Prevalence and Correlates of Concurrent and Simultaneous Cannabis and Cigarette Use among Past-Year Cannabis-Using US College Students

Subst Use Misuse. 2020;55(2):329-336. doi: 10.1080/10826084.2019.1668015. Epub 2019 Oct 1.


Background: Cannabis and tobacco use are significant public health concerns among young adults, with concurrent (in the same time period) and simultaneous (at the same time so the effects overlap) use of both substances on the rise. Few studies have examined these behaviors among college students. Objective: We examined the prevalence of concurrent and simultaneous cannabis and cigarette (combustible or electronic) use among a sample of college students and characterized the psychosocial predictors of concurrent and simultaneous use compared to using cannabis alone. Methods: Data on past-3 months cannabis and cigarette use were collected on 1352 college students who were past-year cannabis and alcohol users yielding four groups: cannabis-only users (n = 686), concurrent cannabis and cigarette users (CCAC; n = 235), simultaneous cannabis and cigarette users (SCAC; n = 293), and non-recent users of either substance (n = 138). Multinomial logistic regression analyses were utilized to predict group membership. Results: Relative to the cannabis-only group, White, compared to Non-White students, males, compared to females, frequent, compared to infrequent, alcohol users, including those who used alcohol simultaneously with cigarettes, and illicit drug users were more likely to belong to the CCAC or SCAC group. Conclusions: Findings suggest the need for unique intervention efforts to prevent onset or reduce co-use among male and White students as well as illicit drug users and frequent alcohol users.

Keywords: Cannabis; cigarettes; college students; concurrent use; simultaneous use; tobacco.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Alcohol Drinking / epidemiology*
  • Cigarette Smoking / epidemiology*
  • Comorbidity
  • Ethnicity / statistics & numerical data
  • Female
  • Humans
  • Male
  • Marijuana Smoking / epidemiology*
  • Prevalence
  • Prospective Studies
  • Sex Factors
  • Students / statistics & numerical data*
  • Substance-Related Disorders / epidemiology*
  • United States / epidemiology
  • Universities / statistics & numerical data*
  • Young Adult