Cannabis Use Linked to Progression to Regular Tobacco Use

13.0 percent of total new regular tobacco use in the United States was attributed to cannabis use

By Elana Gotkine HealthDay Reporter

THURSDAY, Oct. 30, 2025 (HealthDay News) — Cannabis use in 2017 was associated with regular tobacco use in 2021 among U.S. youth and young adults who had never regularly used tobacco, according to a study published online Oct. 23 in Tobacco Control.

Jiayu Chen, from the University of California, San Diego, and colleagues examined the association between past 12-month cannabis use in 2017 and new-onset regular tobacco use in 2021 in a prospective study involving a U.S. cohort aged 12 to 24 years who had never regularly used tobacco. Propensity score-matching was performed for exposed and unexposed residents.

The researchers found that 32.7 percent of U.S. youths aged 12 to 17 years who used cannabis progressed to regular tobacco use in 2021, representing an increase of 15.6 percentage points compared with matched controls. Overall, 14.0 percent of cannabis users aged 18 to 24 years reported regular tobacco use at follow-up, an increase of 5.4 percentage points compared with matched controls. In a matching analysis, 13.0 percent of total new regular tobacco use in the United States was attributed to cannabis use; in the absence of cannabis, 509,800 fewer U.S. youth and young adults would have progressed to regular tobacco use.

“This study provides evidence that failure to address cannabis use among young people has the potential to undermine the progress tobacco control efforts have made in reducing tobacco initiation and progression to regular use,” the authors write.