Substance Use
Does Onset of Problematic Substance Use and Externalizing Mental Health Problems Predict Cannabis Vaping Initiation Among U.S. Adults? Findings from the Population Assessment of Tobacco and Health (PATH) Study, Waves 5 and 6 Olatokunbo Osibogun* Olatokunbo Osibogun Wei Li Ememgini Elo-Eghosa Olufemi Erinoso
Aim: Research has demonstrated that externalizing problems (i.e., aggression and impulsivity) are linked with substance use, including marijuana. However, the emergence of new consumption methods, like cannabis vaping, necessitates a focused examination of their relationship with externalizing behaviors and problematic substance use to identify susceptible groups. This study examines the longitudinal relationships between externalizing mental health problems, substance use problems (SUPs), and the initiation of cannabis vaping among US adults.
Methods: Data was drawn from the nationally-representative Population Assessment of Tobacco and Health (PATH) longitudinal Study Wave 5 (2018/19) and Wave 6 (2021). The analytic sample comprised cannabis vaping naïve adults (18+) at Wave 5 (baseline) who provided cannabis-vaping responses at Wave 6 (follow-up). We used weighted multivariable logistic regression models with adjusted odds ratios (AOR) to estimate associations between the onset of externalizing and substance use problems and the initiation of cannabis-vaping at follow-up (outcome), among adults with no history of these problems at baseline.
Results: The sample comprised mostly males (52.4%; 95% CI:50.2-54.6) and 25.5% (95% CI:23.4-27.7) were young adults aged 25-34 years. Participants who developed high externalizing mental problems had higher odds of initiating cannabis-vaping at follow-up (AOR:2.2; 95% CI:1.6-3.2). Similarly, those who developed moderate (AOR:1.7; 95% CI:1.3-2.3) and high substance use problems (AOR:2.7; 95% CI:1.5-4.8) had higher odds of cannabis-vaping at follow-up compared to those who remained without SUPs.
Conclusion: Our findings suggest interventions targeting externalizing problems and problematic substance use may be crucial for preventing the initiation of newer modes of substance use like cannabis-vaping.