McLean Hospital, Belmont, Massachusetts.
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
JAMA Netw Open. 2019 Nov 1;2(11):e1916015. doi: 10.1001/jamanetworkopen.2019.16015.
Marijuana use is increasing among adults and often co-occurs with other substance use; therefore, it is important to examine whether parental marijuana use is associated with elevated risk of substance use among offspring living in the same household.
To examine associations of parental marijuana use with offspring marijuana, tobacco, and alcohol use and opioid misuse.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used survey data from the 2015 through 2018 National Surveys on Drug Use and Health (NSDUH), which provide nationally representative data on adolescents or young adults living with a parent (the mother or the father). Annual average percentages were based on survey sampling weights. Final analyses were conducted September 21 through 23, 2019.
Parental marijuana use status.
Offspring self-reported use of marijuana, tobacco, or alcohol or misuse of opioids.
Survey respondents included 24 900 father-offspring or mother-offspring dyads sampled from the same household. Among mothers living with adolescent offspring, 8.2% (95% CI, 7.3%-9.2%) had past-year marijuana use, while 7.6% (95% CI, 6.2%-9.2%) of mothers living with young adult offspring had past-year marijuana use. Among fathers living with adolescent offspring, 9.6% (95% CI, 8.5%-10.8%) had past-year marijuana use, and 9.0% (95% CI, 7.4%-10.9%) of fathers living with young adult offspring had past-year marijuana use. Compared with adolescents whose mothers never used marijuana, adjusted relative risk (ARR) of past-year marijuana use was higher among those whose mothers had lifetime (without past-year) marijuana use (ARR, 1.3; 95% CI, 1.1-1.6; P = .007), less than 52 days of past-year marijuana use (ARR, 1.7; 95% CI, 1.1-2.7; P = .02), or 52 days or more of past-year marijuana use (ARR, 1.5; 95% CI, 1.1-2.2; P = .02). Compared with young adults whose mothers never used marijuana, adjusted risk of past-year marijuana use was higher among those whose mothers had lifetime (without past-year) marijuana use (ARR, 1.4; 95% CI, 1.1-1.7; P = .001), less than 52 days of past-year marijuana use (ARR, 1.5; 95% CI, 1.0-2.3; P = .049), or 52 days or more of past-year marijuana use (ARR, 1.8; 95% CI, 1.3-2.5; P = .002). Compared with adolescents whose fathers never used marijuana, adolescents whose fathers had less than 52 days of past-year marijuana use were more likely to use marijuana (ARR, 1.8; 95% CI, 1.2-2.7; P = .006). Compared with young adults whose fathers never used marijuana, young adults whose fathers had 52 days or more of past-year marijuana use were more likely to use marijuana (ARR, 2.1; 95% CI, 1.6-2.9; P < .001). Compared with their peers whose parents never used marijuana and after adjusting for covariates, the adjusted risk of past-year tobacco use was higher among adolescents whose mothers had lifetime marijuana use (ARR, 1.3; 95% CI, 1.0-1.6; P = .03), less than 52 days of past-year marijuana use (ARR, 1.5; 95% CI, 1.0-2.1; P = .04), or 52 days or more of past-year marijuana use (ARR, 1.6; 95% CI, 1.1-2.3; P = .03); adolescents whose fathers had lifetime marijuana use (ARR, 1.5; 95% CI, 1.1-1.9; P = .004) or 52 days or more of past-year marijuana use (ARR, 1.8; 95% CI, 1.2-2.7; P = .006); young adults whose mothers had lifetime marijuana use (ARR, 1.2; 95% CI, 1.0-1.4; P = .04); and young adults whose fathers had 52 days or more of past-year marijuana use (ARR, 1.4; 95% CI, 1.0-1.9; P = .046). Compared with their peers whose parents had no past marijuana use and after adjusting for covariates, risk of past-year alcohol use was higher among adolescents whose mothers had lifetime marijuana use (ARR, 1.2; 95% CI, 1.1-1.4; P = .004), less than 52 days of past-year marijuana use (ARR, 1.5; 95% CI, 1.2-1.9; P = .002), or 52 days or more of past-year marijuana use (ARR, 1.3; 95% CI, 1.0-1.7; P = .04). After adjusting for covariates, parental marijuana use was not associated with opioid misuse by offspring.
In this cross-sectional study, parental marijuana use was associated with increased risk of substance use among adolescent and young adult offspring living in the same household. Screening household members for substance use and counseling parents on risks posed by current and past marijuana use are warranted.
重要性：在成年人中，大麻的使用正在增加，并且经常与其他物质的使用同时发生；因此，研究父母使用大麻是否与同住家庭的子女使用大麻、烟草和酒精以及阿片类药物滥用的风险增加有关是很重要的。
目的：检查父母使用大麻与子女使用大麻、烟草和酒精以及阿片类药物滥用的关联。
设计、地点和参与者：本横断面研究使用了 2015 年至 2018 年全国药物使用和健康调查（NSDUH）的调查数据，该调查提供了与父母（母亲或父亲）同住的青少年或年轻成年人的全国代表性数据。年度平均百分比基于调查抽样权重。最终分析于 2019 年 9 月 21 日至 23 日进行。
暴露情况：父母使用大麻的情况。
主要结果和测量：子女自我报告的大麻、烟草或酒精使用或阿片类药物滥用。
结果：调查受访者包括 24900 对从同一家庭中抽取的父母-子女或父母-子女对。在与青少年子女同住的母亲中，8.2%（95%CI，7.3%-9.2%）过去一年使用过大麻，而与年轻成年子女同住的母亲中，7.6%（95%CI，6.2%-9.2%）过去一年使用过大麻。在与青少年子女同住的父亲中，9.6%（95%CI，8.5%-10.8%）过去一年使用过大麻，与年轻成年子女同住的父亲中，9.0%（95%CI，7.4%-10.9%）过去一年使用过大麻。与母亲从未使用过大麻的青少年相比，母亲有终生（无过去一年）大麻使用史（ARR，1.3；95%CI，1.1-1.6；P=0.007）、过去一年使用大麻不足 52 天（ARR，1.7；95%CI，1.1-2.7；P=0.02）或过去一年使用大麻 52 天或以上（ARR，1.5；95%CI，1.1-2.2；P=0.02）的青少年，其过去一年使用大麻的相对风险（ARR）更高。与母亲从未使用过大麻的年轻成年人相比，母亲有终生（无过去一年）大麻使用史（ARR，1.4；95%CI，1.1-1.7；P=0.001）、过去一年使用大麻不足 52 天（ARR，1.5；95%CI，1.0-2.3；P=0.049）或过去一年使用大麻 52 天或以上（ARR，1.8；95%CI，1.3-2.5；P=0.002）的年轻人，其过去一年使用大麻的风险更高。与父亲从未使用过大麻的青少年相比，过去一年使用大麻不足 52 天的青少年更有可能使用大麻（ARR，1.8；95%CI，1.2-2.7；P=0.006）。与父亲从未使用过大麻的年轻成年人相比，过去一年使用大麻 52 天或以上的年轻成年人更有可能使用大麻（ARR，2.1；95%CI，1.6-2.9；P<0.001）。与父母从未使用过大麻且调整了混杂因素的同龄人相比，母亲有终生大麻使用史（ARR，1.3；95%CI，1.0-1.6；P=0.03）、过去一年使用大麻不足 52 天（ARR，1.5；95%CI，1.0-2.1；P=0.04）或过去一年使用大麻 52 天或以上（ARR，1.6；95%CI，1.1-2.3；P=0.03）的青少年，父亲有终生大麻使用史（ARR，1.5；95%CI，1.1-1.9；P=0.004）或过去一年使用大麻 52 天或以上（ARR，1.8；95%CI，1.2-2.7；P=0.006）的青少年，母亲有终生大麻使用史（ARR，1.2；95%CI，1.0-1.4；P=0.04）的年轻成年人，以及父亲过去一年使用大麻 52 天或以上（ARR，1.4；95%CI，1.0-1.9；P=0.046）的年轻成年人，其过去一年使用烟草的风险更高。与父母过去没有使用过大麻且调整了混杂因素的同龄人相比，母亲有终生大麻使用史（ARR，1.2；95%CI，1.1-1.4；P=0.004）、过去一年使用大麻不足 52 天（ARR，1.5；95%CI，1.2-1.9；P=0.002）或过去一年使用大麻 52 天或以上（ARR，1.3；95%CI，1.0-1.7；P=0.04）的青少年，以及过去一年使用大麻不足 52 天（ARR，1.5；95%CI，1.2-1.9；P=0.002）的年轻人，其过去一年使用酒精的风险更高。调整混杂因素后，父母的大麻使用与子女的阿片类药物滥用无关。
结论和相关性：在这项横断面研究中，父母使用大麻与同住家庭的青少年和年轻成年人的物质使用风险增加有关。对同住家庭成员进行药物使用筛查并为父母提供有关当前和过去大麻使用风险的咨询是有必要的。
