Reasons for multiple tobacco product and cannabis co-use among Texas young adults

Objective: This study examines differences in reasons for e -cigarette, cigarette, and cannabis use across exclusive, dual, co-, and poly co-users. Methods: Participants were 645 young adults who reported past 30-day (P30D) use of e -cigarettes, cigarettes, or cannabis at wave 14 (Fall, 2021) of the Texas Adolescent Tobacco Marketing and Surveillance System (TATAMS). Exclusive users reported P30D use of one product, dual users reported P30D use of e -cigarettes and cigarettes, co-users reported use of cannabis and one tobacco product, and poly co-users reported P30D use of all three products. Participants were asked if they agreed with a series of reasons for using their respective products. Multinomial logistic regression analyses were conducted to examine associations between reasons for use and pattern of use, controlling for sex, race/ethnicity, and lifetime product use. Results: 26.36 % of P30D users reported cannabis and tobacco use. Poly co-users were more likely to report using e -cigarettes because their friends do than e -cigarette co-users (aRRR = 2.64; 95 %CI = 1.19 -5.83) and dual tobacco users (aRRR = 5.11; 95 %CI = 1.73 -15.12). Poly co-users were more likely to smoke cigarettes while drinking alcohol (aRRR = 4.68; 95 %CI = 1.06 -20.72) or to experience a pleasurable buzz (aRRR = 5.48; 95 % CI = 1.62 -18.57) than exclusive cigarette users. Poly co-users more often reported using cannabis for taste (aRRR = 3.13; 95 %CI = 1.51 -6.51), because their friends use it (aRRR = 2.19; 95 %CI = 1.08 -4.42), and while drinking alcohol (aRRR = 2.13; 95 %CI = 1.03 -4.41) than exclusive cannabis users. Conclusions: Given that reasons for use differ significantly among types of multiple product users and exclusive users, interventions should be tailored to address the specific tobacco and cannabis use practices of young adults.