The biggest warning sign in a new cannabis study may not be the product itself, but how many different ways a person uses it. An analysis of 17,732 U.S. adults found that people who combined smoking, vaping, edibles, dabbing, and other methods were far more likely to use cannabis daily and meet criteria for cannabis use disorder than people who mainly relied on one route. The findings point to consumption patterns as a possible early signal of addiction risk.
The researchers analyzed responses from the 2022–2023 National Survey on Drug Use and Health, separating participants into groups based on their preferred methods. The most concerning category was made up of “polymodal” users—people who used nearly every available form. About 67% of that group met criteria for cannabis use disorder, compared with 47% of people who smoked and vaped, 36% of primarily smoked users, and 15% of those who mainly consumed edibles. The same general pattern appeared in measures of daily use and addiction-related symptoms.
The study’s results align with a broader analysis published in the journal Addiction, which also found that using multiple cannabis routes was associated with substantially higher odds of cannabis use disorder. In that separate analysis, 53.9% of past-year cannabis users reported more than one method, while the overall disorder rate was 30.3%. Multimodal users had roughly four times the adjusted odds of cannabis use disorder compared with the reference group. The journal analysis also found that moderate-to-severe cases were concentrated among multimodal and dab users.
That does not mean switching between formats causes addiction. Both studies are based on survey data collected at one point in time, so they cannot establish whether broader experimentation leads to heavier use or whether people with an existing dependence seek out additional products and delivery methods. Other factors—including potency, age, mental health, medical use, access, and the reasons someone uses cannabis—may also influence the results.
Still, the pattern gives clinicians a practical question to add to routine screening: not only how often someone uses cannabis, but whether they smoke it, vape it, eat it, dab it, and use other products interchangeably. Cannabis use disorder is diagnosed through symptoms such as difficulty cutting back, persistent cravings, tolerance, withdrawal, and continued use despite problems—not simply through the presence of cannabis use. Clinical evaluation therefore remains necessary rather than treating a particular consumption style as a diagnosis.
For consumers, the research suggests that a growing menu of cannabis products can make total exposure harder to recognize. Someone who rarely smokes may still be using cannabis frequently through gummies, cartridges, concentrates, and beverages. The next step for researchers will be determining whether tracking the number of consumption methods can help identify risky use earlier, before occasional or recreational use develops into a disorder.
