Cannabis problem experiences among users of the tobacco–cannabis combination known as blunts

Abstract

Background In most of the world, cannabis smokers mix loose tobacco inside a joint, pipe, spliff, or cone. More recently, a ‘blunt’ formulation combines these two drugs by inserting cannabis into a hollowed-out cigar. Epidemiological research linking simultaneous use of these two drugs and the development of cannabis use disorders (CUD) remains unclear. This study estimates associations linking blunt smoking with levels and subtypes of cannabis problems. Methods Cross-sectional data on 27,767 past-year cannabis users were analyzed from the US National Survey on Drug Use and Health (NSDUH) conducted from 2009–2012. Ten self-reported items of DSM-IV CUD features elicited a single latent trait of cannabis problem (CP) severity, which was then regressed on past-year blunt smoking and past-month blunt frequency measures within the context of a conceptual model. Differential item functioning (DIF) analysis evaluated potential bias in CP feature response by blunt smoking history. Results Past-year blunt smoking was associated with higher CP severity compared to cannabis users who did not smoke blunts. Days of blunt smoking in the past month also predicted higher CP severity than less frequent blunt use. Those smoking blunts experienced more subjectively felt tolerance and having spent more time obtaining or using cannabis, but were less likely to experience other problems, even at the same level of CP severity. Conclusions These findings suggest smoking blunts might promote the development of problematic cannabis use. Responses to cannabis problems differed by history of blunt smoking, possibly implicating an influence of tobacco on measurement of cannabis use disorders.

Let’s Be Blunt: Consumption Methods Matter Among Black Marijuana Smokers

“…Although studies have acknowledged that blunt use is associated with an increased risk of marijuana-related problems (Fairman, 2015), this study adds to the literature by showing that among Blacks, the increased risk of marijuana abuse or dependence is largely found among females. It is also important to note that among past-month marijuana smokers, females reported using blunts at a slightly higher rate than males (17 vs. 14 days).…”

“…The adult literature also demonstrates an association between being Black and co-use, with couse increasing significantly in this population over the past decade (Schauer et al, 2015). Blacks may prefer blunts to joints because blunts can hold more marijuana, they burn more slowly, they are easier to transport and conceal, they help culturally distinguish young marijuana users from the older generation of marijuana users, and Blacks are more likely than other racial groups to have friends who smoke blunts (Fairman, 2015;Mariani et al, 2011;Ream et al, 2006;Sifaneck et al, 2006;Sinclair et al, 2012).…”

Trends and Correlates of Cannabis-involved Emergency Department Visits: 2004 to 2011

“…For example, Montgomery (2015) found that blunt use among blacks was related to a pattern of an earlier age of onset of cigarette, cigar and cannabis use than no use of blunt (tobacco use only). Recent studies showed that blunt use was associated with increased odds of cannabis use disorder among blacks (Cohn et al, 2016; Fairman, 2015). Lastly, blacks have faced more barriers to mental health care than white, and a delay to access timely healthcare may be related to excess use of ED care (Cook et al, 2010).…”

Usual Modes of Marijuana Consumption Among High School Students in Colorado

“…Black, Multiracial, and LGB youth were significantly more likely report "other" as their usual mode of consumption, as were those reporting early marijuana use (i.e., use before age 13), frequent marijuana use (i.e., used >20 times in the past 30 days), and cigarette smoking. Because blunt use (i.e., smoking marijuana using a hollowed-out cigar) is more common among Blacks, those who report cigarette smoking, and those with a cannabis use disorder (Fairman, 2015;Golub, 2006;Soldz et al, 2003), some youth reporting "other" as their usual mode of consumption may have been referring to blunt use (i.e., they may consider blunt use as distinct from smoking marijuana). Future studies could provide clarity about other modes of use by inviting participants to specify the modes they are referring to.…”