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. 2018 Feb 23;53(3):357-369.
doi: 10.1080/10826084.2017.1327978. Epub 2017 Aug 9.

Reasons for Marijuana and Tobacco Co-use Among Young Adults: A Mixed Methods Scale Development Study

Carla J Berg  1 , Jackelyn Payne  1 , Lisa Henriksen  2 , Patricia Cavazos-Rehg  3 , Betelihem Getachew  1 , Gillian L Schauer  4 , Regine Haardörfer  1
Affiliations

Reasons for Marijuana and Tobacco Co-use Among Young Adults: A Mixed Methods Scale Development Study

Carla J Berg et al. Subst Use Misuse. .

Abstract

Background: Marijuana-tobacco co-use has increased recently, particularly in young adults.

Objectives: We conducted a mixed-methods study to: (1) examine reasons for co-use; and (2) develop a scale assessing reasons for co-use among participants in a longitudinal cohort study of 3,418 students aged 18-25 from 7 Georgia colleges and universities.

Methods: Phone-based semi-structured interviews were conducted in Summer 2015 among 46 current (past 30-day, n = 26) or lifetime (n = 20) marijuana users. Subsequently, scale items were developed and included at Wave 3. Participants reporting past 4-month tobacco and marijuana use (n = 328) completed the Reasons for Marijuana-Tobacco Co-use section.

Results: Per qualitative data, reasons for marijuana-tobacco co-use included synergistic effects, one triggering or preceding the other's use, using one to reduce the other's use, co-administration, social context, and experimentation. The survey subsample included 37.1% who used cigarettes, 30.4% LCCs, 9.4% smokeless, 23.7% e-cigarettes, and 30.4% hookah. Four subscale factors emerged: (1) Instrumentality, indicating synergistic effects; (2) Displacement, indicating using one product to reduce/quit the other; (3) Social context, indicating use in different settings/social situations; and (4) Experimentation, indicating experimentation with both but no specific reasons for co-use. These subscales demonstrated distinct associations with tobacco type used; nicotine dependence; marijuana and alcohol use frequency; tobacco and marijuana use motives, respectively; perceptions of tobacco and marijuana; and parental and friend use. Including these subscales in regressions predicting nicotine dependence and days of marijuana use significantly contributed to each model.

Conclusions: These findings might inform theoretical frameworks upon which marijuana-tobacco co-use occurs and direct future intervention studies.

Keywords: Substance use; marijuana use; risk factors; tobacco use; young adults.

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Conflict of interest statement

Declaration of interests

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Participant flowchart. Note: The Study 2 N of 328 included those reporting past 4-month use of marijuana and at least one tobacco product and also had complete data regarding reasons for marijuana-tobacco co-use.
See this image and copyright information in PMC

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