LAUSR

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.