Sedani Ami E, Frank-Pearce Summer G, Beebe Laura A, Campbell Janis E, Peck Jennifer D, Chou Ann F, Cohn Amy M
Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
Nicotine Tob Res. 2025 Jan 22;27(2):208-216. doi: 10.1093/ntr/ntae202.
This study examined the association between the current co-use of cannabis and cigarettes in the past 30 days and subsequent cigarette discontinuation (past 30-day point-prevalence abstinence) among U.S. adults with established cigarette use in the Population Assessment of Tobacco and Health (PATH) Study. Additionally, we investigated the impact of co-use on the subsequent discontinuation of all combustible tobacco products.
A total of 26 381 observations contributed by 8218 adults with established cigarette use (ie, smoked ≥100 cigarettes in their lifetime, and currently smoking cigarettes every day or some days) from waves 1-5 of the PATH Study were included in the analysis. Weighted generalized estimating equations (GEE) models were used to evaluate the association between current co-use at baseline (waves 1-4) with the outcomes assessed at the subsequent wave (cigarette and combustible tobacco discontinuation at waves 2-5). Final models included: Demographic characteristics (age, sex, race and ethnicity, and educational attainment), behavior characteristics (intention to quit, internalizing symptoms, externalizing symptoms, and substance use problems), and wave-pair.
Over one-third (35.91%) of the adults currently smoking cigarettes self-reported co-use during the study period. Cannabis use among adults with established cigarette use increased over time. Co-use was associated with decreased odds of cigarette smoking discontinuation at follow-up, after adjusting for covariates (aOR: 0.81; 95% CI: 0.72, 0.93; p = .0018). Similar effect sizes were observed for the discontinuation of all combustible tobacco products (aOR: 0.75; 95% CI: 0.65, 0.86; p < .0001).
Cannabis use among adults with established cigarette use was inversely related to subsequent cigarette discontinuation, suggesting that co-use may reduce the likelihood of successful tobacco cessation.
Findings demonstrate that cannabis use may lead to lower odds of discontinuation among adults with established cigarette use; therefore, individuals who co-use cigarettes and cannabis may need additional tobacco cessation support. Notably, this study observed an increase in the co-use of cigarettes and cannabis, emphasizing the need for researchers and public health programs to shift their focus toward understanding and addressing concurrent substance use among adults who smoke cigarettes.
本研究在烟草与健康人口评估（PATH）研究中，调查了过去30天内大麻与香烟同时使用的情况与美国有吸烟习惯的成年人随后戒烟（过去30天的点流行率戒断）之间的关联。此外，我们还研究了同时使用大麻和香烟对随后所有可燃烟草产品戒断的影响。
分析纳入了PATH研究第1 - 5波中8218名有吸烟习惯的成年人（即一生中吸烟≥100支，且目前每天或有时吸烟）提供的总共26381条观察数据。采用加权广义估计方程（GEE）模型来评估基线时（第1 - 4波）同时使用大麻和香烟与后续波次（第2 - 5波中的戒烟和可燃烟草戒断）评估的结果之间的关联。最终模型包括：人口统计学特征（年龄、性别、种族和民族以及教育程度）、行为特征（戒烟意愿、内化症状、外化症状和物质使用问题）以及波次对。
在研究期间，目前吸烟的成年人中超过三分之一（35.91%）自我报告同时使用大麻和香烟。有吸烟习惯的成年人中使用大麻的情况随时间增加。在调整协变量后，同时使用大麻和香烟与随访时戒烟几率降低相关（校正后比值比：0.81；95%置信区间：0.72，0.93；p = 0.0018）。对于所有可燃烟草产品的戒断也观察到了类似的效应大小（校正后比值比：0.75；95%置信区间：0.65，0.86；p < 0.0001）。
有吸烟习惯的成年人中使用大麻与随后戒烟呈负相关，这表明同时使用大麻和香烟可能会降低成功戒烟的可能性。
研究结果表明，有吸烟习惯的成年人中使用大麻可能导致戒烟几率降低；因此，同时使用香烟和大麻的人可能需要额外的戒烟支持。值得注意的是，本研究观察到香烟和大麻同时使用的情况有所增加，这凸显了研究人员和公共卫生项目需要将重点转向了解和解决吸烟成年人中的并发物质使用问题。
