Hindson Josephine, Hanstock Tanya, Dunlop Adrian, Kay-Lambkin Frances
Hunter New England Health District, Newcastle, Australia.
University of Newcastle, Callaghan, Australia.
JMIR Form Res. 2020 Dec 7;4(12):e14344. doi: 10.2196/14344.
Tobacco use is disproportionately higher in people who smoke cannabis than in the general population, increasing the severity of dependence for cannabis use, decreasing the likelihood of successful quit attempts for both cannabis and tobacco, and increasing the risk of relapse for both substances. Opportunities to address tobacco use in people using cannabis are being missed.
This study aims to investigate the feasibility of engaging tobacco smokers who were accessing treatment for cannabis, with a tobacco-focused internet-based Healthy Lifestyle Program (iHeLP; 4 modules). It was hypothesized that iHeLP completion would be associated with decreases in tobacco use and improved quality of life (QoL) and psychological health. It was also hypothesized that iHeLP completion would be higher in those who additionally received telephone support. Given that iHeLP aimed to improve healthy lifestyle behaviors, it was also hypothesized that there would be reductions in cannabis use.
A total of 13 smokers seeking treatment for cannabis use were randomly allocated to iHeLP alone or iHeLP plus telephone support. Participants were engaged in iHeLP over 8 weeks and completed a 12-week follow-up assessment.
Results from 10 participants who completed the follow-up indicated that the acceptability of iHeLP was high-very high in terms of general satisfaction, appropriateness of services, effectiveness, and met need. Additional telephone support increased modal module completion rates for iHeLP from 0 to 2 but did not provide any other significant advantages over iHeLP alone in terms of cannabis use, tobacco use, QoL, or psychological health. Participants in the iHeLP-alone condition (n=4) reported a mean reduction of 5.5 (SD 9.00) tobacco cigarettes per day between baseline and follow-up, with a concomitant mean reduction in expired carbon monoxide (CO) of 5.5 parts per million (ppm, SD 6.91). The iHeLP plus telephone support group (n=6) reported a mean reduction of 1.13 (SD 4.88) tobacco cigarettes per day and a mean reduction of 9.337 ppm of expired CO (SD 5.65). A urinalysis indicated that abstinence from cannabis was achieved by 2 participants in the iHeLP-alone group and three participants in the iHeLP plus telephone support group. Between baseline and follow-up assessments, iHeLP-alone participants reported a mean reduction in days of use of cannabis in the prior month of 6.17 days (SD 13.30). The average reduction in the number of days of cannabis use for the iHeLP plus telephone support group was also 6.17 days (SD 13.59).
Despite the small sample size, this study provides preliminary support for the use of internet-delivered, tobacco-focused interventions in tobacco smokers seeking treatment for cannabis use.
吸食大麻者的烟草使用率远高于普通人群，这增加了大麻使用的依赖程度，降低了成功戒除大麻和烟草的可能性，并增加了两种物质复吸的风险。针对吸食大麻者解决烟草使用问题的机会正在被错过。
本研究旨在调查让正在接受大麻治疗的吸烟者参与以烟草为重点的基于互联网的健康生活方式项目（iHeLP；4个模块）的可行性。假设完成iHeLP与烟草使用减少、生活质量（QoL）改善和心理健康改善相关。还假设在额外接受电话支持的人群中，iHeLP的完成率会更高。鉴于iHeLP旨在改善健康生活方式行为，还假设大麻使用会减少。
共有13名寻求大麻使用治疗的吸烟者被随机分配到仅接受iHeLP或iHeLP加电话支持组。参与者在8周内参与iHeLP，并完成了为期12周的随访评估。
10名完成随访的参与者的结果表明，iHeLP在总体满意度、服务适宜性、有效性和满足需求方面的可接受性很高——非常高。额外的电话支持使iHeLP的模块完成率中位数从0提高到2，但在大麻使用、烟草使用、生活质量或心理健康方面，与仅接受iHeLP相比没有提供任何其他显著优势。仅接受iHeLP组（n = 4）的参与者报告，从基线到随访期间，每天平均减少5.5支（标准差9.00）香烟，呼出一氧化碳（CO）平均减少5.5 ppm（标准差6.91）。iHeLP加电话支持组（n = 6）报告，每天平均减少1.13支（标准差4.88）香烟，呼出CO平均减少9.337 ppm（标准差5.65）。尿液分析表明，仅接受iHeLP组有2名参与者、iHeLP加电话支持组有3名参与者实现了大麻戒断。在基线和随访评估之间，仅接受iHeLP的参与者报告前一个月大麻使用天数平均减少6.17天（标准差13.30）。iHeLP加电话支持组大麻使用天数的平均减少量也为6.17天（标准差13.59）。
尽管样本量较小，但本研究为在寻求大麻使用治疗的吸烟者中使用基于互联网的、以烟草为重点的干预措施提供了初步支持。
