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. 2024 Aug 1:261:111355.
doi: 10.1016/j.drugalcdep.2024.111355. Epub 2024 Jun 6.

Trends in marijuana and heavy alcohol use by cigarette smoking status among US adults: An analysis of the 2002-2019 NSDUH

Jacob James Rich  1 , Sudie E Back  2 , Thanh C Bui  3 , Eden Y Bernstein  4 , Phuc Le  5
Affiliations

Trends in marijuana and heavy alcohol use by cigarette smoking status among US adults: An analysis of the 2002-2019 NSDUH

Jacob James Rich et al. Drug Alcohol Depend. .

Abstract

Background: Polysubstance use is associated with adverse health outcomes, yet little research has measured changes in polysubstance use. We aimed to 1) estimate trends in marijuana and heavy alcohol use by cigarette smoking and demographic subgroups, and 2) examine patient factors associated with concurrent use among adults who were smoking.

Methods: We conducted a repeated cross-sectional analysis of 687,225 non-institutionalized US adults ≥18 years from the 2002-2019 National Survey on Drug Use and Health. Participants were stratified into current, former, and never smoking groups. Main outcomes were prevalence of heavy alcohol use, marijuana use, and concurrent use of both substances.

Results: From 2002-2019, heavy alcohol use declined from 7.8 % to 6.4 %, marijuana use rose from 6.0 % to 11.8 %, and concurrent use of alcohol and marijuana remained stable. Among adults who were smoking from 2005 to 2019, higher education was associated with higher odds of heavy alcohol use, while older ages, female gender, non-White race/ethnicity, and government-provided health insurance were associated with lower odds. The odds of marijuana use decreased in females, older ages, and higher incomes while increasing in people with poorer health status, higher education, government-provided or no health insurance, and serious mental illness. Compared to White adults who were smoking, Black counterparts had higher odds of marijuana use (OR=1.23; 95 %CI: 1.15-1.29), while Hispanic (OR=0.68; 95 %CI: 0.63-0.72) and other racial/ethnic identities (OR=0.83; 95 %CI: 0.77-0.90) had lower odds.

Conclusions: Our study suggests marijuana use might not be sensitive to changes in the use of tobacco and alcohol.

Keywords: Alcohol; Cannabis; Marijuana; NSDUH; Polysubstance use; Smoking.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Jacob James Rich is a policy analyst at Reason Foundation.

Figures

Fig. 1.
Fig. 1.
Prevalence of cigarette smoking status among US adults, National Survey on Drug Use and Health, 2002–2019, a) overall prevalence and b) prevalence by age groups.
Fig. 2.
Fig. 2.
Trends in use of marijuana and heavy alcohol by cigarette smoking status in US adults, National Survey on Drug Use and Health, 2002–2019.
See this image and copyright information in PMC

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