Our sample included men who participated in both t0 and t2 assessments and used cannabis but no other illicit drugs at t0. The baseline assessment (t0) was done from 2010 to 2012, first follow-up (t1) from 2012 to 2014, and second follow-up (t2) from 2016 to 2018. Objective To examine whether consuming cannabis with a water pipe was associated with later consumption of other illicit drugs compared with not using a water pipe.ĭesign, Setting, and Participants The Cohort Study on Substance Use Risk Factors (C-SURF) was a population-based study, recruiting 5987 Swiss men aged 18 to 25 years from 3 of 6 Swiss Armed Forces recruitment centers (response rate: 79.2%). Importance There are concerns that the use of water pipes to consume cannabis is associated with increased risks of engaging in more addictive behaviors. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.