Marijuana use predicts onset of current little cigar use in a national sample of US young adults.

Background: This study examined whether young adult marijuana use increases risk of subsequent large cigar (LC) and little cigar/cigarillo (LCC) use among naïve users.

Methods: Data were from 8 waves of the Truth Initiative Young Adult Cohort, a national sample of US young adults aged 18-34 assessed every 6 months. Discrete-time survival analyses examined whether baseline ever marijuana use among never cigar users predicted onset of past 30-day LC and LCC use and whether baseline ever LC and LCC use among never marijuana users predicted onset of past 30-day marijuana use. Models adjusted for demographics, past 30-day alcohol use, past 30-day tobacco product use, and menthol tobacco use.

Results: In adjusted models, baseline ever marijuana use predicted onset of past 30-day LCC but not LC use. Cumulative risk ratios showed that 23% of ever marijuana users at baseline reported past 30-day use of LCCs by the end of wave 8 compared to just 3% of baseline never marijuana users. Race and past 30-day use of specific tobacco products also predicted onset of past 30-day LC and LCC use. Past 30-day use of alcohol uniquely predicted onset of past 30-day LCC use but not LC use. Baseline ever LC and LCC use did not predict onset of past 30-day marijuana use in models that adjusted for demographics, alcohol, and specific tobacco product use.

Conclusions: Ever marijuana use among US young adults may be an important predictor of onset of regular LCC use. Findings suggest different pathways linking marijuana to different cigar sub-types.