The term “blunt” has multiple meanings for products that individuals smoke. A “blunt” originally referred to a mid-size, cylindrical tobacco cigar with a flat (blunt) tip (Perelman’s Pocket Cyclopedia of Cigars; 2010). However, by the 1990s in the United States, the term “blunt” began to refer to a tobacco cigar (often an inexpensive tobacco blunt cigar) that had been hollowed out and filled with cannabis (e.g., Golub et al., 2005). Blunt wraps also can be used to make blunts and comprise only the external wrapper for making a blunt. The wrap is filled with cannabis and rolled up to create the blunt. Initially, all blunt wraps were made of tobacco, so all blunt use (i.e., tobacco-only blunt cigars, hollowed out tobacco cigars filled with cannabis, tobacco blunt wraps filled with cannabis) reflected tobacco-cannabis co-use.

However, in the past several years, tobacco-free blunt wraps entered the market. These wraps are made from non-tobacco sources including hemp, banana leaves, Cordia leaves, and Tendu leaves. Tobacco-free blunt wraps are marketed as a healthier, tobacco-free, and nicotine-free alternative to traditional tobacco blunts (Jordan, 2020) and often carry additional appealing descriptors on product packaging or in product descriptions like “natural,” “no synthetic dyes or colors,” “organic and GMO-free,” and “vegan” (Ghezelbash, 2023). These marketing strategies may appeal to individuals who are opposed to using tobacco, who dislike the effects of nicotine, and/or who dislike the taste of cigars or tobacco blunt wraps but who enjoy the experience of smoking a blunt, which often contains significantly more cannabis than a joint, lasts longer, and is often used in social situations. With the introduction of tobacco-free blunt wraps, blunts can no longer universally be considered tobacco-cannabis co-use; smoking a tobacco-free blunt wrap filled with cannabis constitutes cannabis use only. Therefore, assessing the type of blunt used to smoke cannabis is critical for determining whether use constitutes co-use with tobacco or exclusive cannabis use.

Blunts are particularly popular among youth and young adults (Kong et al., 2018) and often are the first product tried (Mayer et al., 2020). Unfortunately, tobacco-cannabis co-use, including blunts, is associated with many negative outcomes among young people including increased exposure to both cannabis and nicotine (Mayer et al., 2020), which can impede neurological development during this critical period and facilitate the development of nicotine and cannabis dependence (Yuan et al., 2015); increased toxicant exposure including carbon monoxide compared to tobacco or cannabis use alone (Meier and Hatsukami, 2016); concurrent use of cigarettes, cigars, and e-cigarettes (e.g., Camenga et al., 2014; Mayer et al., 2020); poor mental health (Ramo et al., 2012); and engagement is high-risk behaviors like driving after use (Tucker et al., 2019). Given the popularity of blunts among youth and the many associated concerns, we examined high school students’ self-reported use of tobacco and tobacco-free products for making blunts. This allowed us to determine what percentage of blunt use constituted tobacco-cannabis co-use versus exclusive cannabis use. Additionally, we assessed lifetime use of a variety of tobacco products (e.g., e-cigarettes, cigarettes) to determine what percentage of students who endorsed exclusively using tobacco-free blunts reported using tobacco product(s) or not. This allowed us to determine what percentage of students endorsing exclusive tobacco-free blunt use would be accurately or inaccurately classified as engaging in lifetime tobacco product use overall. It is critical to highlight the scope of misclassification given the broader need to establish accurate population-based estimates of tobacco product use.