Association between contraband tobacco and illicit drug use among high school students in Canada.

A particularly challenging issue to tobacco cessation efforts is the availability of contraband cigarettes. While studies have linked contraband tobacco to smoking initiation and poor cessation outcomes, little is known about its association with illicit drug use among adolescents. We examine the association between contraband tobacco and illicit drug use among adolescent students using a national representative sample of 2,136 current smoker students in grades 9-12 from the 2010-2011 Youth Smoking Survey. About 31 % of adolescent current smokers in grades 9-12 use contraband cigarettes. Prevalence in the use of illicit drugs ranged from 9 to 37 %, with MDMA being the most commonly used drug. Adjusted logistic regression revealed that smokers of contraband cigarettes, when compared with non-contraband cigarette smokers, were more likely to use cocaine (OR 2.14; CI 1.29-3.56), heroin (OR 7.92; CI 3.00-20.91), amphetamines (OR 4.25; CI 2.07-8.74), MDMA (OR 2.00; CI 1.25-3.19), hallucinogens (OR 2.18; CI 1.34-3.55), and ketamine (OR 3.48; CI 1.61-7.54). This paper adds to the existing evidence of the negative effects of contraband tobacco by showing that adolescent contraband smokers are more likely to use illicit drugs. Given the addictive nature of these drugs and the potential for such behavior to spill over into adulthood, more efforts should be invested in addressing this problem.