2000 年至 2020 年美国 12 年级青少年的酒精、大麻和同时使用的时间趋势：按性别、父母教育程度以及种族和民族划分的差异。
Temporal trends in alcohol, cannabis, and simultaneous use among 12th-grade U.S. adolescents from 2000 to 2020: Differences by sex, parental education, and race and ethnicity.
机构信息
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA.
出版信息
Alcohol Clin Exp Res. 2022 Sep;46(9):1677-1686. doi: 10.1111/acer.14914. Epub 2022 Sep 20.
BACKGROUND
Simultaneous use of alcohol and cannabis to enhance each other's effect can cause potential harm. Time trends are diverging in adolescent use of alcohol, which is declining, and cannabis, which is increasing among certain subgroups. However, little is known about trends in their simultaneous and non-simultaneous use. Racial and socioeconomic disparities are emerging in cannabis use, which may portend consequences to public health.
METHODS
The 2000 to 2020 Monitoring the Future surveys included approximately 38,000 U.S. 12th-grade students with information on simultaneous use and pertinent demographic factors. A 5-level alcohol/cannabis measure included past-year simultaneous use (i.e., alcohol and cannabis use at the same time), non-simultaneous alcohol and cannabis use, alcohol-use-only, cannabis-use-only, and no use. Multinomial logistic regressions estimated associations (adjusted relative risk ratios; aRRR) with time period (2000 to 2004, 2005 to 2009, 2010 to 2014, 2015 to 2020). Models were adjusted and included interactions with sex, race/ethnicity, and parental education.
RESULTS
Between 2000 and 2020, simultaneous alcohol/cannabis use among 12th graders decreased from 24.4% to 18.7%. From 2015 to 2020 compared to 2000 to 2004, the odds of simultaneous use (adjusted relative risk ratio (aRRR) vs. no use = 0.57, 95% CI [0.50, 0.66]) and alcohol-use-only (aRRR = 0.55, 95% CI [0.49, 0.61]) decreased, while cannabis-use-only odds increased (aRRR = 2.59, 95% CI [1.87, 3.59]). Notably, the prevalence of cannabis-use-only more than doubled from 2011 to 2019. The odds of simultaneous use, alcohol-use-only, and non-simultaneous use of alcohol and cannabis declined more rapidly among males than females, whereas the odds for cannabis-use-only increased faster for females than males. Increases in cannabis-use-only were faster for non-white adolescents.
CONCLUSION
Simultaneous use of alcohol and cannabis is declining among U.S. adolescents, but the decline is slower among females than males. Declines in simultaneous use are largely concomitant with historical declines in alcohol use, indicating that a continued focus on reducing alcohol use among adolescents and young adults has extended benefits to other adolescent substance use. However, cannabis use without any reported past-year alcohol use more than doubled in the last decade, a concerning trend.
背景
同时使用酒精和大麻会相互增强效果，从而可能造成潜在危害。青少年使用酒精的时间趋势正在发生变化，其使用量呈下降趋势，而某些亚群的大麻使用量却在增加。然而，对于两者同时使用和非同时使用的趋势，人们知之甚少。大麻的使用在种族和社会经济方面存在差异，这可能预示着会对公共卫生产生影响。
方法
“监测未来”调查在 2000 年至 2020 年期间对大约 38000 名美国 12 年级学生进行了调查，其中包括同时使用酒精和大麻的情况以及相关人口统计因素。包含过去一年同时使用（即同时使用酒精和大麻）、非同时使用酒精和大麻、仅使用酒精、仅使用大麻和未使用的 5 级酒精/大麻测量方法。采用多项逻辑回归估计了时间（2000 年至 2004 年、2005 年至 2009 年、2010 年至 2014 年、2015 年至 2020 年）的关联（调整后的相对风险比；aRRR）。调整后的模型包括与性别、种族/民族和父母教育的交互作用。
结果
在 2000 年至 2020 年期间，12 年级学生中同时使用酒精和大麻的比例从 24.4%降至 18.7%。与 2000 年至 2004 年相比，2015 年至 2020 年期间，同时使用（调整后的相对风险比（aRRR）与未使用的比值为 0.57，95%CI [0.50, 0.66]）和仅使用酒精（aRRR 为 0.55，95%CI [0.49, 0.61]）的可能性降低，而仅使用大麻的可能性增加（aRRR 为 2.59，95%CI [1.87, 3.59]）。值得注意的是，仅使用大麻的比例从 2011 年到 2019 年翻了一番多。与女性相比，男性同时使用、仅使用酒精和非同时使用酒精和大麻的可能性下降得更快，而女性仅使用大麻的可能性增加得更快。非白人群体中仅使用大麻的比例上升更快。
结论
美国青少年同时使用酒精和大麻的比例正在下降，但女性的下降速度比男性慢。同时使用的减少在很大程度上与酒精使用的历史下降相一致，这表明继续关注减少青少年和年轻人的酒精使用，对其他青少年物质使用也有扩展益处。然而，在过去十年中，没有报告过去一年使用过酒精的大麻使用量增加了一倍多，这是一个令人担忧的趋势。
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