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A study of 17,732 U.S. adults who used cannabis in the prior month found that people using nearly every available form had higher rates of daily use and cannabis use disorder than other groups. The observational findings show an association, not that using multiple forms causes addiction.
A national study found that U.S. adults who used cannabis in nearly every available form reported higher rates of daily use and cannabis use disorder than people who mainly smoked, vaped or ate cannabis. The analysis, led by researchers at NYU Langone Health and published online August 8 in the journal Addictive Behaviors, identifies a consumption pattern that may help clinicians decide when to ask more about cannabis use, but it does not show that using multiple forms causes addiction.
The researchers analyzed responses from 17,732 adults who said they had used cannabis in the previous month. The data came from the 2022–2023 National Survey on Drug Use and Health. Statistical analysis grouped participants into four broad patterns: 48% primarily smoked cannabis, 21% combined smoking and vaping, 17% mainly used edibles, and 14% used cannabis in almost every available form. That last category was described as the polymodal group.
About half of polymodal users said they used cannabis every day. The reported rate was 31% among people who smoked and vaped, 28% among those who primarily smoked, and about 13% among those who mainly used edibles. Rates of cannabis use disorder also differed: 67% in the polymodal group, compared with 47% in the smoking-and-vaping group, 36% among primarily smokers and 15% among primarily edible users.
Cannabis use disorder is a medical diagnosis associated with difficulty controlling use and other symptoms. The study reports the share in each group who met diagnostic criteria; it does not establish that every person in those groups had the same severity or experience. The researchers also found demographic differences: adults ages 18 to 25 made up nearly one-third of the smoking-and-vaping and polymodal groups, while women represented more than half of the primarily edible group. The study did not determine why participants chose particular methods.
How Use Patterns Could Guide Screening
The findings suggest that asking how someone consumes cannabis, not only whether they use it, could give clinicians useful information when considering whether to ask further questions. The high rate of cannabis use disorder in the polymodal group makes that pattern a possible signal for fuller assessment, but it is not a diagnosis by itself and cannot establish an individual’s risk without a clinical evaluation.
The results may also matter for public health communication. The researchers say prevention messages often focus on smoking, even as cannabis is also vaped, eaten and consumed in concentrated forms. Messages may need to address risks associated with different methods and combinations, rather than treating all cannabis use as one pattern. The study did not test whether any particular message changes behavior or health outcomes.
There is a separate respiratory concern in the findings: participants who smoked cannabis were more likely to also smoke cigarettes than those who mainly vaped or used edibles. Senior author Joseph J. Palamar said using both smoked products can expose people to a broader range of combustion-related chemicals. This is a concern raised by the authors, not a measurement of lung injury in this survey analysis.
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Four Patterns in a National Survey
Cannabis can be consumed by smoking, vaping or eating edibles; dabbing involves heating concentrated cannabis products and inhaling the vapor. The source report says recent national survey figures indicate that about 43.8 million Americans aged 12 and older had used cannabis in the previous 30 days, more than 15% of that age group. That broader figure describes prevalence, while the study’s analysis focused on adults who reported past-month use.
Researchers used the 2022–2023 survey to identify groups based on similarities in reported consumption methods. The article describes this as the first national analysis of how different methods naturally cluster, but the findings remain a snapshot of reported behavior in that survey period. The age and gender patterns are descriptive; they do not explain what led participants to choose smoking, vaping, edibles or multiple methods.
“Our findings suggest that using cannabis in multiple forms may be a red flag for heavier use and symptoms of addiction.”
— Omar El-Shahawy, study lead author and assistant professor at NYU Grossman School of Medicine
Limits of the Survey Findings
The study is observational, so it cannot determine whether using cannabis in multiple forms leads to heavier use or cannabis use disorder. The relationship could reflect other factors, including reasons for use or patterns of use that the analysis did not establish. The authors say the research identifies an association, not cause and effect.
Participants reported their own cannabis habits, which may have been incomplete or inaccurate. The study also did not examine why people selected particular methods, whether those choices changed over time, or whether people used the products in specific combinations or quantities. The reported percentages describe the study’s groups and should not be treated as an individual prediction.
It also remains unknown whether the demographic patterns reflect preferences, access, effects sought or other influences. El-Shahawy said future research could examine whether people who prefer edibles are more likely to use cannabis for concerns such as pain or difficulty sleeping. The supplied report does not provide details about the study’s statistical uncertainty or subgroup sample sizes.
Researchers Plan to Study Motives
The research team hopes to investigate why people choose different consumption methods, including whether some edible users turn to cannabis to manage pain or sleep difficulties. Further work could clarify how method choices relate to frequency, reasons for use and disorder symptoms, though the report does not give a timetable for that research.
For now, the findings support attention to consumption method as one possible part of a conversation about cannabis use. They do not establish a new diagnostic test or show that switching methods reduces risk. The next steps are further research and, as El-Shahawy suggested, clinicians asking about both whether and how patients use cannabis when deciding whether a fuller assessment is appropriate.
Key Questions
What cannabis-use pattern had the highest rates in the study?
The polymodal group, whose members used cannabis in almost every available form, had the highest reported rates of daily use and cannabis use disorder.
Does using several forms of cannabis cause addiction?
The study cannot answer that. It was observational and found an association between the polymodal pattern and higher rates of cannabis use disorder, not proof of cause and effect.
How many people were included in the analysis?
The researchers analyzed survey responses from 17,732 adults who reported cannabis use in the previous month, using data from the 2022–2023 National Survey on Drug Use and Health.
What did the study say about cannabis edibles?
About 15% of participants who mainly used edibles met criteria for cannabis use disorder, the lowest rate among the four groups. The study did not establish why people chose edibles or whether the pattern applies to every edible user.
What are researchers planning to study next?
The team hopes to examine why people choose particular consumption methods, including whether some people who prefer edibles use cannabis for concerns such as pain or sleep difficulties.
Source: sciencedaily.com
