California Department of Public Health, California Tobacco Control Program, Sacramento, CA, United States.
Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, United States.
Addict Behav. 2023 Oct;145:107777. doi: 10.1016/j.addbeh.2023.107777. Epub 2023 Jun 12.
Knowledge about the respiratory health consequences of adolescents' use of tobacco products with cannabis remains limited. We studied whether e-cigarettes, combustible cigarettes, and cannabis were independently associated with asthma in a population-based sample of 150,634 public high school students (10th and 12th graders), drawn in a two-stage design to be representative of the state of California in 2019-2020. Measures were obtained for use of e-cigarettes, combustible cigarettes, and cannabis; motives for use (three substances); method of use (for cannabis); ever being diagnosed with asthma; and having an asthma attack in past 12 months. Cross-classification indicated Nonuse for 64% of the sample; 15% Dual E-cigarette/Cannabis Use; 10% Exclusive Cannabis Use; 5% Exclusive E-cigarette Use; and 5% Triple Use. Multinomial logistic regression with a three-level criterion variable, controlling for age, sex, parental education, race/ethnicity, and three types of household use showed that compared with Nonuse, odds of Lifetime Asthma (vs. Never Had) was elevated for Triple Use (AOR = 1.14, CI 1.06-1.24), Dual E-cigarette/Cannabis Use (1.17, 1.12-1.23), Exclusive Cannabis Use (1.17, 1.11-1.23), and Exclusive E-cigarette Use (1.10, 1.02-1.18). Similar results were noted for Recent Asthma. Among persons who had used cannabis, 88% of the Triple group and 74% of the Dual E-cigarette/Cannabis group reported both smoking and vaping cannabis. Thus, co-occurrence of e-cigarette and cannabis use was a common pattern among adolescents in this study, and subgroups of cannabis and e-cigarette use showed similar associations with asthma. Preventive approaches should highlight the health implications of exclusive or combined e-cigarette and cannabis use.
关于青少年使用含大麻的烟草制品对呼吸系统健康影响的知识仍然有限。我们研究了电子烟、可燃香烟和大麻是否与 2019-2020 年在加利福尼亚州以两阶段设计抽取的具有代表性的 150634 名公立高中生(10 年级和 12 年级)的哮喘之间存在独立关联。措施包括电子烟、可燃香烟和大麻的使用情况;使用动机(三种物质);使用方法(大麻);是否曾被诊断患有哮喘;以及在过去 12 个月内是否有哮喘发作。交叉分类显示,样本中 64%的人未使用;15%的人同时使用电子烟和大麻;10%的人单独使用大麻;5%的人单独使用电子烟;5%的人同时使用三种产品。使用具有三级分类变量的多变量逻辑回归,控制年龄、性别、父母教育程度、种族/民族以及三种家庭使用类型,结果表明与未使用相比,终生哮喘(从未有过)的可能性更高三重使用(AOR=1.14,95%CI 1.06-1.24),电子烟和大麻双重使用(1.17,1.12-1.23),单独使用大麻(1.17,1.11-1.23)和单独使用电子烟(1.10,1.02-1.18)。最近的哮喘也有类似的结果。在使用过大麻的人群中,三重组中有 88%的人报告同时吸烟和吸食大麻,电子烟和大麻双重使用组中有 74%的人报告同时吸烟和吸食大麻。因此,在这项研究中,电子烟和大麻同时使用在青少年中是一种常见模式,大麻和电子烟使用的亚组与哮喘的关联相似。预防方法应强调单独或联合使用电子烟和大麻的健康影响。