Patterns and Correlates of Cannabis, Electronic Cigarettes, and Tobacco Use Among Illinois Adolescents

Objectives Our study aims to identify social and behavioral factors associated with the sole-, dual-, and poly-substance use of cannabis, electronic cigarettes (ECs), and combustible tobacco among Illinoisan adolescents during the period when medical and recreational marijuana use have both been legalized. Methods Data came from the 2022 Illinois Youth Survey (IYS, administered to 8th-, 10th-, and 12th-grade adolescents). Multinomial regression models were used to estimate the associations between social, environmental, and behavioral characteristics and substance use patterns of sole-, dual-, and poly-substance use. Results After adjusting for demographics, self-reported depression, being bullied at school, self-perceived campus being unsafe, having peer pressure, and alcohol use were significantly associated with higher odds of sole-, dual-, and poly-substance use, respectively, compared with no substance use at all. Participating in structured sports, having family rules on substance use, living in rural areas, and living in more economically affluent areas significantly reduced the odds of sole-, dual-, and poly-substance use, respectively. Conclusions Our study identified several social, environmental, and behavioral factors associated with adolescent substance use. Findings can help inform program designs, prevention strategies, and clinical screening to tackle adolescent substance use.