US study links using cannabis in multiple forms to higher addiction risk
NYU Langone Health researchers found in a national survey of US adults that people who use cannabis in almost every form have much higher rates of daily use and cannabis use disorder. The study shows an association, not causation.
A new US study suggests the way people consume cannabis may signal a higher risk of heavy use or addiction. Researchers at NYU Langone Health, the medical centre of New York University, published the work in the journal Addictive Behaviors. They found that about one in seven US cannabis users consumes it in nearly every available form, and that this group has particularly high rates of daily use and cannabis use disorder, the medical diagnosis for cannabis addiction.
What the researchers analysed
The team used data from the 2022–2023 National Survey on Drug Use and Health, covering 17,732 adults who had used cannabis in the previous month. Using statistical methods, they identified four consumption patterns. They describe the work as the first national analysis of how different methods of use naturally cluster together.
- 48% mainly smoked cannabis.
- 21% combined smoking and vaping.
- 17% mainly used edibles.
- 14% formed the "polymodal group", using almost every form.
Differences between groups
About half of the polymodal group used cannabis daily, versus 28% of mainly smokers, 31% of those who smoked and vaped, and roughly 13% of edible users. Cannabis use disorder criteria were met by 67% of the polymodal group, 47% of those who smoked and vaped, 36% of mainly smokers and 15% of edible users.
Adults aged 18 to 25 made up nearly a third of both the smoking-and-vaping and polymodal groups. Edibles were favoured more often by women and college graduates. People who smoked cannabis were also more likely to smoke cigarettes, which the authors say exposes their lungs to a wider range of chemicals from combustion.
Limitations and conclusions
Lead author Omar El-Shahawy said clinicians should ask patients not only whether but how they use cannabis, and noted that public health messages still focus mostly on smoking. The data were self-reported and the study is observational, so it cannot show that using multiple forms directly raises addiction risk. The authors plan to examine motivations for different consumption patterns in future work. The research was funded by the US National Institutes of Health.
