BACKGROUND: Tobacco and cannabis co-use prevalence is rising, with older adults disproportionately impacted.
OBJECTIVE: Assess tobacco and cannabis co-use by health and sociodemographic characteristics among adults 65+ years.
METHODS: Using National Survey on Drug Use and Health nationally representative data (2021-2023), we estimated past-month tobacco and cannabis co-use prevalence among adults 65+ years (N = 15,672). Multinomial logistic regressions examined associations between health and sociodemographic characteristics with past-month co-use, tobacco-only use, and cannabis-only use (vs. former use).
RESULTS: One in six reported past-month use of either cannabis or tobacco (1.7% co-used). More chronic disease diagnoses was associated with lower co-use (e.g., one vs. none: adjusted relative risk ratio [aRRR] = 0.47). Co-use was higher among people with worse self-rated health (e.g., fair/poor vs. excellent/very good: aRRR = 2.73) and past-year mental illness (aRRR = 2.07).
CONCLUSIONS: Clinicians working with older adults should account for cannabis co-use in tobacco cessation and disseminate evidence-based cannabis information.
Past-month tobacco and cannabis co-use by chronic disease and sociodemographic factors among U.S. adults 65+ years (2021-2023)
Journal of Applied Gerontology [Epub 2026 Aug 20]. doi: 10.1177/07334648261479376.