Hindocha Chandni, Freeman Tom P, Ferris Jason A, Lynskey Michael T, Winstock Adam R
Clinical Psychopharmacology Unit, University College London , London , UK.
Institute for Social Science Research, University of Queensland , QLD , Australia.
Front Psychiatry. 2016 Jul 5;7:104. doi: 10.3389/fpsyt.2016.00104. eCollection 2016.
Cannabis and tobacco are common drugs of abuse worldwide and are often used in combination through various routes of administration (ROAs). Here, we aimed to provide an overview of how cannabis and tobacco routes varied across countries and assess the impact of tobacco-based ROAs on motivation to use less cannabis, and less tobacco, in different models. A cross-sectional online survey (Global Drugs Survey 2014) was completed by 33,687 respondents (mean age = 27.9; % female = 25.9) who smoked cannabis at least once in the last 12 months. Most common ROA, frequency of cannabis/tobacco use, and questions about motivation to use less cannabis/tobacco were recorded. Tobacco-based ROA were used by 65.6% of respondents. These were most common in Europe (77.2-90.9%) and Australasia (20.7-51.6%) and uncommon in the Americas (4.4-16.0%). Vaporizer use was most common in Canada (13.2%) and the United States (11.2%). Using a non-tobacco ROA was associated with a 10.7% increase in odds for "desire to use less" tobacco (OR: 1.107, 95% CI: 1.003, 1.221), 80.6% increase in odds for "like help to use less tobacco" (OR: 1.806, 95% CI: 1.556, 2.095), and a 103.9% increase in the odds for "planning to seek help to use less tobacco" (OR: 2.039, 95% CI: 1.638, 2.539), in comparison to using a tobacco-based ROA. Associations between ROA and intentions to use less cannabis were inconsistent. Results support considerable global variation in cannabis and tobacco ROA. Tobacco routes are common, especially "joints with tobacco," especially in Europe, but not in the Americas. Non-tobacco-based routes are associated with increased motivation to change tobacco use. Interventions addressing tobacco and cannabis need to accommodate this finding and encourage non-tobacco routes.
大麻和烟草是全球常见的滥用药物，并且常常通过各种给药途径联合使用。在此，我们旨在概述大麻和烟草的给药途径在各国之间如何不同，并评估在不同模式下基于烟草的给药途径对减少大麻和烟草使用动机的影响。一项横断面在线调查（2014年全球药物调查）由33687名受访者（平均年龄=27.9岁；女性占比=25.9%）完成，这些受访者在过去12个月中至少吸食过一次大麻。记录了最常见的给药途径、大麻/烟草使用频率以及关于减少大麻/烟草使用动机的问题。65.6%的受访者使用基于烟草的给药途径。这些在欧洲（77.2%-90.9%）和澳大拉西亚（20.7%-51.6%）最为常见，而在美洲（4.4%-16.0%）则不常见。蒸发器使用在加拿大（13.2%）和美国（11.2%）最为普遍。与使用基于烟草的给药途径相比，使用非烟草给药途径与“渴望减少使用”烟草的几率增加10.7%（比值比：1.107，95%置信区间：1.003，1.221）、“希望得到帮助减少烟草使用”的几率增加80.6%（比值比：1.806，95%置信区间：1.556，2.095）以及“计划寻求帮助减少烟草使用”的几率增加103.9%（比值比：2.039，95%置信区间：1.638，2.539）相关。给药途径与减少大麻使用意图之间的关联并不一致。结果支持大麻和烟草给药途径在全球存在相当大的差异。基于烟草的途径很常见，尤其是“与烟草混合的卷烟”，特别是在欧洲，但在美洲并非如此。非烟草给药途径与改变烟草使用的动机增加相关。针对烟草和大麻的干预措施需要考虑到这一发现，并鼓励采用非烟草途径。
