How Negative Emotional States are Associated with the Dual Substance Use of E-cigarettes and Cannabis



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E-cigarettes and cannabis are two of the most used substances among young adult Americans, and use is continuing to increase (Boakye et al., 2022; Clendennen et al., 2021). Moreover, dual use of these substances is common among college students (Buckner, Morris, et al., 2021). Research has found significant linkages between negative emotional states (depression, anxiety, and stress), impulsivity, and e-cigarette and cannabis use individually; however, only one previous study has examined the relationship between this dual substance use and negative emotional states. This research suggests that dual substance use is associated with increased mental health symptomology (Buckner, Morris, et al., 2021), but it does not elucidate directionality of this relationship. The aim of this study was to assess whether negative emotional states and impulsivity are associated with individual and dual substance use of e-cigarettes and cannabis. A secondary data analysis examined college students’ (overall n = 585) negative emotional states, impulsivity, e-cigarette use (n = 112), cannabis use (n = 210), and dual substance use (n = 82). This study found higher anxiety and impulsivity scores significantly predicted higher cannabis use while higher stress scores significantly predicted lower cannabis use. Moreover, anxiety was found to significantly predict dual substance use, illustrating how anxiety plays a vital role in problematic cannabis use and high dual substance use. These findings suggest that anxiety treatments could lower dual substance use as a result. Thus, future research should examine how anxiety-targeted cognitive behavioral therapy (CBT) impacts monthly cannabis use and dual substance use.



Psychology, Clinical