Substance Use
Patterns and Correlates of Cannabis Use Modes Among U.S. Adults Brian Fairman* Brian Fairman
Background: With cannabis use on the rise, understanding consumption modes and their sociodemographic correlates is vital for public health. Different modes, such as combustible, blunt, and vape use, carry unique risks and may reflect diverse user profiles. This study examines these patterns to inform targeted interventions.
Methods: This study analyzed adults aged 18+ who reported using cannabis in the past 30 days (n = 6,886), based on 2021 data from the Population Assessment of Tobacco and Health Study. Participants identified their modes of use, including combustible forms (joints, pipes, hookahs, or bongs), blunts, vapes, or other methods. Multivariable logistic regression assessed associations between cannabis use modes and demographics, tobacco and alcohol use, physical and mental health, social media use, and respiratory issues.
Results: Approximately 39 million adults (16%) reported using cannabis in the past 30 days. Among these users, nearly two-thirds (65%) combusted cannabis, while over a quarter used blunts (27%), vapes (29%), or other methods (26%). Most adults (67%) used a single mode, and 22% used two modes. The most common dual-mode combinations were combustible and vaping (8.3%) and combustible and blunts (6.5%). Combustible use was associated with being male, White, a sexual minority, never or previously married, of lower-middle income, and with smoking cigarettes, cigars, or pipes, as well as consuming five or more alcoholic drinks per week. Blunt use was linked to younger age, Black or other non-White populations, sexual minorities, lower education levels, lower incomes, and smoking cigarettes, e-cigarettes, and cigars. Vape use was more common among younger, non-Black individuals, sexual minorities, those with higher incomes, non-cigarette smokers, e-cigarette users, and people spending over five hours on social media daily. Other modes were associated with older age (65+), females, White individuals, sexual minorities, college graduates, higher incomes, and non-smokers. Using one mode was generally inversely related to using another, except blunt smokers, who were more likely to vape.
Conclusions: Cannabis consumption is common among adults, with significant variation in mode of use and associated sociodemographic factors. Combustible use remains the most prevalent mode, linked to multiple traditional smoking behaviors, while blunt and vape use exhibit distinct associations with age, race/ethnicity, and income. These findings highlight the need for targeted public health interventions addressing the diverse patterns of cannabis use and their unique correlates.