Available online 6 December 2023, 111055

Author links open overlay panel, , , , , Abstract

Significance:

Adolescent vaping behavior includes vaping of multiple substances, including both nicotine and cannabis (dual-vaping). This study describes the prevalence and the sociodemographic correlates of past 30-day dual-vaping.

Methods

We recruited adolescents ages 13-17 from five New England states (Massachusetts, Connecticut, Rhode Island, Vermont, New Hampshire) through the Prodege online survey panel from April 2021 to August 2022. Dual-vaping was defined as vaping both nicotine and cannabis (THC and/or CBD) in the past 30-days. We analyzed the prevalence of sole-nicotine, sole-cannabis, and dual-vaping of nicotine and cannabis and used multinomial logistic regression to examine associations between sociodemographic factors and sole- and dual-vaping of nicotine and cannabis.

Results

The analytic sample included 2013 observations from 1858 participants (mean age 15.1 years, 46.2% female, 74.1% White, 82.2% heterosexual). Among these observations, 5.6% reported past 30-day sole-nicotine vaping, 5.5% reported sole-cannabis vaping, and 7.3% had dual-vaped. Correlates for higher odds of past 30-day dual-vaping included total social media sites used and household tobacco use, in contrast with sole-cannabis vaping, which included older age and self-reported depression (all p’s <0.05).

Discussion

Adolescent past 30-day dual-vaping of nicotine and cannabis was more prevalent than past 30-day sole-vaping of either nicotine or cannabis alone. Future studies should continue to collect detailed data on the type of substances, besides nicotine, that adolescents are vaping.

Section snippetsBackground

The 2022 National Youth Tobacco Survey found that 14.1% of U.S. high school students reported past 30-day e-cigarette use (vaping), and the 2022 Monitoring the Future (MTF) survey found that 10.3% of 10th graders and 14.8% of 12th graders reported vaping cannabis in the past 30-days (Berg et al., 2021, Osman et al., 2019, Ramo et al., 2013). Dual-use of nicotine/tobacco and cannabis is associated with worse overall outcomes in terms of severity of nicotine dependence, tobacco cessation

Study Design and Sampling Frame

The study design consisted of monthly repeated cross-sectional online surveys administered to participants who were part of an existing online survey panel with Prodege from April 2021 to August 2022. Prodege is an online market research company with access to existing panel members who are available to take part in surveys. The study population included a convenience sample of adolescents aged 13-17 in five New England states: Massachusetts, Rhode Island, Vermont, Connecticut, and New

Participant Demographics

Our five-state sample included participants with an average age of 15.1 years old (SD: 1.4), and 46.2% identified as female, 49.1% as male, and 4.6% as non-binary (Table 1). The majority were heterosexual (82.2%), white (74.1%), non-Hispanic (84.8%), and attended a public school (76.5%).

Characterizing the Dual-Vaping Prevalence

Prevalence of past 30-day vaping was 18.6% (Table 2); 5.6% reported vaping solely nicotine, 5.6% reported vaping solely cannabis (THC and/or CBD), and 7.5% reported past 30-day dual-vaping. Of the participants

DISCUSSION

Our findings show that over one-third of a sample of New England adolescents who reported past 30-day vaping had dual-vaped nicotine and cannabis, which is consistent with other studies that have measured co-use of nicotine and cannabis (Smith and Miller, 2021b, Tucker et al., 2019). Of our sample who had dual-vaped, over 40% reported vaping cannabis the most (of nicotine and cannabis), further highlighting this increased popularity of vaping as a mode of administration of cannabis among

Conclusion

Our findings demonstrate that adolescents in the New England region who vape are more likely to report past 30-day dual-vaping than sole-vaping either nicotine or cannabis alone, making dual-vaping the single largest vaping behavior category. Capturing what adolescents are vaping means asking what substances adolescents are vaping in their devices, and to specifically include non-nicotine substances such as THC, CBD, or non-psychoactive substances (Gaiha et al., 2022). Future research should

Role of Funding Source

Nothing declared.

Competing Interests Statement

No, there are no competing interests.

Funding

J. Liu was funded by the Cancer Prevention Fellowship from the National Cancer Institute – National Institutes of Health grant number 2T32CA057711-27. J. Liu was also supported by the Taube Research Faculty Scholar Endowment (to Dr. Bonnie Halpern-Felsher). This research was supported by award R21DA052421 from the National Institute on Drug Abuse of the National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of

CRediT authorship contribution statement

All authors have contributed to the writing, review, and conceptualization of this manuscript.

CRediT authorship contribution statement

Emmons Karen: Supervision, Writing – review & editing. Tan Andy: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Writing – review & editing. Liu Jessica: Conceptualization, Data curation, Formal analysis, Methodology, Writing – original draft, Writing – review & editing. Winickoff Jonathan: Conceptualization, Supervision, Writing – review & editing. Hanby Elaine: Data curation, Project

Declaration of Competing Interest

No conflict declared.

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