nicotine vaping, across each race/ethnic category.

Results

At baseline, 72.7% never vaped cannabis, 12.7% ever vaped cannabis, and 14.5% currently vaped cannabis. Across three years, risk for cannabis vaping experimentation (never → current) was significantly greater among NH-Blacks, relative to Hispanics (aHR: 1.89), NH-Whites (aHR: 2.27), and NH-Other (aHR: 2.01).

Stratified models showed that current alcohol use was a common predictor of cannabis vaping experimentation among NH-White (aHR: 5.08), Hispanic (aHR: 2.32), and NH-Black (aHR: 2.91) participants. Depression predicted cannabis vaping initiation among Hispanics (aHR: 1.75) and experimentation among NH-Blacks (aHR: 3.95).

Conclusions

Onset of cannabis vaping during youth and young adulthood was most common among NH-Black youth, relative to other race/ethnic categories. Alcohol was a common predictor of cannabis vaping across race/ethnic categories while depression was linked to cannabis vaping transitions among Hispanic and NH-Black youth, only.

Future research should investigate the link between alcohol use, mental health, and cannabis vaping among young people.