Abstract

Background: Despite increases in cardiovascular disease (CVD) prevalence among young and middle-aged adults in the United States (U.S.), associations between lifetime use of cannabis, non-cigarette tobacco products, and illicit drugs with CVD are not fully known. This study aimed to examine these associations among young and middle-aged U.S. adults. Methods: We analyzed a sample of 2933 adults aged 20-59 years from the National Health and Nutrition Examination Survey (2017-2018). CVD (i.e., health care provider diagnosis of coronary heart disease, stroke, or high blood pressure), and substance use (i.e., ever use of cannabis, non-cigarette tobacco, or illicit drugs) were assessed. Adjusted odds ratios were estimated using multivariable logistic regression. Results: Adults who used cannabis had higher odds of coronary heart disease (OR = 5.45, 95% CI: 1.86-15.95), and adults who used cigars had higher odds of stroke (OR = 2.31, 95% CI: 1.06-5.01). Further, increased odds of high blood pressure were associated with e-cigarette (OR = 1.41, 95% CI: 1.12-1.79) and smokeless tobacco (OR = 1.46, 95% CI: 1.01-2.12) use. Conclusions: Lifetime cannabis and non-cigarette use was associated with CVD among young and middle-aged U.S. adults, with the spectrum of disease varying based on substance type. CVD prevention should involve non-cigarette tobacco and cannabis use screening and counseling.

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Year
2025
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Joy L. Hart, Maggie K. Richardson, Alison C. McLeish et al. (2025). Lifetime Cannabis, Non-Cigarette Tobacco, and Illicit Drug Use and Cardiovascular Disease Among Young and Middle-Aged U.S. Adults. American Journal of Lifestyle Medicine . https://doi.org/10.1177/15598276251404883

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DOI
10.1177/15598276251404883