How Adults Use Cannabis May Be Linked to Heavier Use and Cannabis Use Disorder

Researchers analyzed 2022–2023 National Survey on Drug Use and Health data from 17,732 adults who said they had used cannabis in the previous 30 days. They used a statistical method called latent class analysis, which sorts people into groups based on patterns in their answers.

The analysis found four groups. About 48.2% of participants were in a primary-smoking group. Another 20.5% both smoked and vaped. About 16.9% mainly used edibles, meaning cannabis-containing foods or drinks. The remaining 14.4% were in a polymodal group, meaning they used several different forms of cannabis.

The forms people reported included smoking, vaping, edibles, and other ways of using cannabis. The study looked at how these patterns were linked with how often people used cannabis and whether they met criteria for cannabis use disorder, or CUD.

CUD is a clinical term for a pattern of cannabis use that causes problems or loss of control. The abstract does not describe the survey’s detailed assessment of CUD, so the available information cannot show which symptoms were most common or how severe they were for each group.

Daily cannabis use was more likely in the polymodal group than in the primary-smoking group. In the study’s adjusted analysis, the polymodal group had 2.67 times the relative likelihood of daily use compared with the primary-smoking group. Daily use was less likely among people in the mainly-edibles group, with about half the relative likelihood of the primary-smoking group.

The news coverage reports that about half of people in the polymodal group used cannabis daily. That compared with 28% of the primary-smoking group, 31% of the smoking-and-vaping group, and about 13% of the mainly-edibles group.

Cannabis use disorder also followed a similar pattern. The journal abstract says CUD risk was higher in the smoking-and-vaping and polymodal groups than in the primary-smoking group, and lower in the mainly-edibles group. The news coverage reports CUD in about 67% of the polymodal group, 47% of the smoking-and-vaping group, 36% of the primary-smoking group, and 15% of the mainly-edibles group.

The patterns also differed by age and sex. Compared with adults age 50 or older, adults ages 18 to 25 were more likely to be in the smoking-and-vaping group or the polymodal group. Women were more likely to be in the mainly-edibles group than men.

These findings could help make conversations about cannabis use more specific. Rather than asking only whether someone uses cannabis, a health professional may also ask how it is used and how often. That may help identify people who could benefit from a fuller assessment.

Still, this was an observational survey analysis, not a trial. It shows links between patterns of cannabis use, daily use, and CUD, but it cannot establish which came first. It also cannot tell whether using several forms of cannabis itself raises the chance of CUD, or whether people already using cannabis more heavily are more likely to try multiple forms. The researchers also did not examine why participants chose particular methods.