Nicotine Dependence Services, Centre for Addiction and Mental Health, 175 College St., Toronto, Ontario, M5T 1P7, Canada.
Nicotine Dependence Services, Centre for Addiction and Mental Health, 175 College St., Toronto, Ontario, M5T 1P7, Canada; Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.
Drug Alcohol Depend. 2020 Jan 1;206:107756. doi: 10.1016/j.drugalcdep.2019.107756. Epub 2019 Nov 20.
Some studies suggest cannabis use negatively affects tobacco cessation outcomes, but findings have been mixed. We examined whether cannabis use was associated with tobacco cessation outcomes in a real-world primary care setting.
The analytic dataset consisted of 35,246 patients who enrolled between 2014 and 2016 in a primary care-based smoking cessation program in Ontario, Canada. Past 30-day cannabis use, for recreational or medical purposes, was self-reported at enrollment. Thirty-day point prevalence tobacco smoking abstinence was self-reported via online or telephone survey at 6 months post-enrollment.
Thirty days prior to enrollment, 79.9 % of patients had not used cannabis, 16.3 % used cannabis for recreational purposes only, and 3.8 % used cannabis for medical purposes. Unadjusted and adjusted odds of tobacco cessation at 6 months were reduced for patients using cannabis compared to non-users (ORs = 0.76-0.86, ps<0.05). When cannabis use was categorized by purpose, both unadjusted and adjusted odds of cessation were significantly lower for recreational users (ORs = 0.77-0.84, ps<0.05). Medical users had decreased odds of cessation in unadjusted analysis (OR = 0.74, 95 % CI = 0.61-0.89, p = 0.001), but not after adjustment for potential confounders. However, post-estimation contrasts did not indicate a significant difference between the effect of recreational and medical cannabis use.
In a large real-world sample of patients seeking smoking cessation treatment, concurrent cannabis use was associated with decreased success with quitting smoking. Recreational cannabis use was consistently related to poorer cessation outcomes, but medical use was not. Additional research is needed to inform treatment strategies for this growing sub-population of smokers.
一些研究表明，大麻使用会对戒烟结果产生负面影响，但研究结果参差不齐。我们在一个真实的初级保健环境中研究了大麻使用是否与戒烟结果有关。
分析数据集包括 2014 年至 2016 年间在加拿大安大略省一个基于初级保健的戒烟计划中登记的 35246 名患者。过去 30 天的大麻使用情况，包括娱乐或医疗目的，在登记时进行自我报告。在登记后 6 个月，通过在线或电话调查报告 30 天的点患病率吸烟戒断情况。
在登记前 30 天，79.9%的患者未使用大麻，16.3%的患者仅使用大麻用于娱乐目的，3.8%的患者使用大麻用于医疗目的。与非使用者相比，使用大麻的患者在 6 个月时戒烟的未调整和调整后的可能性降低（OR=0.76-0.86，p<0.05）。当大麻使用按目的分类时，娱乐性使用者的戒烟未调整和调整后的可能性都显著降低（OR=0.77-0.84，p<0.05）。在未调整分析中，医疗使用者的戒烟可能性降低（OR=0.74，95%CI=0.61-0.89，p=0.001），但在调整潜在混杂因素后则不然。然而，事后估计对比并没有表明娱乐性和医疗性大麻使用的效果之间存在显著差异。
在寻求戒烟治疗的大量真实世界患者样本中，同时使用大麻与戒烟成功率降低有关。娱乐性大麻使用与较差的戒烟结果持续相关，但医疗性大麻使用则不然。需要进一步研究，以为这一不断增长的吸烟人群提供治疗策略。
