title: Differences in Tobacco Product Use Among Past Month Adult Marijuana Users and Nonusers: Findings From the 2003-2012 National Survey on Drug Use and Health.
abstract: BACKGROUND
  This study assessed differences in individual tobacco product use between past month marijuana users and nonusers, and trends in overall tobacco use and use of specific tobacco products among marijuana users.
  
  
  METHODS
  Data were obtained from 378 459 adults participating in the 2003-2012 National Survey on Drug Use and Health, a cross-sectional, household interview survey conducted annually. Data from the most recent 2 years (2011-2012) were used to assess differences in the prevalence of various tobacco products by past month marijuana status. Data from all years were used to assess historical trends in overall tobacco use, and use of cigarettes, cigars, and blunts among marijuana users; trend significance was assessed using orthogonal polynomials.
  
  
  RESULTS
  From 2011-2012, the prevalence of any past month tobacco use among the 9727 past month marijuana users was 68.6% excluding blunts, and 78.3% including blunts (vs. 25.3% for nonusers, P < .0001); 77.3% of past month marijuana users reported past month combusted tobacco use (vs. 23.4% of non-MJ users, P < .0001). By product, 60.1% of past month marijuana users reported past month cigarette use, 42.0% reported past month blunt use, and 20.6% reported past month cigar use. Overall, adjusted trends in past month cigarette use decreased, while trends in past month blunt use increased; cigar use did not change.
  
  
  CONCLUSIONS
  Tobacco use is highly prevalent among adult marijuana users and represents an important potential comorbidity of marijuana use. In light of increasing policies legalizing marijuana, it is critical to monitor changes in overall and specific tobacco product use.
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA; gillian.schauer@emory.edu.
authors.forename: Gillian L
authors.initials: GL
authors.lastname: Schauer
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA;
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Berg
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA;
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Kegler
authors.affiliation: Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA.
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Donovan
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA;
authors.forename: Michael
authors.initials: M
authors.lastname: Windle
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies / Q000379:methods / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000639:trends*; D008875:Middle Aged; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology* / Q000639:trends*; D062789:Tobacco Products / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult