UCSF

Introduction: Limited research on youth tobacco use addresses cannabis use across different tobacco products and racial/ethnic subgroups. This study examines these patterns of cannabis use among youth who use tobacco using 6 waves of nationally representative data. Methods: This study analyzed the Population Assessment of Tobacco and Health Study data Waves 1-6 (during 2013-2021) in 2024. The authors conducted cross-sectional weighted analyses for each wave. The authors estimated past 30-day use of cannabis among youth who reported past 30-day use of any tobacco, combustible tobacco, and e-cigarette for the total sample and for each racial and ethnic group (Hispanic, non-Hispanic White, non-Hispanic Black, and non-Hispanic other). Results: Across 6 waves, cannabis-use prevalence was over 36% among youth who used any tobacco product, over 40% among those who used combustible tobacco, and 36% among those who used e-cigarettes. There were racial/ethnic disparities in cannabis use among youth who used e-cigarettes, with non-Hispanic Black, non-Hispanic other, and Hispanic youth reporting the highest cannabis-use prevalence. There were no significant racial/ethnic differences in cannabis use among youth who used combustible tobacco. Conclusions: Cannabis use is highly prevalent among youth who use tobacco, with significant disparities by tobacco product and race/ethnicity. The disproportionately high prevalence of cannabis use among non-White youth highlights the need for tailored interventions to address these disparities in cannabis and tobacco use among youth.