Adolescents who have tried cannabis face a markedly higher likelihood of engaging in strongly habit-forming substances, including cocaine, heroin, and improper use of prescription medications. It remains unclear if this heightened likelihood extends to teenage cannabis users who have never used traditional cigarettes, a subgroup that has expanded significantly in recent times. This research tracks the recent expansion in the share of teenage cannabis users who avoid traditional cigarette smoking and assesses their likelihood of using habit-forming substances. The analysis draws from yearly, cross-sectional, representative samples in the Monitoring the Future study involving 607,932 American 12th graders surveyed between 1976 and 2020. For those with any history of cannabis use, the proportion who had no experience with traditional cigarettes rose from 11% in 2000 to 58% in 2020. This subgroup showed rates of habit-forming substance use that exceeded those of non-cannabis-using peers by 8%. By contrast, teenagers with any cannabis experience—irrespective of cigarette history—exhibited rates of habit-forming substance use that were 500% greater than non-users. Teenage cannabis users without a history of traditional cigarette smoking display considerably lower rates of habit-forming substance use compared to the broader population of cannabis users. These findings indicate that efforts and regulations designed to lower teenage involvement with habit-forming substances might be more effective if they target cigarette smoking among cannabis-using adolescents rather than cannabis use in isolation.
