Cailin Conner

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Adolescent substance use has long been a concern due to its potential impact on various aspects of health, including respiratory well-being. While research sheds light on the adverse effects of tobacco and cannabis use on lung health, limited knowledge exists regarding the respiratory consequences when these substances are combined.
A recent population-based study published in Addictive Behaviors investigated the associations between e-cigarette use, combustible cigarette use, cannabis use, and asthma. “We tested for associations of the substance use groups with both lifetime asthma and recent asthma, hypothesizing that groups with E-cigarette Use and Cannabis Use will both have elevated likelihood of asthma and that Triple Use will be particularly elevated,” the authors wrote.
The study included a sample of 150,634 public high school students in grades 10-12, selected using a 2-stage design ensuring representativeness for the state of California from 2019-2020. The researchers collected data on several variables, including e-cigarette use, combustible cigarette use, cannabis use, motives for use, method of cannabis use, asthma diagnosis, and recent asthma attacks. The participants were cross-classified into 5 groups: non-use, dual e-cigarette/cannabis use, exclusive cannabis use, exclusive e-cigarette use, and triple-use.
The study&#8217;s results indicated that most participants (64%) did not use substances, while the remaining participants fell into 1 of 4 substance use categories. Multinomial logistic regression analysis—controlling for demographic factors, household use, and parental education—revealed significant associations between substance use patterns and asthma.
Compared to non-users, all 3 substance use categories (dual e-cigarette/cannabis use, exclusive cannabis use, and exclusive e-cigarette use) showed elevated odds of lifetime asthma and recent asthma attacks. The triple-use category—comprising the combined use of e-cigarettes, combustible cigarettes, and cannabis—displayed the highest odds of both lifetime and recent asthma compared to the non-use group. These findings indicate that the co-occurrence of e-cigarette and cannabis use was a common pattern among adolescents in the study.
Furthermore, the authors observed that among those who reported cannabis use, a significant proportion engaged in both smoking and vaping cannabis. Specifically, 88% of the triple-use group and 74% of the dual e-cigarette/cannabis use group reported using both smoking and vaping methods for cannabis consumption.
The study findings highlight the need for preventive approaches that address the health implications of both exclusive and combined e-cigarette and cannabis use among adolescents. Public health campaigns and educational initiatives should emphasize the potential respiratory risks associated with these behaviors to raise awareness among young individuals, their parents, and educators.
The authors concluded, “Further research is needed to examine the use of inhalation products that may be associated with a diagnosis of asthma and to the use of inhalation products among youth currently with asthma.”
Source: <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306460323001727?via%3Dihub" target="_blank" rel="noopener">Addictive Behaviors</a>

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A study conducted among high school students revealed that the combined use of e-cigarettes, combustible cigarettes, and cannabis was associated with increased asthma risk.

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