Cannabis vaping and tobacco quit intentions, quit attempts, and symptoms of nicotine dependence among youth in the United States.

Abstract

Concurrent use of tobacco and cannabis is common among youth, yet the association between cannabis use and tobacco cessation remains unclear. This study examines the relationship between past 30-day cannabis vaping and four tobacco cessation indicators among a nationally representative sample of youth who use tobacco in the United States. We analyzed pooled 2023-2025 data from the National Youth Tobacco Survey. Participants (n = 5444) were middle and high school students who reported past 30-day tobacco use. Multivariable logistic regression examined the association between past 30-day cannabis vaping and four tobacco cessation indicators (quit intentions, quit attempts, cravings, use within 30min of waking), controlling for number of tobacco product categories used, sex, race/ethnicity, school level, and survey year. An interaction between cannabis vaping and number of tobacco product categories used (single, dual, ≥ 3) was tested to assess whether associations differed across tobacco use patterns. Past 30-day cannabis vaping was associated with lower odds of quit intentions (aOR: 0.76; 95%CI: 0.62-0.94) and higher odds of nicotine dependence symptoms, including cravings (aOR: 1.68; 95%CI: 1.35-2.09) and use within  30min of waking (aOR: 1.83; 95%CI: 1.42-2.36), relative to no cannabis vaping in past 30-days. The interaction between cannabis vaping and number of tobacco product categories used was not significantly associated with any of the four outcomes. Past 30-day cannabis vaping was associated with lower quit intentions and greater nicotine dependence among youth who use tobacco. Addressing cannabis use may be important for improving tobacco cessation efforts among this population.