Abstract

Substance use behaviours have been found to cluster in youth, and cannabis use has been previously linked to tobacco and e-cigarette use. The objective of the current study was to examine the bidirectional associations between cannabis, e-cigarette, and cigarette use among a large sample of Canadian secondary school students. A sample of students in grades 9–11 (n = 14,652) from Ontario and Alberta, Canada who participated in two waves of the COMPASS Study (Time 1 (T1): 2015–2016; Time 2 (T2): 2016–2017) was identified. Autoregressive cross-lagged models investigated the stability of product use between T1 and T2, as well as the bidirectional associations between current cannabis, e-cigarette, and cigarette use while controlling for demographic covariates. Significant autoregressive and bidirectional associations between all three substances were observed. Students who reported using cigarettes and e-cigarettes at T1 were more likely to report using cannabis at T2. Similarly, students who reported using cannabis at T1 were more likely to report using cigarettes and e-cigarettes at T2. Given the bidirectional associations identified between cannabis, e-cigarette, and cigarette use in this research, continued monitoring of evolving policies related to cannabis and e-cigarette use in Canada is needed. Additionally, school and community-based prevention efforts targeting youth should consider addressing poly-substance use.

摘要

已经发现物质使用行为集中在年轻人中，大麻的使用以前与烟草和电子烟的使用有关。本研究的目的是检查大量加拿大中学生样本中大麻、电子烟和香烟使用之间的双向关联。9-11 年级学生样本（n = 14,652) 来自加拿大安大略省和阿尔伯塔省，他们参与了两轮 COMPASS 研究（时间 1 (T1)：2015-2016；时间 2 (T2)：2016-2017）。自回归交叉滞后模型研究了 T1 和 T2 之间产品使用的稳定性，以及当前大麻、电子烟和卷烟使用之间的双向关联，同时控制了人口协变量。观察到所有三种物质之间存在显着的自回归和双向关联。在 T1 报告使用香烟和电子烟的学生更有可能在 T2 报告使用大麻。同样，在 T1 报告使用大麻的学生更有可能在 T2 报告使用香烟和电子烟。鉴于本研究中确定的大麻、电子烟和卷烟使用之间的双向关联，需要继续监测加拿大与大麻和电子烟使用有关的不断变化的政策。此外，针对青少年的学校和社区预防工作应考虑解决多种物质的使用问题。