Successful substance use prevention should focus on alcohol's co-use with a variety of substances of abuse, rather than focus on a single behavior, according to a recent study. Researchers analyzed data from a subset of 18 to 24 year olds (n = 3,940) from 5 waves of the Truth Initiative Young Adult Cohort, a national sample of 18 to 34 year olds. They found:

• No past 30-day use of any substance emerged as the most popular pattern across all years (42%), followed by exclusive past 30-day alcohol use (31%), and past 30-day alcohol use with cigarettes (5%) or marijuana (4%).
• The popularity of exclusive marijuana use increased over time, but only 1% reported exclusive marijuana use without the combination of either alcohol or a tobacco product.
• E-cigarette use only emerged in combination with alcohol and was the least popular pattern of co-use relative to other patterns.