What topics does this cannabis study cover?

This study covers research on: Addiction, Mental Health.

Where was this research published?

Published in Addiction (Abingdon, England) on May 26, 2026.

How cannabis consumption methods shape addiction risk

Associations between modes of cannabis use and cannabis use disorder: Evidence from the 2022 to 2023 United States National Survey on Drug Use and Health.

Addiction (Abingdon, England) • May 26, 2026 • Moderately Relevant

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AI Summary

This national survey study analyzed how different methods of consuming cannabis—smoking, vaping, eating, dabbing, topicals, or combinations—relate to the risk of developing cannabis use disorder (CUD). Using data from over 25,000 U.S. adults from 2022-2023, researchers found that 30.3% of all cannabis users met criteria for CUD, with rates varying dramatically by consumption method. The lowest risk appeared among oral/mucosal-only users (4.4%), while multi-modal users—those using two or more methods—had rates of 40.5%, suggesting that using cannabis in multiple ways substantially increases disorder risk.

The most striking finding was the fourfold increase in CUD risk among multi-modal users compared to those using only oral consumption. Users who combined smoking, vaping, dabbing, and oral consumption faced the highest risk, with nearly 20 times greater odds of CUD than those using only topicals and oral methods. Additionally, traditional smoking (AOR = 2.98) and inhaled routes like dabbing (AOR = 1.89) each showed significantly elevated risks. The study also revealed that moderate-to-severe CUD affected 13.2% of all users, concentrated among multi-modal and dab-only consumers.

These findings suggest that how people consume cannabis matters as much as how frequently they use it. The research indicates that inhaled delivery methods—whether smoked or vaporized—and especially combining multiple consumption methods, are associated with greater risk of developing problematic use patterns. For clinicians, patients, and policymakers, this highlights the importance of considering not just overall cannabis use frequency, but the specific methods and combinations people employ when assessing and addressing cannabis-related harms.

📄 Original Abstract

With expanding cannabis legalization, normalization, and diversifying products and delivery methods in the United States (US), cannabis use disorder (CUD) prevalence is rising. Various modes of cannabis use may influence pharmacokinetics, usage patterns, and harm, affecting CUD risk. We measured associations between modes of cannabis use, including multi-modal patterns, and CUD prevalence and severity. This cross-sectional study analyzed data from a nationally representative sample of US adults using the 2022-2023 National Survey on Drug Use and Health (NSDUH) data. Multivariable logistic regression analyses were employed to estimate the association between modes of cannabis use and past-year CUD, adjusting for potential confounders and covariates. Analyses were stratified by sex, age, and cannabis use frequency. Among multi-modal users, common combinations and their associations with CUD were further examined. Respondents 18 years or older who reported past-year cannabis use (unweighted n = 25 549; weighted N = 58 850 309). Exposure of interest was the mode of cannabis use, primarily categorized as smoke-only, vape-only, oral/mucosal-only, dab-only, topicals-only, and multi-modal (≥ two modes). The outcome variable was CUD in the past year, and CUD severity, based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Covariates included age, sex, race/ethnicity, income, education, state cannabis law status, age of cannabis initiation, cannabis use motive, frequency of use, perceived risk of smoking cannabis, illicit drug use, past year mental illness, nicotine dependence, and alcohol use disorder. Of the total past-year cannabis users, 53.9% reported multi-modal cannabis use. Overall, CUD prevalence was 30.3%, ranging from 4.4% among oral/mucosal-only to 40.5% among multi-modal, and 28.9% among dab-only users (p < 0.0001). Moderate-to-severe CUD affected 13.2% of all users and was concentrated among multi-modal and dab-only users. In multivariable regression, multi-modal users had fourfold higher odds of CUD (adjusted odds ratio [AOR] = 4.14; 95% confidence interval [CI]: 2.91-5.90). Elevated odds were also observed among smoke-only (AOR = 2.98; 95% CI: 2.02-4.39) and vape/dab-only users (AOR = 1.89; 95% CI: 1.09-3.29), compared with oral/mucosal-only users. Analyses of multi-modal combinations showed the highest CUD odds among those using smoke + vape + oral/mucosal + dab (AOR = 19.74; 95% CI: 9.11-42.75), compared with oral/mucosal + topicals users. In the United States, modes of cannabis use appear to be statistically significantly associated with prevalence and severity of cannabis use disorder, with multi-modal and inhaled routes conferring the greatest risk. Findings underscore the importance of considering mode of use alongside frequency and potency in clinical assessment, prevention, and policy strategies aimed at reducing cannabis-related harms.

Paper Type

📄 Research

Publication

Journal: Addiction (Abingdon, England)
Published: May 26, 2026
PMID: 42186749
DOI: 10.1111/add.70474

Authors (7)

Amrit Baral Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Cerina Dubois Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Lakshmi Kumar Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Janardan Devkota Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Denise C Vidot Global Cannabis and Psychedelics Research Collaboratory, School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.
+2 more authors