BACKGROUND Some studies suggest cannabis use negatively affects tobacco cessation outcomes, but findings have been mixed. We examined whether cannabis use was associated with tobacco cessation outcomes in a real-world primary care setting. METHODS The analytic dataset consisted of 35,246 patients who enrolled between 2014 and 2016 in a primary care-based smoking cessation program in Ontario, Canada. Past 30-day cannabis use, for recreational or medical purposes, was self-reported at enrollment. Thirty-day point prevalence tobacco smoking abstinence was self-reported via online or telephone survey at 6 months post-enrollment. RESULTS Thirty days prior to enrollment, 79.9 % of patients had not used cannabis, 16.3 % used cannabis for recreational purposes only, and 3.8 % used cannabis for medical purposes. Unadjusted and adjusted odds of tobacco cessation at 6 months were reduced for patients using cannabis compared to non-users (ORs = 0.76-0.86, ps<0.05). When cannabis use was categorized by purpose, both unadjusted and adjusted odds of cessation were significantly lower for recreational users (ORs = 0.77-0.84, ps<0.05). Medical users had decreased odds of cessation in unadjusted analysis (OR = 0.74, 95 % CI = 0.61-0.89, p = 0.001), but not after adjustment for potential confounders. However, post-estimation contrasts did not indicate a significant difference between the effect of recreational and medical cannabis use. CONCLUSIONS In a large real-world sample of patients seeking smoking cessation treatment, concurrent cannabis use was associated with decreased success with quitting smoking. Recreational cannabis use was consistently related to poorer cessation outcomes, but medical use was not. Additional research is needed to inform treatment strategies for this growing sub-population of smokers.

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大麻使用与戒烟结局有关吗？初级保健中的观察性队列研究。

背景技术一些研究表明，大麻的使用会对戒烟结果产生负面影响，但研究结果好坏参半。我们检查了在现实世界的初级保健环境中，大麻的使用是否与戒烟结果相关。方法该分析数据集由35246例患者组成，这些患者在2014年至2016年之间参加了加拿大安大略省基于初级保健的戒烟计划。入学时自我报告了过去30天出于娱乐或医疗目的使用大麻的情况。入组后6个月，通过在线或电话调查自我报告了30天的戒烟率。结果在入组前30天，79.9％的患者未使用过大麻，16.3％的患者仅将其用于娱乐目的，而3.8％的患者则将其用于医疗目的。与不使用大麻的患者相比，使用大麻的患者在6个月时未经调整和调整后的戒烟几率降低了（OR = 0.76-0.86，ps <0.05）。当按用途对大麻进行分类时，休闲使用者的未经调整和经调整的戒烟几率均显着降低（OR = 0.77-0.84，ps <0.05）。在未经调整的分析中，医疗使用者的戒烟几率降低了（OR = 0.74，95％CI = 0.61-0.89，p = 0.001），但在对潜在的混杂因素进行调整后却没有。但是，估计后的对比并没有表明娱乐性大麻和医疗性大麻使用之间的显着差异。结论在大量寻求戒烟治疗的患者的真实世界样本中，同时使用大麻与戒烟成功率下降相关。娱乐性大麻的使用始终与戒烟效果较差有关，但医疗用途却没有。需要更多的研究来为这种不断增长的烟民群体提供治疗策略。