A nonprofit publication of the Kentucky Center for Public Service Journalism

Youths using e-cigarettes more likely to try marijuana; connection increased with refillable e-cig pods


By Melissa Patrick
Kentucky Health News

Young people who use electronic cigarettes are more likely to use marijuana, and the odds are even greater for those who start using e-cigarettes early, according to newly published research.

The analysis of 21 separate studies, published in JAMA Pediatrics, found that the odds of marijuana use were 3½ times higher among youth who used electronic cigarettes, than among those who didn’t; that risk was higher among those between the ages of 12 to 17, compared to young adults aged 18 to 25.

The researchers are concerned about the link between e-cigarette use and marijuana.

Teen use of e-cigarettes in Kentucky doubled from 2016 to 2018, according to a state survey.

“Studies have shown that marijuana use during adolescence is associated with reduced cognitive abilities, motivation, satisfaction with life, and life achievement, as well as significantly greater rates of mental health disorders, such as depression, anxiety and schizophrenia,” the summary of the studies says.

Teen use of e-cigarettes in Kentucky doubled from 2016 to 2018, according to a state survey. It found that 26.7 percent of high-school seniors reported using e-cigs in the month before they were surveyed, up from 12.2 percent in 2016.

Among 10th graders, use increased to 23.2 percent from 11.3 percent. Among eighth graders, it rose to 14.2 percent from 7.3 percent. Sixth-graders’ use went to 4.2 percent from 2.3 percent.

A national study found that use of e-cigarettes increased nearly 80 percent among high schoolers and 50 percent among middle schoolers from 2017 to 2018.

The study, involving data from more than 128,000 participants aged 10-24, found that the association with marijuana was stronger in younger youth and those who used both e-cigarettes and other tobacco products, such as traditional cigarettes.

“The findings of increased marijuana use with [e-cigarette] use in younger vs. older youths is consistent with developmental assumptions that a younger, less-developed brain is more vulnerable to substance use and addiction,” says the report.

E-cigarettes have high levels of nicotine, which has been proven to be harmful to the developing brains of teens and may “increase [the] risk for future addiction to other drugs,” according to the Centers for Disease Control and Prevention. The brain develops until about age 25.

The study also found that the association with marijuana was stronger in the studies published in 2017 or after. The reason is unclear, but the researchers point to the rise in refillable cartridges and pod-like devices, which have high levels of nicotine.

The report concludes, “These findings highlight the importance of addressing the rapid increases in e-cigarette use among youths as a means to help limit marijuana use in this population.”


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