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Factors Associated With Marijuana Use Among Treatment-seeking Adult Cigarette Smokers in the Criminal Justice Population

Montgomery, LaTrice, PhD; Schiavon, Samantha, MA; Cropsey, Karen, PsyD

doi: 10.1097/ADM.0000000000000466
Original Research

Objectives: Due to the elevated rates of cigarette use and marijuana use within the criminal justice system, it is critical to develop a stronger understanding of tobacco and marijuana co-use among this population to inform future interventions.

Methods: This study is a secondary analysis of baseline data from a smoking cessation randomized clinical trial of adults (n = 500) in a community correction program. Participants were classified as using cigarettes only or both cigarettes and marijuana through either self-report or positive urine drug screening. Demographics and measures regarding legal, drug use, smoking, mental health, and interpersonal histories were assessed. Logistic regression analyses were conducted to assess factors associated with co-use.

Results: Among adults who smoked cigarettes, 25% reported current marijuana use. Individuals who used both cigarettes and marijuana were more likely than those who only used cigarettes to be African American (80%), male (73.6%), and younger (M = 32.4 [SD = 11.0]). Increasing difficulties with last quit attempt was associated with a reduction in the likelihood of co-use (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.60–0.94, P < 0.05), and benzodiazepine (OR 9.09, 95% CI 1.25–65.94, P < 0.05) and opioid (OR 8.17, 95% CI 2.03–32.93, P < 0.01) use was significantly associated with an increased likelihood of co-use.

Conclusions: This study identified several factors that are associated with an increased risk of cigarette and marijuana co-use among a community correction population. These findings will be valuable for informing targeted prevention and treatment interventions.

Addiction Sciences Division, University of Cincinnati College of Medicine, Cincinnati, OH (LM); Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1008, Birmingham, AL (SS); Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1016, Birmingham, AL (KC).

Send correspondence to LaTrice Montgomery, PhD, Assistant Professor of Psychiatry, Addiction Sciences Division, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Suite 104, Cincinnati, OH 45229. E-mail:

Received 28 March, 2018

Accepted 15 September, 2018

Funding: The research was supported by the National Cancer Institute (NCI) and the National Institutes of Health (NIH) (R01CA141663) to Karen L. Cropsey. The writing of this manuscript was supported by the National Institute on Drug Abuse (NIDA) and NIH to LaTrice Montgomery (K23DA042130). The content is solely the responsibility of the authors and does not represent the official views of NCI, NIDA or NIH. NCI, NIDA or NIH had no role in the design or conduct of the current study.

The authors have no conflicts of interest to disclose.

© 2019 American Society of Addiction Medicine