Wang Nan, Yao Tingting, Sung Hai-Yen, Max Wendy
Department of Public Health Sciences, School of Medicine, University of California, Davis, California, USA.
Institute for Health & Aging, School of Nursing, University of California, San Francisco, California, USA.
Subst Use Misuse. 2022;57(2):193-201. doi: 10.1080/10826084.2021.1995758. Epub 2021 Nov 10.
In November 2016, California voters passed the Adult Use of Marijuana Act making recreational cannabis sales legal to adults aged 21and older starting January 1st, 2018. This study aims to understand the relationship of cannabis use and cigarette smoking with serious psychological distress (SPD) in California in light of the legalization of recreational cannabis sales.
This cross-sectional study included 42,313 adult participants from the 2017 to 2018 California Health Interview Surveys. We used the Kessler-6 (K6) scale to measure psychological distress in the past 30 days. Multiple logistic regression models were used to examine the association between cannabis/cigarette use and SPD.
Cannabis use was positively associated with SPD (AOR = 2.48, 95% CI = 1.57, 3.91), but this association was not significantly different before and after recreational cannabis sales legalization in California (AOR = 0.82, 95% CI = 0.72, 2.05). Cigarette smoking was also positively associated with SPD (AOR = 2.76, 95% CI = 2.05, 3.71). Compared to those who used neither cannabis nor cigarettes, sole cannabis users (AOR = 2.51, 95% CI = 1.75, 3.60), sole cigarette smokers (AOR = 3.23, 95% CI = 2.28, 4.60), and dual users of cannabis and cigarettes (AOR = 5.65, 95% CI = 4.04, 7.89) were more likely to report SPD. Dual users were also more likely to report SPD than sole cannabis users (AOR = 2.25; 95% CI = 1.48, 3.43) and sole cigarette smokers (AOR = 1.75; 95% CI = 1.18, 2.59).
These findings provide evidence for the need to develop effective cessation intervention strategies targeting individuals with SPD to reduce their cannabis use and dual-use of cannabis and cigarettes.
2016年11月，加利福尼亚州选民通过了《成人使用大麻法案》，自2018年1月1日起，娱乐用大麻销售对21岁及以上成年人合法化。本研究旨在根据娱乐用大麻销售合法化的情况，了解加利福尼亚州大麻使用和吸烟与严重心理困扰（SPD）之间的关系。
这项横断面研究纳入了2017年至2018年加利福尼亚州健康访谈调查中的42313名成年参与者。我们使用凯斯勒6项量表（K6）来测量过去30天内的心理困扰。采用多元逻辑回归模型来检验大麻/香烟使用与SPD之间的关联。
大麻使用与SPD呈正相关（调整后比值比[AOR]=2.48，95%置信区间[CI]=1.57，3.91），但在加利福尼亚州娱乐用大麻销售合法化前后，这种关联无显著差异（AOR=0.82，95%CI=0.72，2.05）。吸烟也与SPD呈正相关（AOR=2.76，95%CI=2.05，3.71）。与既不使用大麻也不吸烟的人相比，仅使用大麻的人（AOR=2.51，95%CI=1.75，3.60）、仅吸烟的人（AOR=3.23，95%CI=2.28，4.60）以及同时使用大麻和香烟的人（AOR=5.65，95%CI=4.04，7.89）更有可能报告有SPD。同时使用大麻和香烟的人比仅使用大麻的人（AOR=2.25；95%CI=1.48，3.43）和仅吸烟的人（AOR=1.75；95%CI=1.18，2.59）更有可能报告有SPD。
这些发现为制定有效的戒烟干预策略提供了证据，该策略针对有SPD的个体，以减少他们的大麻使用以及大麻和香烟的同时使用。
