The association between age of initiation and current blunt use among adults: Findings from the national survey on drug use and health, 2014-2019

Drug Alcohol Depend. 2022 Jan 1:230:109191. doi: 10.1016/j.drugalcdep.2021.109191. Epub 2021 Nov 27.


Background: Initiating cannabis use at a young age has been linked to problematic and continued cannabis use in adulthood. Given that approximately 1 in 3 adult cannabis smokers report blunt use, it is important to determine if and how age of blunt initiation is associated with current blunt use among adult blunt smokers.

Methods: This study uses cross-sectional pooled data from the 2014-2019 National Survey on Drug Use and Health (NSDUH) to examine the association between age of blunt initiation and current blunt use among 62,020 adults who reported lifetime blunt use.

Results: Among lifetime blunt smokers, 51.4% initiated blunt use at 18 years or older, 42.1% initiated blunt use at 14-17 years old and 6.5% initiated blunt use at 13 years or younger. Multivariable logistic regression models revealed that odds of past 12-month (aOR: 1.58; 95% CI: 1.45 - 1.72), past 30-day (aOR: 2.58; 95% CI: 2.37 - 2.80) and daily (aOR: 3.17; 95% CI: 2.61 - 3.86) blunt use were greater among adults who initiated blunt use at 13 years of age or younger relative to those who initiated blunt use at 18 years of age or older, controlling for covariates.

Conclusions: Early onset of blunt use among adolescents is associated with current blunt use in adulthood among lifetime blunt users. Given the adverse health effects associated with blunt use and the prevalence of adult cannabis users who report blunt use, cannabis interventions and policies should be expanded to target blunt use among early initiators.

Keywords: Adolescent; Age; Blunt use; Cannabis.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Humans
  • Marijuana Smoking* / epidemiology
  • Pharmaceutical Preparations*
  • Smoking Devices
  • Substance-Related Disorders* / epidemiology


  • Pharmaceutical Preparations