Electronic nicotine delivery system use is related to higher odds of alcohol and marijuana use in adolescents: Meta-analytic evidence
Open accessAbstract
Research suggests that electronic nicotine delivery system (ENDS) use is associated with other substance use in adolescents; however, the magnitude of this association and whether this differs between adolescents and adults is not yet well understood. This meta-analysis aimed to quantify the extent to which ENDS use is associated with alcohol and marijuana use among adolescents and to compare the odds across adolescent samples and a comparison group of adult samples. A comprehensive literature review was conducted examining the relationship between ENDS use and alcohol (adolescent k = 40 from 19 independent studies; adult k = 35 from 12 independent studies) and marijuana (adolescent k = 24 from 14 independent studies; adult k = 6 from 3 independent studies) use. Adolescents who use ENDS had greater odds of reporting co-occurring alcohol use (OR = 4.50, p < .001), particularly binge drinking (OR = 4.51), and marijuana use (OR = 6.04, p < .001) than adolescent who did not use ENDS. Adults who use ENDS were also more likely to use alcohol (OR = 1.57, p < .001) and marijuana (OR = 2.04, p < .001) than those who did not use ENDS. ENDS use was associated with significantly greater odds of alcohol use (log odds ratio; LOR = 0.96 (OR = 2.61), p < .001) and a trend of greater marijuana use (LOR = 0.93 (OR = 2.53), p = 0.08) in adolescents than in adults. Effects were large in adolescents and small in adults. Findings suggest that ENDS use should be assessed in adolescents in both research and clinical settings. Importantly, ENDS use is strongly associated with co-occurring alcohol or marijuana use in adolescents.
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Alcohol, cannabis, and nicotine use are often directly related to each other, with all three often used in combination.
“Alcohol, cannabis, and nicotine use are often directly related to each other [226, 228] with all three often used in combination.”
From Consequences of adolescent drug use (2023) · cites this paper as [228]
The Methods (Meta-analytic Method; page unavailable) measure co-occurring ENDS use separately with alcohol and with marijuana, and the Discussion reports substantially higher odds of each among adolescents who use ENDS. The paper does not establish that alcohol and marijuana are directly related to each other or that all three substances are often used together; its analyses examine two-substance relationships. (LLM, conf=0.88)
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Consequences of adolescent drug use
Steinfeld, M. R., & Torregrossa, M. M. (2023) · Translational Psychiatry · doi:10.1038/s41398-023-02590-4 · Cited by 237 · see citing works
“Alcohol, cannabis, and nicotine use are often directly related to each other [226, 228] with all three often used in combination.”
Background
- Authors
- Hershberger, A., Argyriou, E., & Cyders, M.
- Affiliations
- Lexington VA Health Care System (US)
- Indiana University – Purdue University Indianapolis (US)
- Corresponding author
- Hershberger, Alexandra
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 105
- Pages
- 106325
- ISSN
- 0306-4603 (ISSN-L)
- PMC
- PMC7197053
- OpenAlex
- W3003171931
- Cited by
- 39
- References
- 96
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 4 · 2021: 9 · 2020: 3
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (F31 AA024682)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- electronic cigarettes, adolescent substance use, alcohol consumption, cannabis use, binge drinking, co-occurring substance use, adolescents versus adults, tobacco use
- MeSH terms
- Vaping, Marijuana Use, Adolescent, Adult, Alcohol Drinking, Female, Humans, Male, Middle Aged, Odds Ratio, Young Adult, Electronic Nicotine Delivery Systems
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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