A latent class analysis of patterns of tobacco and cannabis use in Australia and their health-related correlates

Drug Alcohol Rev. 2023 May;42(4):815-826. doi: 10.1111/dar.13614. Epub 2023 Feb 13.


Introduction: The shifting landscape in Australia's tobacco and cannabis policies and emerging new products and modes of administration may increase experimentation and the risks of addiction to these drugs.

Methods: We analysed cross-sectional data from the 2019 National Drug Strategy and Household Survey (n = 22,015) of Australians aged 14 and above. Latent class analysis was used to identify distinct groups based on types of tobacco and cannabis products used. The socio-demographic, health-rated correlates and past-year substance use of each latent class was examined.

Results: A four-class solution was identified: co-use of tobacco and cannabis (2.4%), cannabis-only (5.5%), tobacco-only (8.0%) and non-user (84.0%). Males (odds ratio [OR] range 1.5-2.9), younger age (OR range 2.4-8.4), moderate to high psychological distress (OR range 1.3-3.0), using illicit substances in the last year (OR range 1.41-22.87) and high risk of alcohol use disorder (OR range 2.0-21.7) were more likely to be in the tobacco/cannabis use classes than non-users. Within the co-use class, 78.4% mixed tobacco with cannabis and 89.4% had used alcohol with cannabis at least once.

Discussion and conclusions: Approximately 16% of respondents used tobacco or cannabis, or both substances, and no major distinct subgroups were identified by the use of different product types. Mental health issues and the poly-substance use were more common in the class who were co-users of cannabis and tobacco. Existing policies need to minimise cannabis and tobacco-related harms to reduce the societal burden associated with both substances.

Keywords: cannabis; cigarettes; joints; marijuana; tobacco.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia / epidemiology
  • Cannabis*
  • Cross-Sectional Studies
  • Hallucinogens*
  • Humans
  • Latent Class Analysis
  • Male
  • Nicotiana
  • Substance-Related Disorders* / psychology
  • Tobacco Use / epidemiology


  • Hallucinogens