Who mixes cannabis with cigars and why it matters for health

This study examines how smoking cigars or cigarillos alongside cannabis use varies across demographic groups in the U.S. adult population. Analyzing data from 1,524 recreational cannabis users, researchers found that 8.26% of cannabis users also smoke cigars/cigarillos. The findings reveal significant disparities: Black, non-Hispanic cannabis users are five times more likely to engage in this co-use pattern compared to White, non-Hispanic users. Additionally, cannabis users with less formal education (less than an associate degree) show higher rates of cigar/cigarillo smoking, suggesting that socioeconomic and racial factors shape substance use patterns in measurable ways.

Co-users of cannabis and cigars/cigarillos demonstrate distinct consumption preferences and spending patterns. These individuals are significantly more likely to use smoking forms of cannabis, particularly flowers (2.16 times more likely) and pre-rolls (2.05 times more likely), compared to those who use cannabis alone. The financial impact is noteworthy: co-users report spending approximately $72 more per month on cannabis than cannabis-only users, amounting to nearly $900 annually. This elevated spending, combined with increased reliance on inhalation-based cannabis products, suggests that co-users may face heightened exposure to the risks associated with smoking, including respiratory irritation and potentially higher addiction vulnerability.

The research underscores important public health considerations for cannabis policy and harm reduction. Understanding that specific demographic groups show higher co-use rates can inform targeted education and intervention strategies. The association between cigar/cigarillo smoking and increased cannabis spending and product preferences suggests that some users may benefit from information about alternative consumption methods that reduce smoking-related risks, such as edibles, vaporization, or other non-inhalation products. These findings highlight the need for inclusive cannabis education that addresses the real-world behaviors and preferences of diverse user populations.