Department of Psychology, Arizona State University, Tempe, AZ, USA.
Department of Psychology and Neuroscience, Duke University, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA; Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
Lancet Healthy Longev. 2022 Oct;3(10):e703-e714. doi: 10.1016/S2666-7568(22)00201-X.
Cannabis is often characterised as a young person's drug. However, people who began consuming cannabis in the 1970s and 1980s are no longer young and some have consumed it for many years. This study tested the preregistered hypothesis that long-term cannabis users show accelerated biological ageing in midlife and poorer health preparedness, financial preparedness, and social preparedness for old age.
In this longitudinal study, participants comprised a population-representative cohort of 1037 individuals born in Dunedin, New Zealand, between April, 1972, and March, 1973, and followed to age 45 years. Cannabis, tobacco, and alcohol use and dependence were assessed at ages 18 years, 21 years, 26 years, 32 years, 38 years, and 45 years. Biological ageing and health, financial, and social preparedness for old age were assessed at age 45 years. Long-term cannabis users were compared using independent samples t tests with five groups: lifelong cannabis non-users, long-term tobacco users, long-term alcohol users, midlife recreational cannabis users, and cannabis quitters. In addition, regression analyses tested dose-response associations for continuously measured persistence of cannabis dependence from age 18 years to 45 years, with associations adjusted for sex, childhood socioeconomic status, childhood IQ, low childhood self-control, family substance dependence history, and persistence of alcohol, tobacco, and other illicit drug dependence.
Of 997 cohort members still alive at age 45 years, 938 (94%) were assessed at age 45 years. Long-term cannabis users showed statistically significant accelerated biological ageing and were less equipped to manage a range of later-life health, financial, and social demands than non-users. Standardised mean differences between long-term cannabis users and non-users were large: 0·70 (95% CI 0·46 to 0·94; p<0·0001) for biological ageing, -0·72 (-0·96 to -0·49, p<0·0001) for health preparedness, -1·08 (-1·31 to -0·85; p<0·0001) for financial preparedness, and -0·59 (-0·84 to -0·34, p<0·0001) for social preparedness. Long-term cannabis users did not fare better than long-term tobacco or alcohol users. Tests of dose-response associations suggested that cannabis associations could not be explained by the socioeconomic origins, childhood IQ, childhood self-control, and family substance-dependence history of long-term cannabis users. Statistical adjustment for long-term tobacco, alcohol, and other illicit drug dependence suggested that long-term cannabis users' tendency toward polysubstance dependence accounted for their accelerated biological ageing and poor financial and health preparedness, although not for their poor social preparedness (β -0·10, 95% CI -0·18 to -0·02; p=0·017).
Long-term cannabis users are underprepared for the demands of old age. Although long-term cannabis use appears detrimental, the greatest challenge to healthy ageing is not use of any specific substance, but rather the long-term polysubstance use that characterises many long-term cannabis users. Substance-use interventions should include practical strategies for improving health and building financial and social capital for healthy longevity.
The National Institute on Aging and the UK Medical Research Council. The Dunedin Research Unit is supported by the New Zealand Health Research Council and the New Zealand Ministry of Business, Innovation and Employment.
大麻通常被描述为年轻人的毒品。然而，在 20 世纪 70 年代和 80 年代开始吸食大麻的人已经不再年轻，有些人已经吸食了多年。本研究检验了一个预先注册的假设，即长期大麻使用者在中年表现出加速的生物衰老，并且在健康准备、财务准备和社会准备方面较差，以应对老年。
在这项纵向研究中，参与者包括 1972 年 4 月至 1973 年 3 月期间在新西兰达尼丁出生的代表性人群队列中的 1037 个人，随访至 45 岁。大麻、烟草和酒精的使用和依赖在 18 岁、21 岁、26 岁、32 岁、38 岁和 45 岁时进行评估。45 岁时评估生物衰老以及对老年的健康、财务和社会准备情况。使用独立样本 t 检验比较长期大麻使用者与五个组：终生非大麻使用者、长期烟草使用者、长期酒精使用者、中年娱乐性大麻使用者和大麻戒烟者。此外，回归分析测试了从 18 岁到 45 岁持续存在的大麻依赖的剂量反应关系，该关系通过性别、儿童社会经济地位、儿童智商、低儿童自我控制、家庭物质依赖史以及酒精、烟草和其他非法药物依赖的持续性进行调整。
在 45 岁时仍存活的 997 名队列成员中，有 938 名（94%）在 45 岁时接受了评估。长期大麻使用者表现出统计学上显著的加速生物衰老，并且在应对一系列晚年健康、财务和社会需求方面的准备不足。长期大麻使用者与非使用者之间的标准化平均差异较大：生物衰老为 0.70（95%CI 0.46 至 0.94;p<0.0001），健康准备为 -0.72（-0.96 至-0.49;p<0.0001），财务准备为-1.08（-1.31 至-0.85;p<0.0001），社会准备为-0.59（-0.84 至-0.34;p<0.0001）。长期大麻使用者的表现并不优于长期烟草或酒精使用者。剂量反应关系测试表明，大麻关联不能用长期大麻使用者的社会经济出身、儿童智商、儿童自我控制和家庭物质依赖史来解释。长期烟草、酒精和其他非法药物依赖的统计调整表明，长期大麻使用者对多物质依赖的倾向解释了他们的加速生物衰老和较差的财务和健康准备情况，尽管不能解释他们较差的社会准备情况（β-0.10，95%CI-0.18 至-0.02;p=0.017）。
长期大麻使用者对老年的需求准备不足。尽管长期大麻使用似乎有害，但对健康衰老的最大挑战不是使用任何特定物质，而是长期大麻使用者所具有的长期多物质使用。药物使用干预措施应包括改善健康和建立财务和社会资本以实现健康长寿的实用策略。
美国国立卫生研究院和英国医学研究理事会。达尼丁研究单位得到新西兰健康研究理事会和新西兰商业、创新和就业部的支持。
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