Cannabis Use Linked to Increased Tobacco Use Among US Youth and Young Adults

A new study published in Tobacco Control has revealed a significant association between cannabis use and progression to regular tobacco use among US youth and young adults. According to the research, among US youths aged 12-17 years who used cannabis, 32.7% progressed to regular tobacco use in 2021, an increase of 15.6 percentage points compared to their matched controls. Among young adults aged 18-24 years, 14.0% of cannabis users reported regular tobacco use at follow-up, an increase of 5.4 percentage points over their matched controls.

Key Takeaways:

  • Cannabis use among US youth and young adults who had never regularly used tobacco was associated with a large increase in current regular tobacco use in 2021.
  • Among US youths aged 12-17 years who used cannabis, 32.7% (95% CI: 28.9% to 36.7%) progressed to regular tobacco use in 2021, an increase of 15.6 percentage points (pp) (95% CI: 11.1 pp to 20.2 pp) compared to their matched controls.
  • Among young adults aged 18-24 years who used cannabis, 14.0% (95% CI: 11.9% to 16.5%) reported regular tobacco use at follow-up, an increase of 5.4 pp (95% CI: 2.6 pp to 8.2 pp) over their matched controls.
  • The matching analysis attributed 13.0% of total new regular tobacco use in the US to cannabis.
  • In the absence of cannabis, an estimated 509,800 fewer US youth and young adults would have progressed to regular tobacco use in 2021.

Statistics:

  • 32.7% (95% CI: 28.9% to 36.7%) of US youths aged 12-17 years who used cannabis progressed to regular tobacco use in 2021.
  • 14.0% (95% CI: 11.9% to 16.5%) of young adults aged 18-24 years who used cannabis reported regular tobacco use at follow-up.
  • 15.6 percentage points (95% CI: 11.1 pp to 20.2 pp) increase in regular tobacco use among US youths aged 12-17 years due to cannabis use.
  • 5.4 percentage points (95% CI: 2.6 pp to 8.2 pp) increase in regular tobacco use among young adults aged 18-24 years due to cannabis use.
  • 13.0% of total new regular tobacco use in the US attributed to cannabis.
  • Estimated 509,800 fewer US youth and young adults would have progressed to regular tobacco use in 2021 without cannabis use.

Sources:

  • Cannabis use and progression to regular tobacco use among United States youth and young adults: evidence from the Population Assessment of Tobacco and Health (PATH) study, 2017-2021. Tobacco Control, 2025.
  • Tobacco Control can be contacted at: Bmj Publishing Group, British Med Assoc House, Tavistock Square, London WC1H 9JR, England.
  • NewsRx. New Marijuana/Cannabis Findings from University of California San Diego (UCSD) Reported [Cannabis use and progression to regular tobacco use among United States youth and young adults: evidence from the Population Assessment of Tobacco and ...]. Life Science Weekly. November 4, 2025; p 3373.