Objective: Cigarettes, alcohol, cannabis, inhalants and cocaine are the most commonly used substances among high school students in Jamaica. However, there is limited evidence on their co-use and whether the use of one drug predicts the use of the others (multiple substance use). This study aimed to determine whether cannabis use predicts the co-use of the other substances.
Methods: We analysed data from the National Secondary School Survey 2013, Jamaica, using inferential statistics to determine associations.
Results: Lifetime cannabis use was significantly associated with lifetime cigarette use for males (X2 = 282.72, p = 0.000) and females (X2 = 434.32, p = 0.000). Similarly, it was significantly associated with: (a) lifetime use of alcohol for males (X2 = 88.62, p = 0.000) and females (X2= 99.48, p = 0.000); (b) lifetime use of inhalants for males (X2 = 13.28, p = 0.00) and females (X2 = 49.56, p = 0.00); and (c) lifetime cocaine use for males (X2 = 9.78, p = 0.00) and females (X2 = 64.54, p = 0.00). Past-month (recent) use of cannabis was significantly associated with past-month use of cigarettes and alcohol, but not inhalants, for males and females. Logistic regression results showed that lifetime cannabis use was a risk factor for lifetime use of cigarettes (adjusted odds ratio [AOR]: 11.38; 95% confidence interval [CI]: 9.02, 14.37) and alcohol (AOR: 5.84; 95% CI: 4.11, 8.30), but a strong protective factor against lifetime use of inhalants and cocaine. Past-month use of cannabis was a strong protective factor against pastmonth use of cigarettes and alcohol.
Conclusion: Lifetime cannabis use was significantly associated with multiple substance use and was shown to be a risk factor for lifetime use of cigarettes and of alcohol. However, adolescents who reported recent (past-month) use of cannabis were less likely to report recent use of alcohol and cigarettes. These findings suggest the need for research to further explore the role cannabis plays in multiple drug use and offer more concrete explanations for its role.