BACKGROUND: Cigarettes and cannabis are commonly co-used, but few studies have examined the relationship between cigarette demand and cannabis use. This study compared the price-responsiveness of cigarette demand for current vs. non-current adult cannabis users in the U.S.
METHODS: We used cross-sectional data from the National Survey on Drug Use and Health (2004-2019; annual mean unweighted sample size=50,000) to estimate a two-part econometric model of cigarette demand separately for current and non-current cannabis users among U.S. adults. Multivariable logistic regression estimated the impact of cigarette price on the probability of being a current smoker (smoking participation). Multivariable linear regression estimated the impact of cigarette price on the number of cigarettes smoked per day (smoking intensity).
RESULTS: From 2004 to 2019, current smoking prevalence decreased from 24.5% to 16.6%, current cannabis use increased from 5.8% to 11.6%, and dual use of cigarettes and cannabis increased from 3.6% to 4.5% among U.S. adults. For current cannabis users, a 1% increase in cigarette prices would reduce smoking participation by 0.20%, smoking intensity by 0.27%, and total cigarette demand by 0.47%. For non-current cannabis users, a 1% increase in cigarette prices would reduce smoking participation by 0.23%, smoking intensity by 0.13%, and total cigarette demand by 0.36%. Among current cigarette smokers, those who co-use cannabis were significantly more price-responsive (P=0.001) in reducing smoking intensity than those who do not concurrently use cannabis.
CONCLUSIONS: Our findings suggest that increasing cigarette prices reduce smoking prevalence, intensity, and total demand for both cannabis and non-cannabis users. Additionally, increasing cigarette prices would be more effective in reducing cigarette consumption among adult cannabis users than non-cannabis users. Considering the rising prevalence of cannabis consumption and the frequent concurrent use of tobacco and cannabis, policymakers should consider individuals' cannabis use status and dual use of cigarettes and cannabis when formulating tobacco control programs.