Department of Behavioral and Community Health, University of Maryland , College Park , Maryland , USA.
Subst Use Misuse. 2019;54(13):2177-2190. doi: 10.1080/10826084.2019.1638409. Epub 2019 Jul 22.
The co-occurring use of tobacco and marijuana among young adults is an important behavioral phenomenon within the field of substance use. Studying tobacco and marijuana use together among young adults can provide important insight into patterns of initiation and continuation. The primary goal of this study was to examine characteristics associated with co-use among young adults and to discover the ways experiences of co-users can help contextualize trends in co-use. This study employed a sequential explanatory mixed methods design. Quantitative analyses used 12 years of nationally representative National Health and Nutrition Examination Survey (NHANES) data (2005-2016) to assess the characteristics and experiences of young adult (21-30) co-users. Results from analyses of NHANES, prior literature, and theoretical constructs were used to develop a guide for 20 in-depth, semi-structured interviews with young adult co-users living in the state of Maryland. Interviews were analyzed using thematic analysis. Quantitative results and qualitative findings were integrated. The original NHANES analysis occurred during October and November 2017, interviews took place during December 2017 and January 2018, and all mixed methods integration was conducted in 2018. Tobacco and marijuana co-users have unique characteristics and experiences compared to single product users; the experiences of co-users can offer unique insights on co-use. Meta-inferences emerged from integration. : Co-users conceptualize tobacco and marijuana differently and hold different risk perceptions for each substance. Co-users may be at risk for polytobacco product use. These findings highlight the profound influence these two substances have on young adult co-users' experiences and behaviors.
年轻人同时使用烟草和大麻是物质使用领域的一个重要行为现象。研究年轻人同时使用烟草和大麻可以深入了解起始和持续使用的模式。本研究的主要目的是研究年轻人同时使用两者的特征，并发现同时使用的经验如何帮助理解同时使用的趋势。本研究采用了顺序解释性混合方法设计。定量分析使用了 12 年全国代表性的国家健康和营养调查 (NHANES) 数据（2005-2016 年），以评估年轻成年人（21-30 岁）同时使用者的特征和经验。来自 NHANES、先前文献和理论构建体的分析结果用于为 20 名居住在马里兰州的年轻成年同时使用者制定指导方针，进行 20 次深入的半结构化访谈。使用主题分析对访谈进行分析。整合了定量结果和定性发现。原始的 NHANES 分析于 2017 年 10 月和 11 月进行，访谈于 2017 年 12 月和 2018 年 1 月进行，所有混合方法的整合都在 2018 年进行。与单一产品使用者相比，烟草和大麻同时使用者具有独特的特征和经验；同时使用者的经验可以提供对同时使用的独特见解。综合分析得出了元推断。同时使用者对烟草和大麻的概念不同，对每种物质的风险感知也不同。同时使用者可能有使用多种烟草产品的风险。这些发现突出了这两种物质对年轻成年同时使用者的经历和行为的深远影响。
