Cannabis Research
Cannabis Surpasses Cigarettes: A Shift in U.S. Habits
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As cannabis legalization continues to sweep across the United States, a quiet but profound shift is unfolding in how adults use substances. A new study published in Addictive Behaviors titled “Cigarette and cannabis use and co-use among U.S. adults: An examination of prevalence and trends during 2015–2023” reveals a significant trend: more Americans are turning to cannabis, either on its own or in combination with cigarettes, while traditional tobacco use continues to decline.
The findings paint a nuanced picture of modern substance use, one that challenges outdated narratives about who uses what, and why.
A Nation in Transition: From Tobacco to Cannabis
Between 2015 and 2023, the U.S. landscape around cannabis changed dramatically. Over half of all states legalized recreational cannabis for adults, while others adopted decriminalization measures or expanded medical access. These shifts coincided with a cultural reevaluation of cannabis as both a wellness product and a safer alternative to alcohol or nicotine.
During that same time, tobacco use continued its decades-long decline. Yet, researchers noted that some of that space was being filled by cannabis use, which is now more socially and legally accepted than ever before.
The study analyzed data from the National Survey on Drug Use and Health (NSDUH), tracking cigarette-only use, cannabis-only use, and combined use (“co-use”) among U.S. adults ages 18 and older. Results were divided into three periods: 2015–2019, 2020, and 2021–2023.
Key Findings: Cannabis Takes the Lead
The results reveal a clear shift in American substance use habits:
- Cannabis-only use rose sharply from 3.9% in 2015 to 10.6% in 2023.
- Cigarette-only use fell from 15.0% in 2015 to 8.8% in 2023.
- Co-use of both cannabis and cigarettes remained relatively stable but showed specific demographic increases, particularly among divorced or separated adults.
In fact, by 2021–2023, cannabis-only use officially surpassed cigarette-only use for the first time in modern U.S. history. Among young adults aged 18–25, cannabis-only use reached an impressive 18.6%, reflecting shifting attitudes and accessibility among younger generations.
Interestingly, the study also found that cannabis-only use was most common among socioeconomically advantaged groups, those with higher income, college education, and private health insurance. By contrast, cigarette-only use remained concentrated among socioeconomically disadvantaged adults, often correlated with lower education, lower income, and lack of insurance.
These distinctions suggest that cannabis use is not simply replacing tobacco but emerging as a distinctly different cultural and socioeconomic behavior.
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| Year Range | Cannabis-Only Use (%) | Cigarette-Only Use (%) | Co-Use (%) |
|---|---|---|---|
| 2015–2019 | 3.9 | 15.0 | 5.1 |
| 2020 | 7.8 | 10.2 | 5.8 |
| 2021–2023 | 10.6 | 8.8 | 6.0 |
Co-Use and Its Implications
While co-use, consuming both cannabis and cigarettes, did not rise as sharply as cannabis-only use, it remains a critical area of focus. In 2015–2019, co-use was most common among divorced adults (rising from 4.9% to 7.2%), and by 2020, it was highest among divorced or separated adults overall.
Co-use presents unique challenges for health researchers, as both substances interact differently in the body. For instance, while cannabis does not contain the same carcinogenic additives as cigarettes, smoking anything can still irritate the lungs. However, many modern cannabis consumers are shifting toward vaping, edibles, tinctures, or topicals, which may reduce some of the respiratory risks associated with combustion.
The researchers concluded that the trend toward cannabis-only use, and the persistence of co-use calls for updated, nuanced public health messaging rather than alarmist campaigns. The goal is not to stigmatize cannabis, but to promote safer consumption and informed decision-making in an evolving legal landscape.
Why the Shift From Tobacco to Cannabis Matters
The rising preference for cannabis-only use reflects more than changing laws, it marks a cultural pivot. Cannabis, once a symbol of counterculture, is now intertwined with wellness, creativity, and even athletic recovery. As tobacco fades from social favor, cannabis seems to be taking its place as a normalized, though still complex, adult choice.
However, this evolution also demands modernized public health approaches. Traditional anti-smoking campaigns, for instance, may no longer resonate with younger adults who see cannabis as a therapeutic plant rather than a vice. Researchers and policymakers must balance education on potential risks with respect for the plant’s legitimate medical and wellness uses.
The Role of CBD in Nicotine Cessation
Interestingly, the transition from cigarettes to cannabis may also hold potential benefits for tobacco harm reduction. Cannabidiol (CBD) has shown promise in early research as a tool for reducing nicotine cravings.
Research has found that CBD inhalers significantly reduced the number of cigarettes smoked by participants, without increasing anxiety or withdrawal symptoms.
For adults trying to quit smoking, CBD-based products such as tinctures, gummies, or smokables could offer an alternative way to manage cravings and anxiety without the psychoactive effects of THC.
Moving Forward: A Call for Balanced Public Health Strategies
The authors of the 2025 study caution that while cannabis may carry fewer health risks than tobacco, its growing popularity still warrants careful monitoring. Their conclusion underscores the need for a “multi-pronged strategy” that combines public education and access to effective treatment options for those who develop problematic use patterns.
However, prevention messaging must evolve with the times. Demonizing cannabis, as was done with tobacco decades ago, ignores its therapeutic potential and alienates responsible consumers. Instead, researchers and policymakers should focus on accurate education, age-appropriate use, and equitable access to safe products.
Conclusion: What This Means for Public Health
The latest data from 2015 to 2023 marks a defining shift in American substance use. Cannabis-only use has overtaken cigarette-only use, signaling a cultural transformation that extends beyond legalization; it’s about lifestyle, health, and personal agency.
While public health experts work to understand this new landscape, one thing is clear: the conversation around substance use must evolve. Cannabis is not the next tobacco; it’s a complex, medicinal, multifaceted plant whose role in society is still taking shape. The challenge now lies in guiding that evolution responsibly, with science, compassion, and balance.
