Study: As cannabis reform spreads, young people still try tobacco and alcohol first

It goes without saying that the increasing reform and legalization of adult use over the last decade is changing the way we view cannabis and making it more accessible. Throughout this new journey, the opposition has regularly raised concerns about increased access for minors. While many studies have already worked to disprove that more legalization of cannabis inherently means higher use among minors and young adults, a new study looks a little more comprehensive.

Researchers at the University of Oklahoma tracked substance use patterns in a cohort of more than 8,000 young adults (aged 18 to 24) over a six-year period to find out which substances young people typically turn to first. Finally, the study shows that young people typically try alcohol and/or tobacco before experimenting with cannabis.

Study examines the onset of substance use in a new cannabis landscape

The study, titled “First Use of Cannabis Compared to First Use of Alcohol and Tobacco: Associations with Single and Multiple Substance Use Behavior,” was published in the journal Drug and Alcohol Dependence.

The study’s authors note that in 2022, nearly 145 million Americans lived in a state where the use of cannabis, whether recreational or medicinal in some form, was legal, accounting for 45% of the US population. They also noted that legal cannabis markets may be “particularly relevant” for young adults (18-24) as they have the highest proportion of cannabis use in the past year and past 30 days (6.3%) compared to adolescents (6.3%). 23.2%) have adults over 25 years (10.4%).

They note that previous research examining the sequence of initiation to alcohol, tobacco, and cannabis in young adults consistently identified alcohol as a catalyst for later substance use. It begs the question: has legal cannabis use changed the pattern?

“To our knowledge, no studies have examined whether use of cannabis before alcohol and tobacco is associated with a higher risk of reporting current multiple-substance use and other drug use compared to use of cannabis at the same age as alcohol or tobacco,” explain the authors.

Researchers used data from waves 1 through 5 of the Population Assessment of Tobacco and Health (PATH) study with limited usage files spanning September 2013 to November 2019.

For most young adults, alcohol and tobacco use still precede cannabis use

The results showed that few young people (6%) started their substance use with cannabis, and those who did were less likely to use alcohol in their lifetime or to report substance abuse or mental health problems. Among those with cannabis-only introductions, the majority were male (62.3%), more than a third were non-Hispanic white (38.3%), and the majority had at most a high school diploma or GED (65% ), while 34.9% had at least some college experience.

They also found that those who started using alcohol and tobacco at the same time (22%) started using cannabis were more likely to report using multiple drugs later in life.

The study suggests that alcohol is still the most popular substance use: 52% of respondents used alcohol before any other controlled substance.

“Alcohol is predominantly tried before tobacco or cannabis,” the authors concluded.

“Starting cannabis use at an earlier age than with alcohol and tobacco is uncommon. Those who started using cannabis before alcohol and tobacco seemed less likely to have a broad constellation of substance use and psychological distress than those who tried cannabis at the same age that they tried at least one other substance.”

They added, “Finally, the likelihood of reporting current and multiple substance use was highest among young adults who started using cannabis at the same age as alcohol or tobacco.”

Supporting previous insights and fighting the “gateway drug” stereotype.

The researchers noted that the results are consistent with previous studies – they are just the most recent, which better reflect the current reality of the expanding cannabis market.

A 2016 study also found that alcohol is the first substance used by individuals who report polydrug use later in life. The researchers examined the drug use patterns of a nationally representative sample of 2,835 high school seniors. Not only was alcohol the most common first substance, but researchers also said that the earlier someone starts drinking, the greater their likelihood of using illicit substances in the future.

A number of other studies have attempted to examine the long-standing claim that cannabis is a “gateway drug” that leads to further substance use, although studies have repeatedly found the claim to carry little weight.