Background

Little is known about population-level differences between adults who exclusively smoke cigarettes and those who smoke cigarettes and also use cannabis (co-consumers). Thus, this study describes differences on sociodemographic, cigarette-dependence, health and behavioral variables, and risk perceptions associated with smoking cannabis.

Methods

This cross-sectional study included 6941 respondents from the 2020 ITC Four Country Smoking and Vaping Survey (US, Canada, Australia, England). Adult daily cigarette smokers were included and categorized as: cigarette-only smokers (never used cannabis/previously used cannabis, but not in the past 12 months, n = 4857); occasional co-consumers (cannabis use in the past 12 months, but < weekly use, n = 739); or regular co-consumers (use cannabis ≥ weekly, n = 1345). All outcomes were self-reported. Regression models were conducted on weighted data.

Results

Overall, 19.9 % of respondents reported regular cannabis co-use and 10.1 % reported occasional co-use. Regular co-use was highest in Canada (27.2 %), followed by the US (24.4 %), England (12.7 %) and Australia (12.3 %). Compared to cigarette-only smokers, regular co-consumers were more likely to be male and report chest/breathing problems (p < 0.001). All co-consumers were more likely to be younger, have lower income, be experiencing financial stress, reside in Canada, have depressive symptoms, use alcohol more frequently and binge drink, use other tobacco/nicotine products, and perceive smoking cannabis as low health risk and less harmful than smoking cigarettes (all p < 0.001). Cigarette dependence measures were similar between co-consumers and cigarette-only smokers (all p ≥ 0.05).

Conclusions

Although there were no differences on cigarette dependence measures between daily cigarette smokers who do and do not use cannabis, there are several other risk factors that may affect tobacco use and abstinence among co-consumers (e.g., greater depression, high-risk alcohol consumption). Thus, tobacco cessation treatment may require multi-pronged strategies to address other health behaviors. Continued surveillance is needed to determine the nature and health implications of co-use considering changing policies, markets, and products.

中文翻译：

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每天吸烟和同时使用大麻和不同时使用大麻的成年人之间的差异：2020 年 ITC 四国吸烟和电子烟调查的结果

 背景

对于只吸烟的成年人和吸烟同时使用大麻的成年人（共同消费者）之间的人口水平差异知之甚少。因此，这项研究描述了与吸食大麻相关的社会人口统计学、香烟依赖、健康和行为变量以及风险认知方面的差异。

 方法

这项横断面研究纳入了 2020 年 ITC 四国吸烟和电子烟调查（美国、加拿大、澳大利亚、英国）的 6941 名受访者。每日吸烟的成人被纳入并分类为：仅吸烟者（从未使用过大麻/以前使用过大麻，但在过去 12 个月内没有使用过，n = 4857）；偶尔的共同消费者（过去 12 个月内吸食大麻，但<每周吸食一次，n = 739）；或经常共同消费者（使用大麻≥每周，n = 1345）。所有结果均由自我报告。对加权数据进行回归模型。

 结果

总体而言，19.9% 的受访者表示经常同时使用大麻，10.1% 的受访者表示偶尔同时使用大麻。加拿大的定期共同使用率最高（27.2%），其次是美国（24.4%）、英国（12.7%）和澳大利亚（12.3%）。与只吸烟者相比，经常吸烟的人更有可能是男性并报告胸部/呼吸问题（p < 0.001）。所有共同消费者更有可能更年轻、收入较低、面临经济压力、居住在加拿大、有抑郁症状、更频繁地饮酒和酗酒、使用其他烟草/尼古丁产品，并认为吸食大麻不健康比吸烟有风险且危害更小（所有 p < 0.001）。共同消费者和仅吸烟者之间的香烟依赖测量结果相似（所有 p ≥ 0.05）。

 结论

尽管每天吸食和不吸食大麻的吸烟者之间的香烟依赖测量没有差异，但还有其他一些风险因素可能会影响共同消费者的烟草使用和戒烟（例如，更严重的抑郁症、高风险饮酒） 。因此，戒烟治疗可能需要多管齐下的策略来解决其他健康行为。考虑到不断变化的政策、市场和产品，需要持续监测来确定共同使用的性质和健康影响。