{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T14:01:01Z","timestamp":1789912861621,"version":"4.0.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tobacco and cannabis co-use is an increasingly complex public health challenge shaped by rapid expansion of vaping technologies and product diversity. To inform prevention and intervention efforts, behavioral typologies that incorporate use frequency, vaping, dependence\/disordered use indicators are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed pooled 2022\u20132023 National Survey on Drug Use and Health data from 14,\u2009500\u00a0U.S. young adults aged 18\u201329 who reported tobacco\/nicotine or cannabis use. Latent class analysis identified subgroups based on past 30-day tobacco use frequency, nicotine vaping frequency, cannabis use frequency, nicotine dependence (Nicotine Dependence Syndrome Scale), and cannabis use disorder (Diagnostic and Statistical Manual of Mental Disorders-5 criteria).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A four-class model optimally balanced fit and interpretability. The largest subgroup was the nicotine-dominant use class (38.6%), marked by high tobacco use and minimal cannabis involvement. Three distinct co-use classes were identified: low co-use (17.4%), characterized by the lowest levels of tobacco product use, nicotine vaping, and cannabis use and comparatively low nicotine dependence and cannabis use disorder; cannabis-dominant co-use (32.3%), characterized by near-daily cannabis use with relatively low tobacco product use, nicotine vaping, and nicotine dependence; and high-frequency co-use (11.7%), characterized by frequent use of both nicotine products and cannabis and elevated nicotine dependence and cannabis use disorder. Serious psychological distress was associated with nearly twice the risk of cannabis-dominant co-use relative to nicotine-dominant use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incorporating use frequency, vaping behaviors, and validated dependence and disordered use measures revealed distinct, tobacco-cannabis co-use behavioral phenotypes among young adults. Findings underscore the need for integrated prevention and cessation approaches tailored to heterogeneous co-use patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Using latent class analysis, we identified four distinct behavioral profiles, further demonstrating that tobacco\/nicotine and cannabis co-use among young adults is not adequately captured by binary co-use measures or product use frequency alone. Incorporating validated measures of nicotine dependence and cannabis use disorder identified subgroups with differing patterns of substance involvement and clinical burden. These findings support multidimensional surveillance approaches and suggest that screening and intervention strategies may benefit from considering both use behaviors and dependence severity when identifying young adults at greatest risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntag194","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T19:31:47Z","timestamp":1788204707000},"source":"Crossref","is-referenced-by-count":0,"title":["Integrating use frequency, vaping, and dependence to characterize nicotine-cannabis co-use in young adults: a latent class analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4293-5635","authenticated-orcid":false,"given":"Wura","family":"Jacobs","sequence":"first","affiliation":[{"name":"Department of Applied Health Science, School of Public Health Bloomington, Indiana University , 1025 E. 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