BACKGROUND We assess the longitudinal associations between marijuana and cigar (little cigars and cigarillos [LCCs] and large cigars) use on subsequent initiation of marijuana and cigar use. METHODS Data are from a cohort study of 2189 young adults recruited in fall 2010 from 11 colleges in the Southeast. We used discrete-time survival analysis to examine whether ever use of marijuana at baseline (spring 2011, freshman year) predicted initiation of LCCs and large cigars and whether ever use of these cigar products predicted initiation of marijuana use across 10 waves of data collection (2011-2018). RESULTS The sample was 65.3 % female, 83.6 % White, 5.9 % Hispanic, and 61.8 % had college-educated mothers. At baseline, 70 % reported never using LCCs, 71 % reported never using large cigars, and 74 % reported never using marijuana. Ever use of marijuana at baseline was associated with an increased risk of LCC initiation (Incident rate ratio [IRR] = 1.6, 95 %CI = 1.0, 2.5) but not large cigar initiation. Ever use of LCCs (IRR = 1.4, 95 %CI = 1.1, 1.8) and ever use of large cigars (IRR = 1.3, 95 %CI = 1.1, 1.8) at baseline both predicted initiation of marijuana use. CONCLUSIONS Our findings support growing evidence that marijuana and LCCs are strongly associated and use of one substance predicts use of the other. In contrast to studies of adults, we also found that young adults who have tried large cigars may be at increased risk for subsequent marijuana use. These findings highlight the need to consider each product as a potential gateway of the other when developing interventions for young adults.

中文翻译：

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年轻人吸食大麻和雪茄之间的纵向关联。


背景 我们评估了大麻和雪茄（小雪茄和小雪茄 [LCC] 和大雪茄）使用与随后开始使用大麻和雪茄之间的纵向关联。方法 数据来自 2010 年秋季从东南部 11 所大学招募的 2189 名年轻人的队列研究。我们使用离散时间生存分析来检查在基线（2011 年春季，一年级）是否使用大麻可以预测 LCC 和大雪茄的开始，以及在 10 波数据收集中使用这些雪茄产品是否可以预测开始使用大麻（ 2011-2018）。结果 样本中 65.3% 为女性，83.6% 为白人，5.9% 为西班牙裔，61.8% 的母亲受过大学教育。在基线时，70% 的人表示从未使用过 LCC，71% 的人表示从未使用过大雪茄，74% 的人表示从未使用过大麻。基线时吸食大麻与开始 LCC 的风险增加相关（发病率比 [IRR] = 1.6，95%CI = 1.0，2.5），但与吸食大雪茄无关。在基线时曾经使用过 LCC（IRR = 1.4，95 % CI = 1.1，1.8）和曾经使用过大雪茄（IRR = 1.3，95 % CI = 1.1，1.8）都可以预测开始使用大麻。结论 我们的研究结果支持越来越多的证据表明大麻和 LCC 密切相关，并且使用一种物质可以预测另一种物质的使用。与成年人的研究相反，我们还发现尝试过大雪茄的年轻人随后吸食大麻的风险可能会增加。这些发现强调，在为年轻人制定干预措施时，需要将每种产品视为另一种产品的潜在门户。