Public Health Research Unit, CHUQ Medical Research Center, Quebec City, Canada;
Nicotine Tob Res. 2013 Nov;15(11):1832-8. doi: 10.1093/ntr/ntt063. Epub 2013 May 14.
To determine if mulling, the process of adding tobacco to cannabis for its consumption, exposes young cannabis users to significant levels of nicotine.
This observational study performed in 2009-2010 among Swiss youths aged 16-25 years involved the completion of a self-administrated questionnaire and the collection of a urine sample on the same day. Measures of urinary cotinine were blindly performed using liquid chromatography coupled-mass spectrometry. A total of 197 eligible participants were divided in 3 groups based on their consumption profile in the past 5 days: 70 abstainers (ABS) not having used cigarettes or cannabis, 57 cannabis users adding tobacco to the cannabis they smoke (MUL) but not having smoked cigarettes, and 70 cigarette smokers (CIG) not having smoked cannabis.
Exposure to nicotine was at its lowest among ABS with a mean (SE) cotinine level of 3.2 (1.4) ng/ml compared, respectively, with 214.6 (43.8) and 397.9 (57.4) for MUL and CIG (p < .001). While consumption profile appeared as the only significant factor of influence when examining nicotine exposure from the ABS and MUL participants on multivariate analysis, it did not result in substantial differences among MUL and CIG groups.
Urinary cotinine levels found among MUL are high enough to indicate a significant exposure to nicotine originating from the mulling process. In line with our results, health professionals should pay attention to mulling as it is likely to influence cannabis and cigarette use as well as the efficacy of cessation interventions.
为了确定吸食大麻时往大麻中添加烟草的“烟泡”（mulling）做法是否会使年轻的大麻使用者接触到大量尼古丁。
这项在 2009 年至 2010 年期间针对瑞士 16-25 岁青少年进行的观察性研究，包括完成一份自我管理问卷和同日采集尿液样本。采用液相色谱-串联质谱法对尿样中的可替宁进行盲法检测。根据过去 5 天的消费情况，197 名符合条件的参与者被分为 3 组：70 名不吸烟也不吸食大麻的不使用者（ABS），57 名吸食大麻并往其中添加烟草但不吸食香烟的吸食者（MUL），70 名不吸食大麻但吸食香烟的吸烟者（CIG）。
ABS 组的尼古丁暴露水平最低，其可替宁均值（SE）为 3.2（1.4）ng/ml，与 MUL 和 CIG 组相比分别为 214.6（43.8）和 397.9（57.4）（p<0.001）。在多变量分析中，当考察 ABS 和 MUL 参与者的尼古丁暴露情况时，消费模式似乎是唯一具有显著影响的因素，但在 MUL 和 CIG 组之间并未导致明显差异。
在 MUL 组中发现的尿可替宁水平足以表明其通过烟泡过程显著接触到尼古丁。根据我们的结果，卫生专业人员应该注意烟泡，因为它可能会影响大麻和香烟的使用以及戒烟干预的效果。
