{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T17:50:50Z","timestamp":1776880250831,"version":"3.51.2"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>People use similar devices to vape nicotine and cannabis, potentially causing misclassification error in surveys. This study aimed to (1) describe the degree of misclassification of people who vape cannabis as people who used electronic nicotine products (ENPs) in the past 30-days (P30D); and, (2) describe sociodemographic and tobacco use characteristics among people who vaped cannabis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were drawn from the Population Assessment of Tobacco and Health Study Wave 5 (2018-19). People who used ENPs in the P30D and stated that they used cannabis with an ENP (n\u2009=\u20095723) were asked how often this occurred (\u201cevery time\u201d, \u201cmost of the time\u201d, \u201csometimes\u201d, \u201crarely\u201d, \u201cnever\u201d). We report weighted prevalence estimates of cannabis use frequency by sociodemographic characteristics and cigarette smoking status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among adults, 8.9% [95% confidence interval (CI): 8.62\u20139.24] used ENPs in the P30D; among ENP consumers, 9.1% (95% CI: 8.23\u201310.05) used cannabis \u201cevery time.\u201d Excluding \u201cevery time\u201d cannabis use, P30D ENP use was 7.7% (95% CI: 7.44\u20138.02). People who did not smoke tobacco cigarettes were more likely to vape cannabis \u201cevery time\u201d (11.4%; 95% CI: 9.82\u201313.22) compared to people who previously (7.0%; 95% CI: 5.29\u20139.15) or currently (8.3%; 95% CI: 7.02\u20139.71) smoked cigarettes. Among people who used ENPs in the P30D, those who used cannabis \u201cevery time\u201d had greater odds of being younger and identifying as lesbian, gay, bisexual, or something else, Black, or Hispanic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Improved methods are needed to differentiate between nicotine vaping and other types of vaping. Additionally, there is the potential for a greater degree of misclassification by individual characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>People who vape nicotine may also vape cannabis, but there has been little work to-date to understand how accurately surveys differentiate nicotine from cannabis vaping. Though the Population Assessment of Tobacco and Health Study survey clearly asks about nicotine use, 9.1% of people classified as using ENPs in the past 30-day ENP indicated that they were vaping cannabis \u201cevery time\u201d with an ENP. The degree of misclassification of ENP use varied by sociodemographic and tobacco use characteristics. To fully understand ENP use, it is necessary to assess cannabis vaping. Failure to disentangle vaped nicotine from cannabis can over- or under-estimate these respective behaviors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntaf233","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:15:50Z","timestamp":1762866950000},"page":"817-823","source":"Crossref","is-referenced-by-count":1,"title":["Potential Misclassification of Adults Who Vape Cannabis as Adults Who Vape Nicotine and their Associated Sociodemographic and Smoking Characteristics: Results from Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6526-5139","authenticated-orcid":false,"given":"Cara","family":"Drake","sequence":"first","affiliation":[{"name":"Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada , Reno, NV"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Starcevich","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Nevada , Reno, NV"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Hyland","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Roswell Park Comprehensive Cancer Center , Buffalo NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1637-0992","authenticated-orcid":false,"given":"Danielle M","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Roswell Park Comprehensive Cancer Center , Buffalo NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Castleman","sequence":"additional","affiliation":[{"name":"Westat , Rockville, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1400-5932","authenticated-orcid":false,"given":"Jennifer L","family":"Pearson","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada , Reno, NV"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"issue":"18","key":"2026042213022405800_ref1","doi-asserted-by":"publisher","first-page":"475","DOI":"10.15585\/mmwr.mm7218a1","article-title":"Tobacco product use among adults - United States, 2021","volume":"72","author":"Cornelius","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"Suppl 2","key":"2026042213022405800_ref2","doi-asserted-by":"publisher","first-page":"ii4","DOI":"10.1136\/tobaccocontrol-2013-051476","article-title":"Electronic cigarettes: product characterisation and design considerations","volume":"23","author":"Brown","year":"2014","journal-title":"Tob Control"},{"key":"2026042213022405800_ref3","doi-asserted-by":"publisher","first-page":"100222","DOI":"10.1016\/j.abrep.2019.100222","article-title":"Substances used in electronic vapor products among adults in the United States, 2017","volume":"10","author":"Trivers","year":"2019","journal-title":"Addict Behav Rep"},{"issue":"5","key":"2026042213022405800_ref4","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1093\/ntr\/ntaa012","article-title":"It is past time to consider cannabis in vaping research","volume":"22","author":"Pearson","year":"2020","journal-title":"Nicotine Tob Res"},{"issue":"8","key":"2026042213022405800_ref5","doi-asserted-by":"publisher","first-page":"9988","DOI":"10.3390\/ijerph120809988","article-title":"E-cigarettes: a review of new trends in cannabis use","volume":"12","author":"Giroud","year":"2015","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"2026042213022405800_ref6","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.cpr.2011.12.002","article-title":"Tobacco and marijuana use among adolescents and young adults: a systematic review of their co-use","volume":"32","author":"Ramo","year":"2012","journal-title":"Clin Psychol Rev"},{"issue":"11","key":"2026042213022405800_ref7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10826084.2021.1936049","article-title":"Examining use and dual use of tobacco products and marijuana among Minnesota adults","volume":"56","author":"Boyle","year":"2021","journal-title":"Subst Use Misuse"},{"issue":"3","key":"2026042213022405800_ref8","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1080\/08897077.2019.1709603","article-title":"Modes of delivery in concurrent nicotine and cannabis use (\u201cco-use\u201d) among youth: findings from the international tobacco control (itc) survey","volume":"42","author":"Smith","year":"2021","journal-title":"Subst Abus"},{"issue":"3","key":"2026042213022405800_ref9","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1016\/j.amepre.2020.03.014","article-title":"Marijuana vaping in u.S. adults: evidence from the behavioral risk factor surveillance system","volume":"59","author":"Baldassarri","year":"2020","journal-title":"Am J Prev Med"},{"key":"2026042213022405800_ref10","doi-asserted-by":"publisher","first-page":"100519","DOI":"10.1016\/j.abrep.2023.100519","article-title":"The association between cannabis vaping and other substance use","volume":"18","author":"Sun","year":"2023","journal-title":"Addict Behav Rep"},{"issue":"9","key":"2026042213022405800_ref11","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1093\/ntr\/ntae062","article-title":"Dual-vaping of nicotine and cannabis among adults who currently use tobacco products in five New England states","volume":"26","author":"Liu","year":"2024","journal-title":"Nicotine Tob Res"},{"issue":"3","key":"2026042213022405800_ref12","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1080\/10826084.2021.2019773","article-title":"Use of inhaled nicotine and cannabis products among adults who vape both substances","volume":"57","author":"Smith","year":"2022","journal-title":"Subst Use Misuse"},{"key":"2026042213022405800_ref13","doi-asserted-by":"publisher","first-page":"106133","DOI":"10.1016\/j.addbeh.2019.106133","article-title":"Use of tobacco products\/devices for marijuana consumption and association with substance use problems among u.S. young adults (2015-2016)","volume":"102","author":"Seaman","year":"2020","journal-title":"Addict Behav"},{"key":"2026042213022405800_ref14","doi-asserted-by":"publisher","first-page":"108099","DOI":"10.1016\/j.addbeh.2024.108099","article-title":"Use of ends devices and modifications to vape cannabis among adolescents and young adults who also vape nicotine","volume":"157","author":"Ouellette","year":"2024","journal-title":"Addict Behav"},{"issue":"1","key":"2026042213022405800_ref15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-063984","article-title":"Modification of electronic nicotine delivery systems among adolescents and young adults","volume":"154","author":"Kong","year":"2024","journal-title":"Pediatrics."},{"issue":"21","key":"2026042213022405800_ref16","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16214111","article-title":"The prevalence of vaping and smoking as modes of delivery for nicotine and cannabis among youth in Canada, England and the United States","volume":"16","author":"Fataar","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"2026042213022405800_ref17","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1001\/jamapediatrics.2021.6102","article-title":"Evaluation of self-reported cannabis vaping among us youth and young adults who use e-cigarettes","volume":"176","author":"Sun","year":"2022","journal-title":"JAMA Pediatr"},{"issue":"3","key":"2026042213022405800_ref18","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58030412","article-title":"Vaping-associated lung injury: a review","volume":"58","author":"O'Callaghan","year":"2022","journal-title":"Medicina (Kaunas)"},{"issue":"4","key":"2026042213022405800_ref19","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1136\/tobaccocontrol-2016-052934","article-title":"Design and methods of the population assessment of tobacco and health (PATH) study","volume":"26","author":"Hyland","year":"2017","journal-title":"Tob Control"},{"issue":"3","key":"2026042213022405800_ref20","first-page":"223","article-title":"Fay\u2019s method for variance estimation","volume":"6","author":"Judkins","year":"1990","journal-title":"J Off Stat"},{"key":"2026042213022405800_ref21","volume-title":"[computer program]. Version 9.4","author":"Sas institute inc","year":"2015"}],"container-title":["Nicotine and Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntaf233\/65269198\/ntaf233.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/28\/5\/817\/65269198\/ntaf233.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/28\/5\/817\/65269198\/ntaf233.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T17:02:26Z","timestamp":1776877346000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/article\/28\/5\/817\/8320492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,11,11]]},"published-print":{"date-parts":[[2026,4,22]]}},"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntaf233","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2025,11,11]]}}}