Characterizing Tobacco and Marijuana Use Among Youth Experiencing Homelessness in a Midwestern City

Abstract BackgroundCigarette smoking is three times more prevalent among youth experiencing homelessness compared with the general population. Co-use of tobacco and marijuana is also common. The aim of this study is to characterize tobacco and marijuana use among homeless young people in a Midwestern city.MethodsThis study included 96 youth and young adults (52% male, 39% female, 5% transgender/non-binary) attending a homeless drop-in center who had used at least one combustible tobacco product in the past week. We assessed past-month use of tobacco products and marijuana and other product use characteristics (e.g., frequency, brand and flavor).ResultsMost youth experiencing homelessness with past-week combustible tobacco use had used cigarettes (88.5%), cigars (92.7%), and marijuana (85.4%) in the past month. One-third used electronic vapor products, 19.8% smoked hookah, and 11.5% used smokeless tobacco. Most marijuana users co-administered with tobacco (69.8%). Daily combustible tobacco smoking was associated with having a child and smoking out of boredom/habit. Daily marijuana use was associated with using substances to cope with one’s housing situation. Newport and Black & Mild were the most popular brands of cigarettes and cigars. Most non-combustible tobacco users reported not having a usual brand. Cigar smokers reported the most varied selection of flavors.ConclusionsYoung combustible tobacco users experiencing homelessness engage in high-risk use patterns, including poly-tobacco use, co-use of tobacco with marijuana, and frequent combustible product use. Interventions that consider the full context of tobacco and marijuana use are needed to support cessation in this population.