Berg Carla J, Payne Jackelyn, Henriksen Lisa, Cavazos-Rehg Patricia, Getachew Betelihem, Schauer Gillian L, Haardörfer Regine
a Department of Behavioral Sciences and Health Education, Rollins School of Public Health , Emory University , Atlanta , Georgia , USA.
b Stanford Prevention Research Center, Department of Medicine , Stanford University School of Medicine , Palo Alto , California , USA.
Subst Use Misuse. 2018 Feb 23;53(3):357-369. doi: 10.1080/10826084.2017.1327978. Epub 2017 Aug 9.
Marijuana-tobacco co-use has increased recently, particularly in young adults.
We conducted a mixed-methods study to: (1) examine reasons for co-use; and (2) develop a scale assessing reasons for co-use among participants in a longitudinal cohort study of 3,418 students aged 18-25 from 7 Georgia colleges and universities.
Phone-based semi-structured interviews were conducted in Summer 2015 among 46 current (past 30-day, n = 26) or lifetime (n = 20) marijuana users. Subsequently, scale items were developed and included at Wave 3. Participants reporting past 4-month tobacco and marijuana use (n = 328) completed the Reasons for Marijuana-Tobacco Co-use section.
Per qualitative data, reasons for marijuana-tobacco co-use included synergistic effects, one triggering or preceding the other's use, using one to reduce the other's use, co-administration, social context, and experimentation. The survey subsample included 37.1% who used cigarettes, 30.4% LCCs, 9.4% smokeless, 23.7% e-cigarettes, and 30.4% hookah. Four subscale factors emerged: (1) Instrumentality, indicating synergistic effects; (2) Displacement, indicating using one product to reduce/quit the other; (3) Social context, indicating use in different settings/social situations; and (4) Experimentation, indicating experimentation with both but no specific reasons for co-use. These subscales demonstrated distinct associations with tobacco type used; nicotine dependence; marijuana and alcohol use frequency; tobacco and marijuana use motives, respectively; perceptions of tobacco and marijuana; and parental and friend use. Including these subscales in regressions predicting nicotine dependence and days of marijuana use significantly contributed to each model.
These findings might inform theoretical frameworks upon which marijuana-tobacco co-use occurs and direct future intervention studies.
大麻与烟草同时使用的情况最近有所增加，尤其是在年轻人中。
我们开展了一项混合方法研究，以：（1）探究同时使用的原因；（2）开发一个量表，用于评估来自佐治亚州7所高校的3418名18 - 25岁学生的纵向队列研究参与者中同时使用的原因。
2015年夏季，对46名当前（过去30天内，n = 26）或终身（n = 20）大麻使用者进行了基于电话的半结构化访谈。随后，开发了量表项目并纳入第3波调查。报告过去4个月使用过烟草和大麻的参与者（n = 328）完成了大麻 - 烟草同时使用原因部分的调查。
根据定性数据，大麻与烟草同时使用的原因包括协同效应、一种引发或先于另一种使用、使用一种来减少另一种的使用、同时使用、社会背景以及尝试。调查子样本中，37.1%的人使用香烟，30.4%使用低危害卷烟，9.4%使用无烟烟草，23.7%使用电子烟，30.4%使用水烟。出现了四个子量表因素：（1）工具性，表明协同效应；（2）替代，表明使用一种产品来减少/戒掉另一种；（3）社会背景，表明在不同环境/社交场合使用；（4）尝试，表明对两者都进行尝试但没有同时使用的具体原因。这些子量表与所使用的烟草类型、尼古丁依赖、大麻和酒精使用频率、烟草和大麻使用动机、对烟草和大麻的认知以及父母和朋友的使用情况分别呈现出不同的关联。在预测尼古丁依赖和大麻使用天数的回归分析中纳入这些子量表，对每个模型都有显著贡献。
这些发现可能为大麻与烟草同时使用所依据的理论框架提供信息，并指导未来的干预研究。
