Diverging Patterns of Educational Disparities Among Cannabis Users and Cigarette Smokers.

Introduction: Previous research has shown an inverse relationship between cigarette smoking and educational attainment. However, there is relatively scarce research on the relationship between cannabis use and education level. This article examines whether the inverse relationship between cigarette smoking and educational attainment applies to cannabis use. Methods: The 2023 California Health Interview Survey, a representative population-based survey of California adults that assesses health behaviors, was analyzed to examine current cigarette smoking and cannabis use prevalence. Logistic regression was used to examine the association between cigarette smoking/cannabis use and educational attainment among adults aged >26 years (N=20,557), adjusting for age, sex, and race/ethnicity. Results: In 2023, among California adults aged >26 years, current cannabis use prevalence was more than twice as high (13.5%) as current cigarette use prevalence (6.1%). Compared to the odds of being a current cannabis user for those who did not graduate high school, the odds were 2.05 times as high (95% CI=1.35, 3.12) for those who completed high school, 2.57 times as high (95% CI=1.73, 3.80) for those with some college education, and 2.17 times as high (95% CI=1.46, 3.23) for those who completed college. Compared to the odds of being a current cigarette smoker for those who did not graduate high school, the odds were 0.31 times as high (95% CI=0.22, 0.43) for those who completed college. Conclusions: Adults with higher education levels were more likely to be cannabis users than those with less education, which was inverse to the relationship between cigarette smoking and education. Efforts to prevent and reduce cannabis use should have additional focus on those who have completed high school and college.