​Summary: This study examined nicotine and cannabis vaping among adolescents in treatment for substance use disorders. Participants were 363 adolescents aged 12–17) seen for a specialty addiction intake evaluation between 2017 and 2019 at one of six medical offices of a large, integrated health care system in Northern California. Multivariable logistic regression models tested for associations of sociodemographics, cigarette smoking, and substance use disorders with vaping behaviors.

Findings: A majority of adolescents reported ever (68%) or current vaping (60%) of nicotine and/or cannabis; current vaping was similar for nicotine (50%) and cannabis (51%); 40% reported current vaping of both. Current smokers (6% of the sample) had higher odds of ever vaping. Black (versus non-Hispanic white) adolescents had lower odds of current nicotine vaping and current vaping of both nicotine and cannabis. Having an alcohol use disorder was associated with current vaping. Those who endorsed that most friends get drunk/high or that cannabis was their substance of choice had higher odds of current cannabis vaping. Higher neighborhood household income, never versus ever blunt use, and intakes in 2018 and 2019 versus 2017 were associated with higher odds of all vaping outcomes. Vaping was common among adolescents in addiction treatment and varied with sociodemographics and substance-related factors. Research should assess how vaping impacts the development of substance use disorders and whether it interferes with addiction treatment.