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Change over time in adolescent smoking, cannabis use and their association: findings from the School Health Research Network in Wales

Page, Nicholas ORCID:, Hallingberg, Britt, Brown, Rachel ORCID:, Lowthian, Emily, Hewitt, Gillian ORCID:, Murphy, Simon ORCID: and Moore, Graham ORCID: 2021. Change over time in adolescent smoking, cannabis use and their association: findings from the School Health Research Network in Wales. Journal of Public Health 43 (4) , e620-e628. 10.1093/pubmed/fdaa174

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Background While tobacco smoking has declined among UK youth in recent decades, cannabis use has begun to show some growth. Given their interrelationship, growth in cannabis use may act as a barrier to continued reduction in youth smoking. This paper assesses recent tobacco and cannabis use trends in Wales, and their association, to explore whether change in cannabis use might have impacted youth tobacco smoking prevalence. Methods Repeat cross-sectional data on tobacco and cannabis use were obtained from biennial Welsh Student Health and Wellbeing surveys between 2013 and 2019. Data were pooled and analysed using logistic regression with adjustment for school-level clustering. Results No change in regular youth tobacco smoking was observed between 2013 and 2019. In contrast, current cannabis use increased during this time, and cannabis users had significantly greater odds of regular tobacco smoking. After adjusting for change in cannabis use, a significant decline in youth tobacco smoking was observed (OR 0.95; 95% confidence intervals: 0.92, 0.97). Conclusion Recent growth in cannabis use among young people in Wales may have offset prospective declines in regular tobacco smoking. Further reductions in youth smoking may require more integrated policy approaches to address the co-use of tobacco and cannabis among adolescents.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Social Sciences (Includes Criminology and Education)
Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Additional Information: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
Publisher: Springer Verlag (Germany)
ISSN: 0943-1853
Funders: Wellcome Trust
Date of First Compliant Deposit: 10 September 2020
Date of Acceptance: 31 August 2020
Last Modified: 06 Sep 2023 19:50

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