(PS6-45) Social motives and contexts of cannabis use as predictors of cannabis and tobacco co-use at the daily level among sexual and gender minorities

Using cannabis and tobacco on the same day (i.e., co-use) has been on the rise among young adults. Examining co-use is important as it has been associated with worse health outcomes like higher frequency use along with increased rates of depression and anxiety. Social motives and use in social settings have been identified as daily risk factors for cannabis and tobacco use. While risk factors for co-use have been examined among the general population, there is a lack of literature about co-use among sexual and gender minority (SGM) populations. This is problematic as SGM individuals co-use cannabis and tobacco at higher rates than their heterosexual, cisgender peers. The current study aims to further the literature by investigating the role of social motives and contexts for cannabis and tobacco co-use at the daily level among SGM individuals.
This study utilized longitudinal data from an ecological momentary assessment (EMA) study of substance use that included SGM individuals. Only participants who endorsed tobacco use were included in analyses (N=107). Demographic differences (age, race, sexual/gender identity) were examined as individual-level predictors of the frequency of co-use, while social motives for cannabis use and social contexts of cannabis use were examined at within-person predictors of the likelihood of co-use in multilevel models.
When participants reported social reasons for using cannabis and engaged in cannabis use in social contexts, they were more likely to report using tobacco alongside cannabis during the same observation. Neither gender identity nor sexual identity were associated with the frequency of engaging in cannabis and tobacco co-use during the EMA period.
These findings indicate that participants’ co-use of cannabis and tobacco is more likely to occur when SGM report social motives for cannabis use and use cannabis in social contexts. This information can help to inform intervention strategies by raising awareness about daily level risk factors for co-use within this population. The results of this study are limited as data was not collected on the mode of tobacco use (e.g., smoking or vaping). These findings suggest that a focus on reducing co-use in social contexts as an intervention may be an effective strategy for reducing co-use.