Adolescents' self-defined tobacco use status, marijuana use, and tobacco dependence

Abstract Aims To examine differences in tobacco use and dependence between adolescents who are and are not marijuana users. Design Cross-sectional analysis of existing survey data. Participants Data were obtained from 7440 adolescents who completed the British Columbia Youth Survey of Smoking and Health II (BCYSOSH-II), a school based survey conducted in 2004. Measures Responses to demographic, current smoking, alcohol use, self-defined tobacco and marijuana use status questions, perceived physical and mental addiction to tobacco, modified-Fagerstrom Tolerance Questionnaire (M-FTQ), and the Dimensions of Tobacco Dependence Scale (DTDS) were obtained. Findings Marijuana users were 5.9 times more likely to be current tobacco smokers and reported higher levels of perceived addiction to tobacco as compared with marijuana non-users. After controlling for demographics, life-time tobacco use, and alcohol use, marijuana use was associated with the nicotine dependent and sensory dimensions of tobacco dependence. Conclusions Adolescents who concurrently use tobacco and marijuana may be more tobacco dependent than are marijuana non-users. Concurrent use of marijuana may be a factor associated with tobacco dependence among a sub-group of concomitant drug-using adolescents.