Introduction
This study seeks to identify adolescent nicotine and cannabis vaping patterns and
the characteristics of those adolescents who comprised each pattern.
Methods
This prospective longitudinal survey study measured the relationship between nicotine
and cannabis vaping among 1,835 adolescents from 4 public high schools outside of
Philadelphia, Pennsylvania. Adolescents completed in-classroom surveys, including
questions of lifetime and past 30–day nicotine and cannabis vaping, at Wave 1 (fall
2016, ninth grade) and 6-month intervals for the following 36 months (fall 2019, 12th
grade). Data were analyzed in 2021.
Results
A sequential processes growth mixture model revealed 4 latent conjoint classes of
nicotine and cannabis vaping: early, declining dual use (Class 1: n=259); rapidly increasing dual use (Class 2: n=128); later, slower dual use (Class 3: n=313); and no use (Class 4: n=1,136). Increased odds of belonging to Class 1 and Class 2 versus belonging to Class
4 were significantly associated with cigarette smoking (OR=3.71, OR=2.21), alcohol
use (OR=2.55, OR=4.39), peer vaping (OR=1.24, OR=1.20), sensation seeking (OR=1.03,
OR=1.11), positive E-cigarette expectations (OR=1.21, OR=1.17), and cigar smoking
(OR=2.39 Class 2 only). Increased odds of belonging to Class 3 versus Class 4 were
significantly associated with alcohol use (OR=1.66), perceived benefits of E-cigarette
use (OR=1.03), positive E-cigarette expectations (OR=1.08), depressive symptoms (OR=1.02),
and sensation seeking (OR=1.03).
Conclusions
From middle to late adolescence, vaping of nicotine and cannabis develop in close
parallel. Regulatory policy and prevention interventions should consider the interplay
between these 2 substances during this period of adolescence.
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Published online: March 29, 2022
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© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
