With more states legalizing the use of marijuana for medical or recreational purposes, one wonders if there has been an increase in the rate of combustible tobacco smoking. Odani et al (10.1542/peds.2019-1372) evaluated trends in marijuana and combustible tobacco use using data obtained in national drug use surveys among young adults 18-22 years from 2002 to 2016. The authors looked for differences in those in college compared to those not in college. Their findings reveal some good news and bad news. From a good news standpoint, the authors note that during the period of time studied, there was a significant decrease in the rate of exclusive tobacco smoking. However, as expected, there was an increase in marijuana use over the same period of time. College students had a steeper decrease in smoked tobacco and a higher rate of exclusive marijuana use. Those not in college showed just the opposite findings.
We asked Drs. Walley, Jenssen, and Wilson, all clinical investigators in the area of smoking and substance abuse, to share their thoughts in an accompanying commentary (10.1542/peds.2019-3025). They point out that underlying the changes in tobacco and marijuana use was the arrival of e-cigarettes and vaping devices, which can be used for tobacco and marijuana. As the commentary authors point out, some marijuana products that can be used in an e-cigarette device may also contain nicotine meaning that teens and young adults who think they are vaping just marijuana may also be exposing themselves to nicotine as well and all the risks that go with such exposures.
The study and commentary smoke out a number of concerns underlying the findings being reported, so check out both and then share what you learn with your teen patients, so they realize the inherent dangers and adverse effects of using either tobacco or marijuana products during their adolescent years.