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J Sch Health. 2014 Mar;84(3):151-9. doi: 10.1111/josh.12137.
This study explores the patterns of use and co-use of tobacco and cannabis among Ontario adolescents over 3 decades and if characteristics of co-users and single substance users have changed.
Co-use trends for 1981-2011 were analyzed using the Centre for Addiction and Mental Health Ontario Student Drug Use and Health Survey, which includes 38,331 students in grades 7, 9, and 11. A co-user was defined as someone reporting daily tobacco and/or cannabis use in the past month. Trends over time (by gender and academic performance) were analyzed with logistic regression.
The prevalence of tobacco-only use, cannabis-only use, and co-use fluctuated considerably. During 1981-1993, there were more tobacco-only users than co-users and cannabis-only users; since 1993 the prevalence of tobacco use has decreased dramatically. Co-use prevalence peaked at 12% (95% confidence interval: 9, 15) in 1999, when prevalence of overall use of both substances was highest. In 2011, 92% of tobacco users also used cannabis, up from 16% in 1991.
In 2011 nearly all students who smoke tobacco daily also use cannabis. Non-regular use of either substance is highest now compared with the past 3 decades. Contemporary tobacco and cannabis co-users are significantly different than past users. Youth prevention programs should understand the changing context of cannabis and tobacco among youth.
本研究探讨了安大略省青少年在 30 多年间使用烟草和大麻的模式和共用量，以及共使用者和单一物质使用者的特征是否发生了变化。
使用成瘾和心理健康中心安大略省学生毒品使用和健康调查（该调查包括 7、9 和 11 年级的 38331 名学生）分析了 1981-2011 年的共用量趋势。共使用者被定义为在过去一个月内每天使用烟草和/或大麻的人。使用逻辑回归分析了随时间变化的趋势（按性别和学业成绩）。
烟草单一使用、大麻单一使用和共使用的流行率波动较大。在 1981-1993 年期间，烟草单一使用者多于共使用者和大麻单一使用者；自 1993 年以来，烟草使用的流行率急剧下降。共用量的流行率在 1999 年达到峰值（95%置信区间：9，15），当时两种物质的总使用率最高。2011 年，92%的烟草使用者也使用大麻，而 1991 年这一比例为 16%。
2011 年，几乎所有每天吸烟草的学生都使用大麻。与过去 30 年相比，现在非规律使用任何一种物质的比例最高。现在的当代烟草和大麻共使用者与过去的使用者有显著不同。青年预防计划应了解青年中大麻和烟草不断变化的情况。
