a Department of Epidemiology , University of Florida , Gainesville , FL , USA.
Am J Drug Alcohol Abuse. 2018;44(4):452-462. doi: 10.1080/00952990.2018.1434535. Epub 2018 Mar 7.
Marijuana and tobacco are considered two closely related substances. It is of great significance to understand the mutual impact of marijuana and cigarette use when more states in the US have legalized marijuana use.
This study aims to investigate the transitions between marijuana and cigarette use among adolescents and emerging adults.
Guided by the probabilistic discrete events systems (PDES) theory, a five-stage model with 21 transition paths was constructed to quantify dynamic transitions between marijuana and cigarette use. The five stages were NU: Never-user, MU: Current marijuana user, CU: Current cigarette user, MCU: Current marijuana-cigarette user, and FU: Former-user. The proposed five-stage PDES model was tested using the 2013 National Survey on Drug Use and Health data (N = 26,665, 50.45% male). Transition probabilities were estimated using the Moore-Penrose generalized inverse matrix method.
Among the adolescents, 51.14% of the CUs transited to use marijuana (MCU/MU), higher than the proportion of those who first used marijuana and then transferred to cigarettes (MCU/CU) (41.66%). The quitting rates for MUs, CUs and MCUs were 29.38%, 25.93% and 27.76%, respectively. Of the total FUs, 31.90% transited to MUs, 17.06% to CUs, and 17.39% to MCUs. Among the young adults, more people progressed from MUs to CUs. Transition probabilities by single year of age were also estimated.
This is the first study to quantify marijuana-cigarette transitions. Study findings indicate more cigarette-to-marijuana transitions for adolescents and more marijuana-to-cigarette transitions for emerging adults. Future intervention programs should consider this age-related difference in marijuana-cigarette use transitions.
大麻和烟草被认为是两种密切相关的物质。随着美国更多的州使大麻合法化，了解大麻和香烟使用之间的相互影响具有重要意义。
本研究旨在调查青少年和成年早期人群中大麻和香烟使用之间的转变情况。
本研究以概率离散事件系统（PDES）理论为指导，构建了一个包含 21 条转变路径的五阶段模型，以量化大麻和香烟使用之间的动态转变。五个阶段分别为：NU：从不使用者；MU：当前大麻使用者；CU：当前香烟使用者；MCU：当前大麻-香烟使用者；FU：前使用者。使用 2013 年全国毒品使用与健康调查数据（N=26665，50.45%为男性）对所提出的五阶段 PDES 模型进行了检验。使用 Moore-Penrose 广义逆矩阵法估计了转变概率。
在青少年中，51.14%的 CU 转变为使用大麻（MCU/MU），高于首次使用大麻然后转为香烟（MCU/CU）的比例（41.66%）。MU、CU 和 MCU 的戒烟率分别为 29.38%、25.93%和 27.76%。在所有的 FU 中，31.90%转变为 MU，17.06%转变为 CU，17.39%转变为 MCU。在成年早期人群中，更多的人从 MU 转变为 CU。还估计了按单一年龄的转变概率。
这是第一项量化大麻-香烟转变的研究。研究结果表明，青少年中更多的是香烟向大麻的转变，而成人早期更多的是大麻向香烟的转变。未来的干预计划应考虑到大麻和香烟使用转变的这种与年龄相关的差异。
