Understanding the role of cannabis use on cigarette dependence severity among individuals with e-cigarette and combustible tobacco dual use

Background and Objectives

The use of both electronic and combustible cigarettes is related to greater rates of cannabis use. Further, cannabis use is associated with worse combustible smoking-related outcomes, yet little research has identified mechanisms underlying such relations. It may be that negative-affect-related transdiagnostic factors such as emotion dysregulation, anxiety sensitivity, and/or distress intolerance play a mechanistic role in the cannabis–tobacco interrelations.

Methods

The current study tested this hypothesis among 400 adults who endorsed dual use, 33% of whom endorsed current (past 3 months) cannabis use. We conducted analyses of variance and indirect effects model using the PROCESS v4.1 macro in SPSS version 29.

Results

Results indicated that participants who use cannabis reported greater difficulty with emotion regulation, anxiety sensitivity, and cigarette dependence severity. Cannabis use was related to cigarette dependence severity indirectly via difficulty with emotion regulation and anxiety sensitivity.

Discussion and Conclusions

These results indicate that specific transdiagnostic negative-affect-related factors of difficulty with emotion regulation and anxiety sensitivity are associated with cannabis use among adults who smoke combustible and electronic cigarettes.

Scientific Significance

Given that these transdiagnostic factors are malleable, these findings suggest targeting and engaging such mechanisms may offer novel behavioral change strategies for this high-risk population.