E-TERM: Exploring Tobacco Exposure through Recreational Marijuana use Study

Black men are at increased risk for tobacco-related diseases and are disproportionately burdened with tobacco-related deaths. Findings from our previous studies with young Black men (YBM), indicate that YBM: 1) use marijuana more frequently than other substances, and 2) commonly combine marijuana and tobacco in blunts and spliffs (also known as mulling). Young marijuana users are at increased risk for nicotine exposure and addiction related to mulling and yet many are not aware of this risk.


Close-up of a young black man lighting a blunt marijuana cigarette.


Funded by the Tobacco-Related Disease Research Program (TRDRP), the E-TERM study uses a mixed methods approach to explore how marijuana may function as the new “hook” for nicotine addiction by collecting self-report data on marijuana/tobacco use and biological (cotinine levels in saliva) data on tobacco exposure among YBM. Dr. Raina Pang, Professor at the Keck School of Medicine, serves as a Co-Investigator on the project based on her expertise with salivary sample studies. The specific aims for the study are:


Young black man passed out on the floor after smoking a marijuana cigarette

AIM 1: Conduct focus groups and interviews with YBM ages 18-30 to explore: 1) Knowledge, attitudes, beliefs, and perceptions of social norms regarding risks associated with the use of tobacco with smoking/vaping marijuana; 2) Individual-level and social factors associated with self-identification as a smoker and underreporting of tobacco/nicotine exposure; 3) harm reduction strategies (e.g., use of non-tobacco wraps, edible versus combustible forms of cannabis) acceptable to YBM, and 4) the acceptability of using biological saliva samples to assess cotinine levels.  

AIM 2: Collect survey (n=100) and saliva samples (n=50) from YBM ages 18-30 to: 1) quantify factors associated with collateral tobacco/nicotine use; 2) assess cotinine levels at 2 time points; and 3) compare these data to self-reported and perception of risk data.