Gravely Shannon, Driezen Pete, Smith Danielle M, Borland Ron, Lindblom Eric N, Hammond David, McNeill Ann, Hyland Andrew, Cummings K Michael, Chan Gary, Thompson Mary E, Boudreau Christian, Martin Nadia, Ouimet Janine, Loewen Ruth, Quah Anne C K, Goniewicz Maciej L, Thrasher James F, Fong Geoffrey T
Department of Psychology, University of Waterloo, Waterloo, Canada.
Department of Psychology, University of Waterloo, Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada.
Int J Drug Policy. 2020 Apr 16;79:102754. doi: 10.1016/j.drugpo.2020.102754.
Although evidence shows that co-use of cigarettes and cannabis is common, there is little research examining if co-use patterns vary depending on the regulatory environment for cannabis. This study examined patterns of co-use and perceptions of relative harm among cigarette smokers in four countries with different histories, and at different stages of cannabis legalization.
Data are from the 2018 International Tobacco Control 4CV Survey and included 10035 adult cigarette smokers from Canada, United States (US), Australia, and England. At the time of the survey, Canada and the US had relatively more permissive cannabis regulations compared to Australia and England.
Among this sample of 10035 cigarette smokers, Canada had the highest rate of cannabis co-use in the last 12 months (36.3%), followed by the US (29.1%), England (21.6%), and Australia (21.4%). Among past 12 month co-users (n = 3134), the US (40.2%) and Canada (35.2%) had the highest rates of daily cannabis use, followed by smokers in England (26.3%) and Australia (21.7%); Australian co-users had the highest rate of infrequent (<monthly) cannabis use. The highest proportion of co-users who smoked daily and used cannabis daily was in the US (34.8%), followed by Canada (30.6%), England (25.8%), and Australia (22.7%). More co-users in the US (78.3%) and Canada (73.6%) perceived smoked cannabis to be less harmful than cigarettes than in Australia (65.5%) and England (60.8%). The majority of co-users who used cannabis in the last 30 days had smoked it (92.3%), with those in England more likely to smoke cannabis (95.7%) compared to Canada (88.6%); there were no other differences between countries (US: 92.0%, Australia: 93.0%). Co-users in England (90.4%) and Australia (86.0%) were more likely to mix tobacco with cannabis than co-users in Canada (38.5%) and the US (22.3%).
Patterns of tobacco and cannabis co-use differed between countries. Smokers in Canada and the US had higher rates of co-use, daily cannabis use, dual-daily use of both cannabis and cigarettes, and were more likely to perceive smoked cannabis as less harmful than cigarettes compared to England and Australia. Further attention as to how varying cannabis regulations may impact co-use patterns is warranted.
尽管有证据表明香烟和大麻共同使用的情况很常见，但很少有研究探讨共同使用模式是否因大麻的监管环境而异。本研究调查了四个具有不同历史和大麻合法化处于不同阶段的国家中吸烟者的共同使用模式以及对相对危害的认知。
数据来自2018年国际烟草控制4CV调查，包括来自加拿大、美国、澳大利亚和英国的10035名成年吸烟者。在调查时，与澳大利亚和英国相比，加拿大和美国对大麻的监管相对更为宽松。
在这10035名吸烟者样本中，加拿大在过去12个月中大麻共同使用的比例最高（36.3%），其次是美国（29.1%）、英国（21.6%）和澳大利亚（21.4%）。在过去12个月的共同使用者中（n = 3134），美国（40.2%）和加拿大（35.2%）的每日大麻使用率最高，其次是英国（26.3%）和澳大利亚（21.7%）的吸烟者；澳大利亚的共同使用者偶尔（<每月）使用大麻的比例最高。每日吸烟且每日使用大麻的共同使用者比例最高的是美国（34.8%），其次是加拿大（30.6%）、英国（25.8%）和澳大利亚（22.7%）。与澳大利亚（65.5%）和英国（60.8%）相比，美国（78.3%）和加拿大（73.6%）更多的共同使用者认为吸食大麻比吸烟危害小。在过去30天内使用过大麻的大多数共同使用者吸食过大麻（92.3%），与加拿大（88.6%）相比，英国（95.7%）的人更有可能吸食大麻；其他国家之间没有差异（美国：92.0%，澳大利亚：93.0%）。与加拿大（38.5%）和美国（22.3%）的共同使用者相比，英国（90.4%）和澳大利亚（86.0%）的共同使用者更有可能将烟草与大麻混合使用。
不同国家烟草和大麻的共同使用模式存在差异。与英国和澳大利亚相比，加拿大和美国的吸烟者共同使用、每日使用大麻、同时每日使用大麻和香烟的比例更高，并且更有可能认为吸食大麻比吸烟危害小。有必要进一步关注不同的大麻监管如何可能影响共同使用模式。
