Trends in and Characteristics of Marijuana and Menthol Cigarette Use Among Current Cigarette Smokers, 2005-2014.

Background: Given increasing co-marijuana and tobacco use in the United States, this study aimed to explore the overlap between menthol cigarette use (MCU) and marijuana.

Methods: Data came from past month US cigarette smokers 12 years and older responding to the National Survey on Drug Use and Health between 2005 and 2014 (N = 51 500). Prevalence, demographics and substance use characteristics from 2013 to 2014 were assessed across four groups, based on past month marijuana and tobacco use: cigarette smokers with marijuana and MCU, with marijuana but no MCU, with no marijuana but MCU, and with use of neither. Multivariable logistic regression explored the relationship between MCU, marijuana, and dependence. Linear and quadratic trends were assessed using logistic regression with orthogonal polynomials.

Results: Past month marijuana/MCU among cigarette smokers was 8.3% in 2013-2014. Overall, marijuana/MCU was significantly higher among blacks versus whites (20.8% vs. 5.8%, p < .0001), though among 12-25 year olds, prevalence was significantly higher among whites versus blacks (6.3% vs. 0.9% for 12-17-year-olds; 39.2% vs. 26.8% for 18-25-year-olds). Marijuana/MCU increased significantly between 2005 and 2014 overall, and among whites and blacks. No adjusted associations were found between marijuana, MCU and nicotine or marijuana dependence.

Conclusions: Past month marijuana/MCU among cigarette smokers is increasing in the United States, with specific racial and age-based disparities. Research about the implications of consuming both marijuana and menthol, and the potential overlap in consumption of flavors across the products is warranted to better inform future preventive and treatment approaches.

Implications: This is the first study to assess the overlap between MCU and marijuana use among a nationally representative sample of US current smokers ages 12 and older. Findings from this study suggest that past month marijuana and menthol use among cigarette smokers is increasing in the United States, with specific racial/ethnic and age-based disparities. More research about the implications of consuming both marijuana and menthol, and the potential overlap in consumption of flavors in marijuana and tobacco products is warranted to better understand what preventive and treatment approaches may be needed.