Substance Use
Social determinants of blunt use among youth in the US: National Youth Tobacco Survey 2022 Rime Jebai* Rime Jebai Sarah D. Kowitt Jennifer Cornacchione Ross
The use of blunts (hollowed-out cigars filled with marijuana) has become popular among youth. Research on psychological distress and other determinants of blunt use is scant. This study examined social determinants of blunt use among a nationally representative sample of US youth.
Data were from middle and high school students who participated in the 2022 cross-sectional National Youth Tobacco Survey (n=28,291). Psychological distress was classified into none, mild, moderate, and severe based on the four-item Patient Health Questionnaire (PHQ-4) for depression and anxiety. Youth who reported using a blunt at least once in their lifetime were classified as ever blunt users. To estimate the association between psychological distress, race, sexual orientation, and ever blunt use, weighted logistic regression was performed adjusted for sex, age, school type, and past 30 days use of tobacco products.
Overall, 8% of youth reported ever blunt use and nearly 13% reported severe psychological distress. In addition, 16% of youth reported being lesbian, gay, or bisexual (LGB), and 12% were non-Hispanic Black. Compared to youth without psychological distress, those with mild [OR=1.54, 95% CI (1.15,2.06)], moderate [1.73, (1.29,2.31)], and severe [2.29, (1.74,3.01)] distress were more likely to report ever blunt use. Compared to non-Hispanic White youth, non-Hispanic Black [2.07, (1.54,2.79)] and Hispanic [1.48, (1.16,1.89)] youth were more likely to report ever blunt use. The odds of ever blunt use were higher among youth identifying as LGB [1.47, (1.29,1.82)] compared to straight/heterosexual. The odds of ever blunt use were also higher among polytobacco users (>2 tobacco products) vs. single use (only one tobacco product) [2.50, (1.51,4.12)] and among cigar smokers [3.29, (1.71,6.34)].
Youth who reported being LGB, Black, or Hispanic and those with psychological distress were more likely to report ever blunt use. Findings underscore the importance of tobacco and substance use control efforts designed to reach minority communities and those with psychological distress.