Schauer Gillian L, King Brian A, McAfee Timothy A
Department of Health Services, School of Public Health, University of Washington, United States; CDC Foundation, 600 Peachtree Street NE, Suite 1000, Atlanta, GA, 30308, United States.
Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, United States.
Addict Behav. 2017 Oct;73:165-171. doi: 10.1016/j.addbeh.2017.04.023. Epub 2017 Apr 29.
Approximately 70% of current (past 30-day) adult marijuana users are current tobacco users, which may complicate tobacco cessation. We assessed prevalence and trends in tobacco cessation among adult ever tobacco users, by marijuana use status.
Data came from the National Survey on Drug Use and Health, a cross-sectional, nationally representative, household survey of U.S. civilians. Analyses included current, former, and never marijuana users aged≥18 reporting ever tobacco use (cigarette, cigar, chew/snuff). We computed weighted estimates (2013-2014) of current tobacco use, recent tobacco cessation (quit 30days to 12months), and sustained tobacco cessation (quit>12months) and adjusted trends in tobacco use and cessation (2005-2014) by marijuana use status. We also assessed the association between marijuana and tobacco use status.
In 2013-2014, among current adult marijuana users reporting ever tobacco use, 69.1% were current tobacco users (vs. 38.5% of former marijuana users, p<0.0001, and 28.2% of never marijuana users, p<0.0001); 9.1% reported recent tobacco cessation (vs. 8.4% of former marijuana users, p<0.01, and 6.3% of never marijuana users, p<0.001), and 21.8% reported sustained tobacco cessation (vs. 53.1% of former marijuana users, p<0.01, and 65.5% of never marijuana users, p<0.0001). Between 2005 and 2014, current tobacco use declined and sustained tobacco cessation increased among all marijuana use groups.
Current marijuana users who ever used tobacco had double the prevalence (vs. never-marijuana users) of current tobacco use, and significantly lower sustained abstinence. Interventions addressing tobacco cessation in the context of use of marijuana and other substances may be warranted.
目前（过去30天内）约70%的成年大麻使用者也是目前的烟草使用者，这可能会使戒烟变得复杂。我们按大麻使用状况评估了成年既往烟草使用者中戒烟的患病率和趋势。
数据来自全国药物使用和健康调查，这是一项针对美国平民的横断面、具有全国代表性的家庭调查。分析纳入了年龄≥18岁、报告曾使用过烟草（香烟、雪茄、咀嚼烟草/鼻烟）的当前、既往和从未使用过大麻的使用者。我们计算了当前烟草使用、近期戒烟（已戒烟30天至12个月）和持续戒烟（已戒烟超过12个月）的加权估计值（2013 - 2014年），并按大麻使用状况调整了烟草使用和戒烟的趋势（2005 - 2014年）。我们还评估了大麻与烟草使用状况之间的关联。
在2013 - 2014年，在报告曾使用过烟草的成年当前大麻使用者中，69.1%为当前烟草使用者（相比之下，既往大麻使用者为38.5%，p<0.0001；从未使用过大麻的使用者为28.2%，p<0.0001）；9.1%报告近期戒烟（相比之下，既往大麻使用者为8.4%，p<0.01；从未使用过大麻的使用者为6.3%，p<0.001），21.8%报告持续戒烟（相比之下，既往大麻使用者为53.1%，p<0.01；从未使用过大麻的使用者为65.5%，p<0.0001）。在2005年至2014年期间，所有大麻使用组中当前烟草使用减少，持续戒烟增加。
曾使用过烟草的当前大麻使用者当前烟草使用的患病率是从未使用过大麻者的两倍，且持续戒烟率显著更低。在使用大麻和其他物质的背景下针对戒烟的干预措施可能是必要的。
