University of Waterloo, Canada.
University of Waterloo, Canada.
Addict Behav. 2022 Dec;135:107434. doi: 10.1016/j.addbeh.2022.107434. Epub 2022 Jul 21.
Little is known about population-level differences between adults who exclusively smoke cigarettes and those who smoke cigarettes and also use cannabis (co-consumers). Thus, this study describes differences on sociodemographic, cigarette-dependence, health and behavioral variables, and risk perceptions associated with smoking cannabis.
This cross-sectional study included 6941 respondents from the 2020 ITC Four Country Smoking and Vaping Survey (US, Canada, Australia, England). Adult daily cigarette smokers were included and categorized as: cigarette-only smokers (never used cannabis/previously used cannabis, but not in the past 12 months, n = 4857); occasional co-consumers (cannabis use in the past 12 months, but < weekly use, n = 739); or regular co-consumers (use cannabis ≥ weekly, n = 1345). All outcomes were self-reported. Regression models were conducted on weighted data.
Overall, 19.9 % of respondents reported regular cannabis co-use and 10.1 % reported occasional co-use. Regular co-use was highest in Canada (27.2 %), followed by the US (24.4 %), England (12.7 %) and Australia (12.3 %). Compared to cigarette-only smokers, regular co-consumers were more likely to be male and report chest/breathing problems (p < 0.001). All co-consumers were more likely to be younger, have lower income, be experiencing financial stress, reside in Canada, have depressive symptoms, use alcohol more frequently and binge drink, use other tobacco/nicotine products, and perceive smoking cannabis as low health risk and less harmful than smoking cigarettes (all p < 0.001). Cigarette dependence measures were similar between co-consumers and cigarette-only smokers (all p ≥ 0.05).
Although there were no differences on cigarette dependence measures between daily cigarette smokers who do and do not use cannabis, there are several other risk factors that may affect tobacco use and abstinence among co-consumers (e.g., greater depression, high-risk alcohol consumption). Thus, tobacco cessation treatment may require multi-pronged strategies to address other health behaviors. Continued surveillance is needed to determine the nature and health implications of co-use considering changing policies, markets, and products.
关于仅吸烟和同时吸烟及使用大麻的成年人之间的人群水平差异，知之甚少。因此，本研究描述了与吸烟大麻相关的社会人口学、香烟依赖、健康和行为变量以及风险认知方面的差异。
本横断面研究包括来自 2020 年 ITC 四国吸烟和蒸气调查（美国、加拿大、澳大利亚、英国）的 6941 名受访者。将成年每日吸烟的吸烟者纳入并分为以下几类：仅吸烟的吸烟者（从未使用过大麻/以前使用过大麻，但过去 12 个月未使用，n=4857）；偶尔共同使用者（过去 12 个月内使用大麻，但<每周使用，n=739）；或经常共同使用者（每周使用大麻≥，n=1345）。所有结果均为自我报告。对加权数据进行回归模型分析。
总体而言，19.9%的受访者报告有规律地共同使用大麻，10.1%的受访者报告偶尔共同使用大麻。在加拿大（27.2%），其次是美国（24.4%）、英国（12.7%）和澳大利亚（12.3%），定期共同使用者的比例最高。与仅吸烟的吸烟者相比，经常共同使用者更可能为男性，并且报告有胸部/呼吸问题（p<0.001）。所有共同使用者更可能为年轻、收入较低、经济压力大、居住在加拿大、有抑郁症状、更频繁地使用酒精和狂饮、使用其他烟草/尼古丁产品，并且认为吸烟大麻的健康风险较低，比吸烟香烟的危害小（均 p<0.001）。共同使用者和仅吸烟的吸烟者的香烟依赖衡量标准相似（均 p≥0.05）。
尽管使用大麻的每日吸烟者和不使用大麻的每日吸烟者在香烟依赖衡量标准上没有差异，但仍存在其他一些风险因素可能会影响共同使用者的烟草使用和戒烟（例如，更大的抑郁，高风险的饮酒行为）。因此，烟草戒断治疗可能需要多管齐下的策略来解决其他健康行为问题。需要继续进行监测，以确定共同使用的性质和健康影响，考虑到政策、市场和产品的变化。
