Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA.
Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA.
Addict Behav. 2025 Jan;160:108191. doi: 10.1016/j.addbeh.2024.108191. Epub 2024 Oct 30.
Cannabis is increasingly the first substance used by young people and research indicates that cannabis use may precede the onset of tobacco use. Little is known, however, about the role of cannabis use in stages of electronic nicotine delivery systems (ENDS) uptake and progression across young adulthood. This study examined the associations between past 30-day (P30D) cannabis use frequency and transitions in ENDS use among young adults.
5,018 18-29-year-olds (64.2% female) were recruited from 24 Texas colleges to participate in a multi-wave study across a 4.5-year period from 2014 to 2019. A continuous time, multi-state Markov model was used to assess associations between P30D cannabis use frequency and three ENDS use transitions, spanning at least six months 1) never to P30D use (initiation); 2) P30D to non-P30D use (desistance); and 3) non-P30D to P30D use (re-uptake). The model also included socio-demographic and time-varying intrapersonal (other tobacco use, alcohol use, sensation seeking, depressive symptoms) and interpersonal (peer ENDS use) confounding factors.
Past 30-day cannabis use frequency was associated with an increased probability of ENDS initiation and decreased probability of desistance in the model adjusted for socio-demographic and confounding factors. Past 30-day cannabis use frequency was not associated with an increased probability of ENDS re-uptake in the adjusted model.
Cannabis use is associated with the uptake and continuation of ENDS use. Findings are concerning given that the most popular ENDS devices used by young adults contain high concentrations of nicotine that increase the risk for nicotine dependence and lifelong use.
大麻越来越成为年轻人首选的物质，研究表明大麻的使用可能先于烟草的使用。然而，关于大麻使用在年轻人电子尼古丁传送系统（ENDS）使用的开始和发展阶段中的作用知之甚少。本研究调查了过去 30 天（P30D）大麻使用频率与年轻人 ENDS 使用变化之间的关系。
2014 年至 2019 年期间，从德克萨斯州的 24 所大学招募了 5018 名年龄在 18 至 29 岁的（64.2%为女性）参与者参加一项为期 4.5 年的多波研究。使用连续时间、多状态马尔可夫模型来评估 P30D 大麻使用频率与三种 ENDS 使用变化之间的关系，至少跨越 6 个月：1）从不使用 P30D（开始）；2）P30D 至非 P30D 使用（停止）；3）非 P30D 至 P30D 使用（重新开始）。该模型还包括社会人口统计学和随时间变化的内在因素（其他烟草使用、酒精使用、感觉寻求、抑郁症状）和人际因素（同伴 ENDS 使用）。
在调整了社会人口统计学和混杂因素的模型中，过去 30 天的大麻使用频率与 ENDS 开始的可能性增加和停止的可能性降低有关。在调整后的模型中，过去 30 天的大麻使用频率与 ENDS 重新开始的可能性增加无关。
大麻的使用与 ENDS 使用的开始和持续有关。鉴于年轻人最常使用的 ENDS 设备含有高浓度的尼古丁，这增加了尼古丁依赖和终生使用的风险，这些发现令人担忧。
