Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Departments of Geography and Demography and the Consortium on Substance Use and Addiction, The Pennsylvania State University, PA, USA.
Addict Behav. 2023 Sep;144:107758. doi: 10.1016/j.addbeh.2023.107758. Epub 2023 May 26.
Perceived harm is associated with substance use. Changes in product and policy landscapes may impact perceived harms of tobacco and cannabis. This study aimed to examine changes in young adults' perceived harms of tobacco and cannabis and their associations with use behavior during a period including both before and after legalization of cannabis.
We conducted a panel survey of California Bay Area young adults (mean age = 23.5 years old, 64.4% female) in 2014 and 2019-2020. Participants (N = 306) reported past 30-day use and perceived harms of tobacco and cannabis at both waves. Perceived harms to health of cannabis and tobacco (cigarettes, e-cigarettes, hookah, smokeless tobacco, and secondhand tobacco smoke) were measured from 1-"Not at all harmful" to 7-"Extremely harmful." Mixed-effects logistic regressions examined associations between perceived harms and use of tobacco and cannabis, controlling for demographics.
Participants perceived lower harm for cannabis than for tobacco products. Perceived harms of e-cigarettes, hookah, and smokeless tobacco significantly increased over time; while perceived harms of cigarettes, secondhand tobacco smoke, and cannabis did not change. Increased perceived harm of e-cigarettes was associated with lower odds of any tobacco use (OR = 0.72, 95%CI = 0.56, 0.92), and increased perceived harm of cannabis was associated with lower odds of any cannabis use (OR = 0.51, 95%CI = 0.42, 0.62).
Findings suggest that perceived harms of e-cigarettes and cannabis play important roles in driving young adult use behaviors. Risk communication efforts that increase perceptions of health harms related to e-cigarettes and cannabis may decrease use of tobacco and cannabis among young people.
感知到的危害与物质使用有关。产品和政策环境的变化可能会影响人们对烟草和大麻危害的感知。本研究旨在考察在包括大麻合法化前后的一段时间内，年轻人对烟草和大麻危害的感知变化及其与使用行为的关系。
我们对加利福尼亚湾区的年轻成年人（平均年龄 23.5 岁，64.4%为女性）进行了一项面板调查，分别在 2014 年和 2019-2020 年进行。参与者（N=306）在两次调查中报告了过去 30 天内使用烟草和大麻的情况以及对其危害的感知。对大麻和烟草（香烟、电子烟、水烟、无烟烟草和二手烟草烟雾）的健康危害感知从 1-“一点也不有害”到 7-“极其有害”进行测量。混合效应逻辑回归控制了人口统计学因素，考察了感知危害与烟草和大麻使用之间的关系。
参与者对大麻的危害感知低于对烟草产品的感知。电子烟、水烟和无烟烟草的感知危害随时间显著增加；而香烟、二手烟草烟雾和大麻的感知危害没有变化。电子烟感知危害增加与任何烟草使用的几率降低相关（OR=0.72，95%CI=0.56，0.92），而大麻感知危害增加与任何大麻使用的几率降低相关（OR=0.51，95%CI=0.42，0.62）。
研究结果表明，电子烟和大麻的感知危害在驱动年轻人使用行为方面发挥着重要作用。增加与电子烟和大麻相关的健康危害感知的风险沟通工作，可能会减少年轻人对烟草和大麻的使用。
