{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T10:36:33Z","timestamp":1793097393250,"version":"4.5.0"},"posted":{"date-parts":[[2026,4,6]]},"group-title":"Public and Global Health","reference-count":40,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"award":["5R36OD037669-02"],"award-info":[{"award-number":["5R36OD037669-02"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,10,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Polyuse of tobacco, nicotine, and cannabis products has increased among adolescents and young adults, but less is known about the prevalence of environmental (i.e., secondhand) exposure to these products. This study aimed to identify groups of tobacco, electronic nicotine delivery systems, and cannabis use and environmental exposures among adolescents and young adults.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data were collected between 2018 and 2022 from adolescents and young adults enrolled in the Environmental influences on Child Health Outcomes (ECHO) research program. A multiple-group latent class analysis characterized age group (early, middle, or late adolescence\/young adulthood) patterns of environmental exposure to cannabis smoke, tobacco smoke, and electronic nicotine delivery system aerosol emissions (\u22651 hour\/day or cohabitation with daily indoor use), and personal use of cannabis, tobacco, and electronic nicotine delivery systems, categorized as experimental (&lt;1 time\/month) or current (\u22651 time\/month).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Among 2,876 participants from 19 ECHO cohorts (\n                    <jats:italic>\n                      M\n                      <jats:sub>age<\/jats:sub>\n                    <\/jats:italic>\n                    = 17.28 years; 52% [\n                    <jats:italic>n<\/jats:italic>\n                    =1,495] female, 9.1% [\n                    <jats:italic>n<\/jats:italic>\n                    =248] Hispanic, 58.4% [n=1,583] non-Hispanic White), four classes were identified: No Use\/No Exposure (53%), No Use\/Polyexposure (10%), Experimental Use\/Low Exposure (22%), and Polysubstance Use\/Polyexposure (14%). The No Use\/No Exposure and No Use\/Polyexposure classes primarily included early and middle adolescents, whereas the Experimental Use\/Low Exposure and Polysubstance Use\/Polyexposure classes primarily included late adolescents and young adults.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings suggest that investigating environmental exposures alongside polyuse is an emerging priority for tobacco and cannabis research and prevention. Prospective data from future ECHO releases can extend our findings by characterizing polyuse and polyexposure over time and identifying correlates of risk.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.04.03.26350120","type":"posted-content","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T21:50:14Z","timestamp":1775512214000},"source":"Crossref","is-referenced-by-count":0,"title":["Latent Classes of Cannabis, ENDS, and Tobacco Use and Environmental Exposure Among Adolescents and Young Adults in the ECHO Cohort"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4569-6676","authenticated-orcid":false,"given":"Hannah J.","family":"Appleseth","sequence":"first","affiliation":[{"name":"Department of Psychology, Oklahoma State University, Stillwater, OK"},{"name":"Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7334-6489","authenticated-orcid":false,"given":"John M.","family":"Felt","sequence":"additional","affiliation":[{"name":"Center for Healthy Aging, The Pennsylvania University, University Park, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9034-4293","authenticated-orcid":false,"given":"Amy M.","family":"Cohn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The University of Oklahoma Health Campus, Oklahoma City, Oklahoma"},{"name":"TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Campus, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1582-2747","authenticated-orcid":false,"given":"Rebecca J.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of California Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0415-3237","authenticated-orcid":false,"given":"Julie M.","family":"Croff","sequence":"additional","affiliation":[{"name":"Department of Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK"},{"name":"Department of Psychiatry & Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8494-097X","authenticated-orcid":false,"given":"Thad R.","family":"Leffingwell","sequence":"additional","affiliation":[{"name":"Department of Psychology, Oklahoma State University, Stillwater, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026102703201135000_2026.04.03.26350120v2.1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470692479.ch8"},{"key":"2026102703201135000_2026.04.03.26350120v2.2","doi-asserted-by":"publisher","DOI":"10.1038\/npjpcrm.2016.67"},{"key":"2026102703201135000_2026.04.03.26350120v2.3","unstructured":"United States: Health and Human Services Department: Office of Public Health and Science, Brody DJ , Brody DJ , Lu Z , Tsai J , National Center for Health Statistics (U.S.). 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