Abstract
INTRODUCTION: Historically, cannabis blunts were made using tobacco products like cigars, but tobacco-free blunt wraps (TFBWs) made from sources like hemp and palm leaves are gaining popularity. While marketed for cannabis, it is unknown what substances adolescents put in TFBWs. Here, we focused on using tobacco in TFBWs. AIMS AND METHODS: From April to May 2024, 4760 Connecticut high school students completed school-wide, anonymous, online surveys. The analytic sample comprised 489 adolescents (44.6% male, 28.2% non-Hispanic White, mean age 16.20 [1.27] years) with lifetime cannabis blunt use who answered questions about TFBW awareness and use, including with tobacco. We examined demographic-, tobacco-, and cannabis-related associations with using tobacco in TFBWs. RESULTS: Of students reporting lifetime cannabis blunt use, 49.7% were aware of TFBWs and 24.7% reported use. Among adolescents using TFBWs, 12.4% reported putting tobacco in TFBWs, and 8.7% reported usually doing so. In bivariate analyses, putting tobacco in TFBWs was associated with using blunts at an earlier age; using other tobacco products; using a greater total number of tobacco products in one's lifetime; and greater dependence on e-cigarettes, cigarettes, and cannabis (p-values <.05). CONCLUSIONS: Few students who use cannabis blunts reported putting tobacco in TFBWs. Yet, using tobacco in TFBWs was associated with negative outcomes like nicotine and cannabis dependence, requiring future investigation. Unlike cigarette rolling papers and tobacco blunt wraps, TFBWs are not regulated by the US Food and Drug Administration as tobacco products. However, surveillance in nationally representative samples may support the need for regulatory action if tobacco use in TFBWs continues. IMPLICATIONS: Although some brands of TFBWs specifically note that their products are not intended for tobacco use, blunts are user-rolled. Results demonstrate that among adolescents who use cannabis blunts and endorse TFBW use, 12.4% have added tobacco to a TFBW and 8.7% regularly do so. If findings are replicated in future national survey studies of adolescents and adults, this would support the United States Food and Drug Administration in regulating TFBWs as tobacco products.