Cornacchione Ross Jennifer, Sutfin Erin L, Suerken Cynthia, Walker Stephannie, Wolfson Mark, Reboussin Beth A
Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA.
Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA.
Drug Alcohol Depend. 2020 Mar 23;211:107964. doi: 10.1016/j.drugalcdep.2020.107964.
We assess the longitudinal associations between marijuana and cigar (little cigars and cigarillos [LCCs] and large cigars) use on subsequent initiation of marijuana and cigar use.
Data are from a cohort study of 2189 young adults recruited in fall 2010 from 11 colleges in the Southeast. We used discrete-time survival analysis to examine whether ever use of marijuana at baseline (spring 2011, freshman year) predicted initiation of LCCs and large cigars and whether ever use of these cigar products predicted initiation of marijuana use across 10 waves of data collection (2011-2018).
The sample was 65.3 % female, 83.6 % White, 5.9 % Hispanic, and 61.8 % had college-educated mothers. At baseline, 70 % reported never using LCCs, 71 % reported never using large cigars, and 74 % reported never using marijuana. Ever use of marijuana at baseline was associated with an increased risk of LCC initiation (Incident rate ratio [IRR] = 1.6, 95 %CI = 1.0, 2.5) but not large cigar initiation. Ever use of LCCs (IRR = 1.4, 95 %CI = 1.1, 1.8) and ever use of large cigars (IRR = 1.3, 95 %CI = 1.1, 1.8) at baseline both predicted initiation of marijuana use.
Our findings support growing evidence that marijuana and LCCs are strongly associated and use of one substance predicts use of the other. In contrast to studies of adults, we also found that young adults who have tried large cigars may be at increased risk for subsequent marijuana use. These findings highlight the need to consider each product as a potential gateway of the other when developing interventions for young adults.
我们评估大麻与雪茄（小雪茄和小烟以及大雪茄）使用之间的纵向关联，以及其对后续大麻和雪茄使用起始情况的影响。
数据来自于2010年秋季从东南部11所大学招募的2189名年轻成年人的队列研究。我们使用离散时间生存分析来检验基线时（2011年春季，大学一年级）曾使用过大麻是否能预测小烟和大雪茄的使用起始情况，以及这些雪茄产品的使用是否能预测在10轮数据收集（2011 - 2018年）期间大麻使用的起始情况。
样本中65.3%为女性，83.6%为白人，5.9%为西班牙裔，61.8%的母亲受过大学教育。在基线时，70%的人报告从未使用过小烟，71%的人报告从未使用过大雪茄，74%的人报告从未使用过大麻。基线时曾使用过大麻与小烟使用起始风险增加相关（发病率比[IRR]=1.6，95%置信区间[CI]=1.0，2.5），但与大雪茄使用起始无关。基线时曾使用过小烟（IRR = 1.4，95%CI = 1.1，1.8）和曾使用过大雪茄（IRR = 1.3，95%CI = 1.1，1.8）均能预测大麻使用的起始情况。
我们的研究结果支持越来越多的证据表明，大麻和小烟密切相关，使用一种物质可预测另一种物质的使用。与成年人的研究不同，我们还发现尝试过大雪茄的年轻成年人后续使用大麻的风险可能会增加。这些发现凸显了在为年轻成年人制定干预措施时，需要将每种产品视为另一种产品潜在的入口。
