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Study: Kids who vape tobacco are more likely to go on to use cannabis

A teenager vapes in Ocean City, Md. (Shuran Huang for The Washington Post)

Vaping is growing more prevalent among young people — in 2021, 1 in 9 high school students said they had vaped in the past month, according to the Centers for Disease Control and Prevention.

Increasingly, those kids are vaping cannabis. But is vaping a gateway to marijuana use?

A new study suggests that is the case, finding that adolescents who use e-cigarettes are over three times more likely to use cannabis than those who don’t — and that more than 1 in 10 youths who say they have never used cannabis go on to do so within a year.

The research, published in JAMA Network Open, relies on the Population Assessment of Tobacco and Health (PATH) study, which has been surveying a nationally representative group of people about their use of tobacco since 2013. Researchers from the University of Alabama at Birmingham and the University of Michigan at Ann Arbor looked at a cohort of 9,828 youths who reported that they had never used marijuana.

Between 2017 and 2019, they found, those who reported vaping were more likely to say they had begun using cannabis one year later than those who didn’t use e-cigarettes. The researchers ruled out factors such as socioeconomic status and other substance use.

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Of the adolescents who hadn’t used cannabis at the beginning of the study, nearly 11 percent used cannabis in the following year, even those who had never used tobacco. But those who said they had smoked e-cigarettes were far more likely to move on to cannabis. E-cigarette users were 3.2 times more likely to use cannabis and 2.9 percent more likely to say they had used it within the past month.

Youths who vape could be more likely to be friends with kids who engage in risky behaviors, the researchers write, adding that the fact that vaping devices can be used to smoke both tobacco and cannabis could account for the association.

Despite the link, the researchers said that vaping cannabis doesn’t seem to make much of a difference in the overall population of adolescents who use marijuana. “Some adolescent e-cigarette users likely simply experiment with cannabis use without becoming established users,” they write.

Earlier this year, the same group of researchers used similar data to show that the majority of teens and young adults have used e-cigarettes to smoke cannabis instead of tobacco.

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