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Goodwin RD, Silverman KD. Evolving Disparities in Cannabis Use Among Youth by Demographics and Tobacco and Alcohol Use in the U.S.: 2013-2021. Am J Prev Med 2024; 66:1035-1042. [PMID: 38272242 DOI: 10.1016/j.amepre.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION This study investigated the prevalence of past 30-day cannabis use among U.S. youth by cigarette use, alcohol use, demographics, and state-of-residence cannabis legal status in 2021 and examined whether changes in cannabis use prevalence were modified by these factors from 2013 to 2021. METHODS Data were drawn from the 24 states that collected cannabis use data participating in the Youth Risk Behavior Surveillance System from 2013 to 2021. Logistic regression analyses estimated past 30-day cannabis prevalence in 2021 and produced AORs by current cigarette, alcohol, and state-of-residence cannabis legal status. The same method was used with year as the exposure, adjusting for sex, race, and ethnicity, to assess trends in prevalence from 2013 to 2021. RESULTS In 2021, cannabis use was more common among female youth (16.75% vs 13.83% [AOR=1.26, 95% CI=1.16, 1.37]) and non-Hispanic Black and Hispanic youth than among non-Hispanic White youth (17.19%, 16.14% vs 14.60% [AOR=1.25, 95% CI=1.12, 1.39 and AOR=1.16, 95% CI=1.04, 1.29, respectively]). Cannabis use was much more common among youth who reported any past 30-day cigarette or alcohol use (44.90% vs 6.48% [AOR=11.80, 95% CI=10.57, 13.18]). Declines in cannabis use were observed independent of state-level cannabis law from 2013 to 2021, and cannabis use prevalence did not differ significantly by state-of-residence cannabis legal status among the 24 participating states in 2021. CONCLUSIONS Public health officials should carefully consider the potential impact of expanding commercialization of cannabis as a wellness product on youth cannabis use, especially with regard to minoritized populations and co-use with tobacco and alcohol. National and state-level public health education on cannabis use and youth-oriented prevention of cannabis uptake are long overdue.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
| | - Kevin D Silverman
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, New York
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Goodwin RD, Zhou C, Silverman KD, Rastogi D, Borrell LN. Cannabis use and the prevalence of current asthma among adolescents and adults in the United States. Prev Med 2024; 179:107827. [PMID: 38128769 DOI: 10.1016/j.ypmed.2023.107827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/27/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Cannabis use has increased among adolescents and adults in the United States (US) in recent years. Few data are available on the prevalence of asthma by frequency of cannabis use. This study aimed to estimate the prevalence of asthma by frequency of past 30-day cannabis use among US individuals. METHODS Data were drawn from the 2020 National Survey on Drug Use and Health (NSDUH), a nationally representative, annual cross-sectional survey of US individuals aged 12 and older in the United States (N = 32,893). Logistic regression models were used to examine the relationship between frequency of any cannabis and/or blunt (i.e., cannabis smoked in a hollowed-out cigar) use in the past 30 days and current asthma, adjusting for demographics and current cigarette smoking. RESULTS Current asthma was more common among US individuals who reported cannabis use in the past 30-days, relative to those who did not (9.8% vs. 7.4%, p < 0.0001). The odds of asthma was significantly greater among individuals reporting cannabis use 20-30 days/month (Adjusted Odds Ratio [AOR] = 1.67, 95% CI:1.21, 2.31), blunt use 6-15 and 20-30 days/month (AOR = 1.9, 95% CI:1.1, 3.2; AOR = 2.2, 95% CI:1.4, 3.6), respectively, than among those without. A positive linear relationship was observed between frequency of a) cannabis use (p < 0.0001) and b) blunt use (p < 0.0001) and current asthma prevalence. CONCLUSIONS Findings suggest a dose-response relationship between frequency of current cannabis use and the prevalence of current asthma in the US individuals.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, New York, NY 10027, United States of America; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Chaoqun Zhou
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Kevin D Silverman
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, New York, NY 10027, United States of America
| | - Deepa Rastogi
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, United States of America
| | - Luisa N Borrell
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, New York, NY 10027, United States of America
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Ozga JE, Shuter J, Chander G, Graham AL, Kim RS, Stanton CA. Co-use of cigarettes and cannabis among people with HIV: Results from a randomized controlled smoking cessation trial. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 7:100172. [PMID: 37342512 PMCID: PMC10277428 DOI: 10.1016/j.dadr.2023.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
Significance People with HIV (PWH) who smoke cigarettes have lower cessation rates than the general population. This study investigated whether changes in cannabis use frequency impedes cigarette cessation among PWH who are motivated to quit. Methods Between 2016-2020, PWH who smoked cigarettes were enrolled in a randomized controlled trial for cigarette cessation. Analyses were limited to PWH who reported on their past 30-day (P30D) cannabis use during four study visits (baseline, 1-month, 3-month, and 6-month) (N=374). Descriptive statistics and multivariable logistic regression were used to evaluate changes in cannabis use frequency from baseline to 6 months and associations with cigarette abstinence at 6 months among PWH who reported no use during all four visits (n=176), as well as those who reported use during at least one visit and who increased (n=39), decreased (n=78), or had no change (n=81) in use frequency. Results Among those who reported cannabis use during at least one visit (n=198), at baseline, 18.2% reported no use. At 6 months, 34.3% reported no use. Controlling for covariates, increased cannabis use frequency from baseline was associated with reduced odds of cigarette abstinence at 6 months versus decreased use frequency (aOR=0.22, 95% CI=0.03, 0.90) or no use at either time-point (aOR=0.25, 95% CI=0.04, 0.93). Conclusions Increased cannabis use over 6 months was associated with reduced odds of cigarette smoking abstinence among PWH who were motivated to quit. Additional factors that influence cannabis use and cigarette cessation simultaneously are in need of further study.
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Affiliation(s)
- Jenny E. Ozga
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Jonathan Shuter
- Department of Medicine, Division of Infectious Diseases, Albert Einstein College of Medicine, The Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, The Bronx, NY, USA
| | | | - Amanda L. Graham
- Innovations Center, Truth Initiative, Washington, DC, USA
- Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Ryung S. Kim
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, The Bronx, NY, USA
| | - Cassandra A. Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
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Islam T, Eckel S, Liu F, Barrington-Trimis J, Harlow AF, Benowitz N, Leventhal A, McConnell R, Cho J. Effects of dual use of e-cigarette and cannabis during adolescence on cigarette use in young adulthood. Tob Control 2023:tc-2022-057542. [PMID: 37147126 DOI: 10.1136/tc-2022-057542] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 04/06/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION E-cigarette and cannabis use by adolescents are risk factors for smoking initiation. We hypothesised that increasingly common dual use of e-cigarette and cannabis in adolescence leads to more frequent cigarette smoking in young adulthood. METHODS Data are from a prospective cohort study in Southern California, where 1164 participants who ever used nicotine products in their lifetime completed surveys in 12th grade (T1:2016), and at 24-month (T2) and 42-month (T3) follow-ups. Past 30-day use (number of days: range=0-30) of cigarettes, e-cigarettes and cannabis, and nicotine dependence, were assessed in each survey. Nicotine dependence for cigarettes and e-cigarettes was assessed using original and modified (for e-cigarette) Hooked on Nicotine Checklists (number of dependent products: range=0-2). Path analysis examined the mediation process via nicotine dependence linking baseline e-cigarette and cannabis use to subsequent increased cigarette use. RESULTS Baseline exclusive use of e-cigarettes (baseline prevalence, 2.5%) was associated with 2.61-fold increase in frequency of smoking days at T3 (95% CI 1.04 to 13.1), exclusive cannabis use (26.0%) with 2.58-fold increase (95% CI 1.43 to 4.98), and dual use (7.4%) with 5.84-fold increase (95% CI 3.16 to 12.81), compared with baseline non-users. Nicotine dependence at T2 mediated 10.5% (95% CI 6.3 to 14.7) and 23.2% (95% CI 9.6 to 36.3) of the association of cannabis and dual use, respectively, with increased smoking at T3. DISCUSSION Adolescent e-cigarette and cannabis use was associated with more frequent smoking during young adulthood, with larger effects of dual use. Associations were partially mediated through nicotine dependence. Dual use of cannabis and e-cigarettes may contribute to the development of nicotine dependence and increased use of combustible cigarettes.
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Affiliation(s)
- Talat Islam
- Department of Population and Public Helath Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah Eckel
- Department of Population and Public Helath Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Feifei Liu
- Department of Population and Public Helath Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jessica Barrington-Trimis
- Department of Population and Public Helath Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alyssa F Harlow
- Department of Population and Public Helath Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Neal Benowitz
- University of California San Francisco, San Francisco, California, USA
| | - Adam Leventhal
- Department of Population and Public Helath Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rob McConnell
- Department of Population and Public Helath Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Junhan Cho
- Department of Population and Public Helath Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Goodwin RD, Shevorykin A, Carl E, Budney AJ, Rivard C, Wu M, McClure EA, Hyland A, Sheffer CE. Daily Cannabis Use Is a Barrier to Tobacco Cessation Among Tobacco Quitline Callers at 7-Month Follow-up. Nicotine Tob Res 2022; 24:1684-1688. [PMID: 35417562 PMCID: PMC9759104 DOI: 10.1093/ntr/ntac096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/08/2022] [Accepted: 04/07/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Cannabis use is increasing among cigarette smokers in the United States. Prior studies suggest that cannabis use may be a barrier to smoking cessation. Yet, the extent to which this is the case among adults seeking to quit tobacco use remains unclear. Tobacco quitlines are the most common provider of no-cost treatment for adults who use smoke in the United States. This study investigated the association between cannabis use and smoking cessation outcomes among quitline callers. AIMS AND METHODS Participants included callers to the New York State Smokers' Quitline, who were seeking to quit smoking cigarettes and were contacted for outcome assessment 7 months after intake. Thirty-day point prevalence abstinence rates were calculated and compared among cannabis use groups, based on frequency of past-30-day cannabis use at baseline (none: 0 days, occasional: 1-9 days, regular: 10-19 days, and daily: 20-30 days). RESULTS Approximately 8.3% (n = 283) of participants (n = 3396) reported past-30-day cannabis use at baseline. Callers with daily cannabis use (20-30 days per month) had significantly lower odds of 30-day abstinence, relative to those who did not use cannabis (odds ratio = 0.5; 95% confidence interval [0.3, 0.9]). CONCLUSIONS Daily cannabis use appears to be associated with poorer smoking cessation treatment outcomes among adults seeking to quit smoking cigarettes via a quitline. Because quitlines are among the most accessible, affordable, and frequently utilized community-based treatments available in the United States, and the prevalence of cannabis use is increasing among cigarette smokers, detailed inquiry into cannabis use might enhance cigarette smoking cessation outcomes. IMPLICATIONS Quitlines are free of cost and accessible to millions of smokers in the United States. The current study found an inverse relationship between daily cannabis use at baseline and 30-day abstinence from cigarette smoking at 7-month follow-up among New York State Smokers' Quitline callers. Findings suggest that daily cannabis use may be a barrier to smoking cessation and sustained abstinence among those seeking help to stop smoking cigarettes.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alina Shevorykin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ellen Carl
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alan J Budney
- Department of Psychiatry, Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Cheryl Rivard
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Melody Wu
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Technology Applications Center for Healthful Lifestyles (TACHL), South Carolina Center of Economic Excellence, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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