Trends in blunt smoking among adults in the United States, 2015-2022

Abstract

Objective: We quantify and compare population-level trends in blunt smoking across demographics as well as behavioral and regulatory factors among adults in the US from 2015 to 2022.

Methods: We analyzed eight (8) years of data from the National Survey of Drug Use and Health (NSDUH). Participants were n = 326,087 adults; a subsample of n = 22,294 current blunt smokers was used to examine daily blunt smoking. We modeled linear trends in lifetime (ever), current (past 30-day), and daily (30/30 days) blunt smoking by: sex, race/ethnicity, age category, income, Major Depressive Episodes, alcohol use, and state-level cannabis regulatory policy.

Results: From 2015 to 2022, lifetime blunt smoking increased ∼21.7 % (p < 0.001), current blunt smoking increased ∼34.4 % (p < 0.001), and daily blunt smoking among current users increased ∼24.5 % (p < 0.001). Lifetime blunt smoking increased significantly more among non-Hispanic White (23.7 %) and Hispanic (30.2 %) relative to non-Hispanic Black (8.6 %) adults; similar increases were observed among those older than 18-25 years. Current blunt smoking increased significantly greater among females (63.6 %) relative to males (19.0 %) and among those who did not use alcohol (92.3 %) relative to those who did use alcohol (23.4 %). Daily blunt smoking increased significantly greater among non-Hispanic White (80.4 %) relative to non-Hispanic Black (3.7 %) adults.

Conclusion: Blunt smoking increased substantially from 2015 to 2022. The greatest increases in blunt smoking were observed among females, older adults, and those who did not use alcohol; groups with historically lower rates of blunt smoking. Future study is needed to understand patterns of blunt initiation, escalation, and use disorder.

Keywords: Blunts; Cannabis; Cannabis use disorder; Cigars; Population health.