Association Between Adolescent Blunt Use and the Uptake of Cigars

Audrain-McGovern, Janet; Rodriguez, Daniel; Alexander, Emily; Pianin, Stephen; Sterling, Kymberle L.

doi:10.1001/jamanetworkopen.2019.17001

Cited by 19 publications

(14 citation statements)

References 38 publications

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“…The association of cigar/cigarillo use with blunt/spliff use may be expected given that blunts are comprised of cannabis rolled in cigar wrappers. This is concerning because blunt use may lead to cigar use among adolescents (Audrain-McGovern, Rodriguez, Alexander, Pianin, & Sterling, 2019) and conversely, cigar use may lead to blunt/spliff use (Fairman & Anthony, 2018). Moreover, multiple tobacco product use has been associated with greater nicotine dependence among smokers in SUD treatment (Guydish, Tajima, et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Correlates of lifetime blunt/spliff use among cigarette smokers in substance use disorders treatment

Campbell

Kapiteni

et al. 2020

Journal of Substance Abuse Treatment

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Background: Co-use of tobacco and cannabis has been associated with greater dependence on and lower quit rates for both substances. Tobacco/cannabis co-use among individuals with substance use disorders (SUDs), a population with high rates of cigarette smoking, may hinder the effectiveness of smoking cessation interventions. We examined rates of lifetime (i.e., ever vs. never) cannabis use among current cigarette smokers in SUD treatment, and we identified the subgroup who had used tobacco and cannabis together in the form of blunts and/or spliffs. We then examined variables associated with lifetime use of blunts and/or spliffs. Methods:We surveyed 562 clients in 20 residential SUD treatment programs in California, USA in 2019.Measures included demographics, lifetime use of any cannabis product, lifetime use of blunt/spliffs, patterns of tobacco use and smoking cessation-related questions. We asked current cigarette smokers who also reported lifetime cannabis use whether they had ever used blunts and/or spliffs. We then assessed relationships of demographic, tobacco use, use of cannabis/tetrahydrocannabinol (THC) in e-cigarettes/vape pens, and smoking cessation-related variables with ever use versus never use of blunts/spliffs.Results: Among 340 current cigarette smokers, 93.2% (n=317) reported lifetime use of any cannabis product. Among current cigarette smokers with lifetime cannabis use, 64.4% reported lifetime blunt/spliff use. Compared to those who had never used blunts/spliffs, lifetime blunt/spliff users were more likely to be younger (OR = 0.93, 95% CI 0.90-0.95), more likely to report lifetime use of cigars/cigarillos (OR = 2.95, CI .1.37-6.32), and to have ever used cannabis/THC in e-cigarettes/vape pens (OR = 4.26, CI 1.54-11.80). They were less often ready to quit smoking within 30 days (OR =0.37, CI 0.23 -0.60), but more likely to want help with smoking cessation (OR = 2.39, CI 1.52-3.77). Conclusion:Current cigarette smokers in SUD treatment reported a high prevalence of lifetime cannabis use.Smokers with a history of blunt/spliff use were more likely to report lifetime use of e-cigarettes/vape pens for cannabis/THC delivery. They wanted help quitting smoking, but felt less prepared to quit in the next 30 days.Attention to cannabis co-use may be warranted when providing smoking cessation interventions during SUD treatment.

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Section: Discussionmentioning

confidence: 99%

Correlates of lifetime blunt/spliff use among cigarette smokers in substance use disorders treatment

Campbell

Kapiteni

et al. 2020

Journal of Substance Abuse Treatment

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“…Adolescents were asked if they had ever smoked a large cigar, little cigar, or cigarillo and, if so, whether they smoked in the past 6 months. 41 Responses were coded as 1 for using any type of cigar and 0 for no use. Marijuana use and alcohol use were assessed by asking adolescents if they had ever used these substances.…”

Section: Psychological Risk Factorsmentioning

confidence: 99%

Conjoint Developmental Trajectories of Adolescent E-cigarette and Combustible Cigarette Use

et al. 2021

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OBJECTIVES:In this study, we sought to identify which adolescents progress to regular electronic cigarette (e-cigarette) use (without cigarette smoking), which adolescents become dual users of both types of cigarettes, and how dual use develops across time.METHODS: Adolescents (N 5 1808) from public high schools outside Philadelphia, Pennsylvania, completed in-classroom surveys at wave 1 (fall 2016, beginning of ninth grade) and at 6-month intervals for the following 36 months (fall 2019, beginning of 12th grade). RESULTS: A sequential processes growth mixture model identified 4 conjoint latent classes: later, rapid e-cigarette uptake (class 1: n 5 230); no use of e-cigarettes or combustible cigarettes (class 2: n 5 1141); earlier, steady e-cigarette uptake (class 3: n 5 265); and dual use of e-cigarettes and combustible cigarettes (class 4: n 5 204). Using a rich set of potential risk factors, multinomial logistic regression assessed the likelihood of belonging to each conjoint class compared with the comparison class (dual use). Adolescents in the dual use class were characterized by a greater number and severity of e-cigarette and combustible cigarette risk factors. Adolescents in the 2 e-cigarettes-only classes were characterized by either e-cigarette-specific risk factors (earlier onset) or no risk factors (later onset). The no use class had an absence of risk factors for e-cigarette and cigarette use.CONCLUSIONS: This study provides new prospective evidence for distinct patterns and profiles of adolescents who progress to current e-cigarette use, including adolescents who were initially cigarette smokers. The findings have implications for prevention intervention timing, tobacco product focus, content, and the adolescent subgroups to target.

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“…1 Cigar blunts have become a popular mode of marijuana consumption among US adolescents. 5,6 Blunts are cigars that have been hollowed out and filled with marijuana; cigar wrappers contain quantifiable levels of nicotine, thus exposing users to nicotine despite the removal of the tobacco filler. 7 Consistent with a potential dependence-producing effect, blunt use is linked to the initiation of combustible cigarettes and other tobacco and nicotine products.…”

mentioning

confidence: 99%

“…11 In another prospective study, researchers found that adolescents who had ever used a blunt at age 14 were 20 times more likely to become a current cigar user across a 2-year follow-up compared with adolescents who had never used a blunt. 5 Cross-sectional data from 4 high schools in Connecticut and New York found that blunt use was associated with concurrent use of electronic cigarettes (e-cigarettes). 12 In fact, in a recent prospective study using data from Population Assessment of Tobacco and Health, authors found that initiating e-cigarettes at wave 1 (2013)(2014) was associated with subsequent marijuana use in wave 2 (2014)(2015), especially among young adolescents aged 12 to 14 years (ie, middle schoolers).…”

mentioning

confidence: 99%

Trends and Factors Related to Blunt Use in Middle and High School Students, 2010–2020

Kalan¹,

Jebai²,

Bursac

et al. 2021

Pediatrics

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BACKGROUND AND OBJECTIVES: Blunt use is a popular mode of marijuana consumption among adolescents in the United States, but little is known about how its prevalence has changed over time or factors associated with its use. With this study, we assessed trends and correlates of past (ever used but not in the past 30 days) and current (used in past 30 days) blunt use among adolescents in Florida. METHODS:We analyzed data from 2010-2020 cross-sectional, statewide representative Florida Youth Tobacco Surveys that comprised 461 706 middle and high schoolers using Joinpoint to calculate annual percentage change (APC) in the weighted prevalence of past and current blunt use. A weighted multivariable regression model was developed by using 2019-2020 Florida Youth Tobacco Survey data to examine the factors associated with past and current blunt use.RESULTS: Whereas the prevalence of past (APC 5 À5.32%) and current (APC 5 À5.28%) blunt use significantly decreased from 2010 to 2015, an increasing trend in current use prevalence (APC 5 14.91%) was observed from 2015 to 2018 and has been approximately constant ever since. Similar increasing trends were observed in current blunt use among female students (APC 5 14.92%), middle schoolers (19.57%), and non-Hispanic (NH) white students (APC 5 11.12%) from 2016 to 2020. Several factors were consistently associated with greater odds of both past and current blunt use for both middle and high schoolers, including older age, being NH Black (versus NH white), past and current use of cigarettes, electronic cigarettes, hookah, cigars, and ever vaping marijuana.CONCLUSIONS: Although blunt use among Florida youth decreased from 2010 to 2015, substantial increases were observed since 2015, suggesting that existing tobacco control programs should incorporate marijuana (and blunt) modules into existing tobacco and nicotine prevention programs.

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Association Between Adolescent Blunt Use and the Uptake of Cigars

Cited by 19 publications

References 38 publications

Correlates of lifetime blunt/spliff use among cigarette smokers in substance use disorders treatment

Correlates of lifetime blunt/spliff use among cigarette smokers in substance use disorders treatment

Conjoint Developmental Trajectories of Adolescent E-cigarette and Combustible Cigarette Use

Trends and Factors Related to Blunt Use in Middle and High School Students, 2010–2020

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