Study Looks at ‘Triple Users’ of Marijuana, Cigarettes, E-cigarettes

A new study has found that there is a sizable group of adolescents who use e-cigarettes as well as marijuana and combustible cigarettes. These so-called triple users are at greater psychosocial and health risk than exclusive users of any one substance. The study, “A Grouping Analysis on Concurrence of E-cigarette, Cigarette, and Marijuana Use in 2019 YRBS Data,” published in the October 2021 issue of Pediatrics (published online Sept. 28), cross-classified use of e-cigarettes, combustible cigarettes, and marijuana among U.S. high school students in the 2019 Youth Risk Behavior Survey. The non-user group (never used any of the three substances) was 43.9% of the representative sample of U.S. adolescents. The largest of the user groups was triple users (16.9% of the sample), followed by dual (E-cigarette plus marijuana) users (15.8%), and exclusive e-cigarette users (13.2%). For risk profile on levels of psychosocial variables, the triple user group was typically elevated above all other groups. The results provide suggestions for further research on the social and health implications of e-cigarettes and indicate a need for more research on prevention approaches for dual and triple users, because additive effects place them at greater risk for adverse health consequences, the authors conclude.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.