Alcohol, tobacco, and marijuana consumption is associated with increased odds of same-day substance co- and tri-use
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Background Little is known about event-level patterns of marijuana co- or tri-use with alcohol and tobacco. Thus, the study goal was to examine patterns of same-day alcohol, cigarette, and marijuana co- and tri-use at the individual level in non-treatment-seeking alcohol users.Methods Participants (N = 551) completed an in-person interview for alcohol, cigarette, and marijuana use over the previous 30 days, and the event-level substance use patterns of n = 179 participants who reported using each of these substances at least once per month were analyzed.Results The use of alcohol, marijuana, or cigarettes independently increased the probability of subsequent, simultaneous co-use of one of the two remaining substances. The co-use of alcohol with cigarettes and marijuana with cigarettes produced generally additive effects on the odds of same day tri-use of marijuana and alcohol, respectively. Conversely, the co-use of alcohol and marijuana produced sub-additive effects on likelihood of cigarette use. Sex moderated several of the observed patterns of co- and tri-use: the relationship between alcohol or cigarette use predicting marijuana co-use was stronger in men, whereas the observed additive relationships between drug co-use leading to tri-use was stronger in women.Conclusions The presented results may aid in the understanding of how simultaneous co-use of marijuana with alcohol and/or tobacco relates to the etiology, maintenance, and treatment of comorbid and trimorbid substance use disorder. Replication and extension of the results in treatment seeking populations using more fine-grained analysis approaches, e.g. ecological momentary assessment, is needed.
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Researchers are increasingly studying effects of drugs in combination to better model human consumption.
“Researchers are increasingly studying the effects of drugs in combination to better model the way humans consume drugs [224–227].”
From Consequences of adolescent drug use (2023) · cites this paper as [226]
The Introduction (page unavailable) says drugs are commonly co-used and describes recent studies of simultaneous use; the Discussion (page unavailable) also refers to studies of combined drug effects. This supports studying drugs in combination, but the paper does not establish that such research is increasing or that researchers undertake it specifically to better model human consumption. (LLM, conf=0.82)
Experimental — accuracy not yet measuredAlcohol, 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 [226]
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Flagged first, then by citations
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Cited by
Sorted by citations
Consequences of adolescent drug use
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“Alcohol, cannabis, and nicotine use are often directly related to each other [226, 228] with all three often used in combination.”
Background
- Authors
- Roche, D. J. O., Bujarski, S., Green, R., Hartwell, E. E., Leventhal, A. M., & Ray, L. A.
- Affiliations
- University of Maryland, Baltimore (US)
- University of California, Los Angeles (US)
- Philadelphia VA Medical Center (US)
- University of Southern California (US)
- Corresponding author
- Ray, L.A.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 200
- Pages
- 40-49
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC6675401
- OpenAlex
- W2944620836
- Cited by
- 106
- References
- 146
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 17 · 2023: 13 · 2022: 20 · 2021: 18 · 2020: 12 · 2019: 1
- FWCI
- 9.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Drug Abuse
- National Institute on Alcohol Abuse and Alcoholism
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Keywords
- alcohol consumption, tobacco use, cannabis use, substance co-use, sex differences, comorbid substance use disorders
- MeSH terms
- Ecological Momentary Assessment, Tobacco Smoking, Marijuana Use, Adult, Alcohol Drinking, Female, Humans, Male, Comorbidity, Substance-Related Disorders, Young Adult
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