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MacCallum CA, Lo LA, Boivin M. Clinical Application of Cannabis Vaporization: Examining Safety and Best Practices. Cannabis Cannabinoid Res 2024. [PMID: 38394323 DOI: 10.1089/can.2023.0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Introduction: Cannabis vaporization is useful for individuals requiring fast-acting method of cannabis administration and for individuals using smoked cannabis as a harm reduction tool. There is a need for guidance on how to assess if a patient is a vaporization candidate and how to safely initiate and monitor cannabis vaporization. Methods: An overview of safe cannabis vaporization, including practical guidance and tactics to promote the lowest-risk use, is provided. This review was developed through a combination of expert clinical opinion and reviewing the available literature. Results: Dried cannabis vaporizers and metered-dose inhalers are recommended to be used over other vaporization devices. Assessing the benefit versus risks of vaporized cannabis and providing guidance for choosing a vaporization device, choosing a cannabis chemovar, and employing a mindful vaping technique are important steps in the safe utilization of vaporized cannabis. Dosing optimization and monitoring to limit adverse events and improve symptom control are essential. Discussion: The utilization of cannabis vaporization presents an important opportunity for clinicians and other health professionals to help facilitate safer cannabis administration and reduce the prevalence of smoked cannabis.
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Affiliation(s)
- Caroline A MacCallum
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Lindsay A Lo
- Department of Public Health Science, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Clendennen SL, Rangwala S, Sumbe A, Case KR, Wilkinson AV, Loukas A, Harrell MB. Understanding college students' experiences using e-cigarettes and marijuana through qualitative interviews. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2848-2858. [PMID: 34871132 PMCID: PMC9178769 DOI: 10.1080/07448481.2021.1998073] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/28/2021] [Accepted: 10/17/2021] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate the contexts in which college students use e-cigarettes and marijuana, perceptions about the benefits and harms, and health effects of use. PARTICIPANTS College student e-cigarette and marijuana ever users (n = 20; 18-21 years old) from the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS). METHODS Participants completed a one-hour long online interview about their experiences using e-cigarettes and marijuana. Thematic content analysis in NVivo identified prominent themes. RESULTS Vaping nicotine and marijuana were preferred and perceived as normal, trendy and useful in circumventing smoke-free campus policies. Preference for nicotine versus marijuana fluctuates during the academic school year in response to campus restrictions and work and school-related activities. College students commonly experienced health effects (shortness of breath, wheezing) attributed to vaping, did not perceive their use as very harmful, and perceived their use as a college-related phase. CONCLUSIONS Findings have implications for college-based health education, resources, and smoke-free policies.
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Affiliation(s)
- Stephanie L. Clendennen
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, Texas, USA
| | - Shazia Rangwala
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, Texas, USA
| | - Aslesha Sumbe
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, Texas, USA
| | - Kathleen R. Case
- Center for Research to Advance Community Health (ReACH), UTHealth San Antonio, San Antonio, Texas, USA
| | - Anna V. Wilkinson
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, Texas, USA
| | - Alexandra Loukas
- Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Melissa B. Harrell
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, Texas, USA
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Waddell JT, Merrill JE, Okey SA, Woods-Gonzalez R, Corbin WR. Subjective effects of simultaneous alcohol and cannabis versus alcohol-only use: A qualitative analysis. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:906-917. [PMID: 36757980 PMCID: PMC10409872 DOI: 10.1037/adb0000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE Theoretical models of addictive behavior suggest that subjective effects serve as a mechanism through which substance use disorders develop. However, little is known about the subjective effects of simultaneous alcohol and cannabis use, particularly whether simultaneous use (a) heightens specific subjective effects or (b) is related to unique subjective effects relative to single-substance effects. The present study used formative, qualitative data analysis to examine patterns of responses within open-answer text response data on subjective effects of simultaneous use. METHOD College students who simultaneously use alcohol and cannabis (N = 443; 68.2% female) were asked to describe how alcohol effects differ on simultaneous alcohol and cannabis use versus alcohol-only use days. RESULTS Conventional content analysis revealed nine concepts related to simultaneous (vs. alcohol-only) use subjective effects including as follows: (a) increased/decreased impairment, (b) low arousal/relaxation, (c) balancing/replacement effects, (d) "cross-faded" effects, (e) little-to-no differences, (f) altered sensation and perception, (g) increased negative affective states, (h) increased appetite, and (i) increased/decreased negative consequences. Increased impairment (N = 191) and increased relaxation (N = 110) were the most often endorsed subjective effects, followed by decreased impairment (N = 55), balancing/replacement effects (N = 50) and cross-faded/enhancement effects (N = 44). CONCLUSIONS Subjective effects from simultaneous use largely map onto domains of single-substance alcohol and cannabis effects (e.g., relaxation, sociability, cognitive/behavioral impairment), but also include distinct domains related to simultaneous use (e.g., balancing/replacement effects, altered sensation and perception). Future quantitative research is needed to validate measures of subjective effects from simultaneous use and their relations with use behavior. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Marinello S. Social Media Marketing Practices of Illinois Recreational Cannabis Dispensaries in the First Year of Legal Sales: Product Promotions, Branding, and Price Promotions. JOURNAL OF DRUG ISSUES 2023. [DOI: 10.1177/00220426231159542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Research from tobacco suggests that the recreational cannabis industry will use aggressive tactics, including product innovation and mass-marketing and advertising, to increase demand for their products. The purpose of this study is to examine product promotions, branding, and promotional pricing on recreational dispensary social media pages in the state of Illinois in the first year of legal sales. Data were collected from all recreational cannabis dispensary Facebook and Twitter accounts and a quantitative content analysis was used to analyze the data. Differences in marketing practices were assessed by neighborhood race/ethnicity and income and dispensary type. Results of the study revealed that flower and edibles were the two most heavily promoted products; promotions for vaporizers and concentrates were also promoted frequently. Posts with branded promotions and price promotions increased substantially over the year. Research suggests that this trend in marketing practices will lead to greater initiation and intensity of cannabis use.
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Affiliation(s)
- Samantha Marinello
- Division of Health Policy and Administration School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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Berey BL, Aston ER, Gebru NM, Merrill JE. Differences in cannabis use characteristics, routines, and reasons for use among individuals with and without a medical cannabis card. Exp Clin Psychopharmacol 2023; 31:14-22. [PMID: 35025588 PMCID: PMC9276841 DOI: 10.1037/pha0000542] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
As recreational and medical cannabis use increases in the U.S., the proliferation of novel cannabis products is expected to continue. Understanding cannabis product preferences and use patterns may inform public health and policy decisions. This study investigated similarities and differences in cannabis use patterns, product preferences, and beliefs about cannabis' subjective effects and therapeutic benefits among individuals with and without a medical cannabis card (MCC). Participants with an MCC completed individual interviews (N = 25; 40% male). Participants without an MCC completed focus groups (N = 31; 6-7 participants/group; 72% male). All sessions followed a semistructured agenda. Participants were queried about their use routines, reasons for using cannabis, and perceptions and experiences of subjective cannabis effects. Thematic analysis of coded transcripts revealed that MCC participants had structured, daily cannabis use routines whereas non-MCC participants' use routines were less structured. Product information including strain and cannabinoid composition were important to MCC participants whereas non-MCC participants primarily evaluated quality based on perceptual (e.g., olfactory) cues. Regardless of MCC status, participants reported misconceptions about cannabis' therapeutic benefits and agreed that the two primary cannabis strains-Indica and Sativa-produced primarily sedative and stimulant effects, respectively. Results have clinical, public health, and policy implications surrounding cannabis recommendation guidelines and ways providers can relay accurate information to patients seeking medical cannabis. Future research assessing demographic and geographic differences in cannabis product preferences and beliefs about medical cannabis use is warranted. Further, quantitative research is needed to evaluate whether cannabis' therapeutic value differs across products. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Benjamin L. Berey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Behavioral and Social Sciences, Brown University School of Public Health
| | | | - Jennifer E. Merrill
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Behavioral and Social Sciences, Brown University School of Public Health
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Kayode A, Adrish S, Muhammad A, Amin R, Muhammad D, Rida Z, Alabi G, Okumede G, Kayode O. Therapeutic Uses of Medical Cannabis: An Overview of its Functions in Disease Management. JOURNAL OF MEDICAL SCIENCES 2023. [DOI: 10.3923/jms.2023.32.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
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McKenzie N, Glassman TJ, Dake JA, Maloney SM, Na L. Factors that influence cannabis vaping habits of college students: A qualitative study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 36282209 DOI: 10.1080/07448481.2022.2135375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/30/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Objective: The purpose of this study is to examine the attitudes and perceptions of college undergraduates regarding cannabis vaping. Participants: Twenty-one, predominantly male (71.4%; Mage = 22, SD = 2.09), undergraduate college students who reported vaping cannabis in the past 30 days. Methods: Participants were interviewed to determine their attitudes and perceptions regarding cannabis vaping. Findings: Thematic analysis uncovered six primary themes and eighteen subthemes. Main themes included (1) Convenience, (2) Discreetness, (3) Mood-Altering Experience, (4) Social Acceptability, (5) Health and Safety, and (6) COVID-19 Pandemic Impact. Conclusion: College students who use cannabis tend to both vape and use combustible methods, depending upon social and physical environment. This population tends to vaporize cannabis for its perceived mood-altering properties. Additional research is needed to further examine the behaviors and attitudes surrounding cannabis vaping among college undergraduates, as well as the development of interventions specific to this demographic.
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Affiliation(s)
- Nicole McKenzie
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, Ohio, USA
| | - Tavis J Glassman
- School of Population Health, University of Toledo, Toledo, Ohio, USA
| | - Joseph A Dake
- School of Population Health, University of Toledo, Toledo, Ohio, USA
| | - S Maggie Maloney
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, Ohio, USA
| | - Ling Na
- School of Population Health, University of Toledo, Toledo, Ohio, USA
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Watson CV, Alexander DS, Oliver BE, Trivers KF. Substance use among adult marijuana and nicotine e-cigarette or vaping product users, 2020. Addict Behav 2022; 132:107349. [PMID: 35580371 PMCID: PMC11056937 DOI: 10.1016/j.addbeh.2022.107349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Co-use of marijuana and tobacco/nicotine have unknown impacts on addiction and health. There are limited data on the extent to which adults are co-using tetrahydrocannabinol (THC)- and nicotine-containing products, in any of their various modes. This study describes adult use of THC- and nicotine-containing products among electronic vaping product (EVP) users. METHODS Data on marijuana and tobacco use were collected from February 25-29, 2020 through an online survey of adults aged ≥18 years who reported using THC- and nicotine-containing electronic vaping products (EVPs) in the past 3 months (n = 3,980). Survey respondents from 18 states participated in the U.S. YouGov panel, a proprietary opt-in internet panel survey of 1.8 million U.S. residents. RESULTS Among those who reported using nicotine and THC-containing EVPs in the past 3 months, 90.1% of respondents reported smoking marijuana in the past 3 months; 82.7% reported smoking as the most frequent mode of marijuana use. Almost 63% of EVP users reported smoking cigarettes; 55.6% reported smoking for over 8 years, while 7.7% had been smoking cigarettes for under a year. CONCLUSIONS In this study, respondents reported cigarette smoking and marijuana smoking in addition to using marijuana- and nicotine- containing EVPs. Considering the unknown health effects of co-use of tobacco and THC-containing products, the finding that adults are vaping THC and nicotine alongside traditional modes of marijuana and tobacco use of these substances warrants further investigation. IMPLICATIONS Findings from this study provide evidence that adults who use nicotine and THC EVPs are also using a variety of other THC-containing and tobacco-containing products. This indicates the importance of continued surveillance to assess trends of polysubstance EVP and multi-modal marijuana and tobacco use. Monitoring various modes of marijuana and tobacco use may inform policies, prevention education, communication, and cessation tools.
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Affiliation(s)
- Christina V Watson
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, United States.
| | - Dayna S Alexander
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, United States
| | - Briana E Oliver
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, United States
| | - Katrina F Trivers
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, United States
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Abstract
Purpose of Review To explore relations between behavioral economic demand for cannabis and cannabis use disorder (CUD). Prior reviews have focused on drug demand in relation to use outcomes more generally. Complementing and enhancing prior work synthesizing research on cannabis demand, the present review endeavors to determine whether specific demand indices derived from the marijuana purchase task are most reliably related to CUD. Additionally, sociodemographic characteristics of participants in these studies were reviewed to identify whether certain populations were underrepresented in behavioral economic cannabis research. Recent Findings Behavioral economic demand is related to CUD; intensity and elasticity of cannabis demand were consistently associated with CUD diagnosis and severity. However, frequently, only select demand indices were assessed or reported, precluding the ability to confirm which indices are superior for denoting CUD risk. Further, most studies enrolled samples that were predominately young adults, Caucasian, and male. Summary As CUD becomes more prevalent in the wake of cannabis legalization, identification of robust predictors of CUD risk is paramount. Cannabis demand is consistently associated with CUD; however, individual indices of import in this relationship remain ambiguous. Subsequent research is needed to confirm index-specific markers of disordered cannabis use, and whether links between demand and CUD generalize across diverse populations.
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Affiliation(s)
- Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box GS121-5, Providence, RI 02912, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Heath, Providence, RI 02912, USA
| | - Benjamin L. Berey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box GS121-5, Providence, RI 02912, USA
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Cloutier RM, Calhoun BH, Linden-Carmichael AN. Associations of mode of administration on cannabis consumption and subjective intoxication in daily life. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2022; 36:67-77. [PMID: 34472879 PMCID: PMC8831393 DOI: 10.1037/adb0000726] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE As cannabis products are becoming increasingly available and young adults are increasingly using vaporizers to consume cannabis, there is a need to understand how this population is using different modes of administration and the extent to which specific modes are associated with differential cannabis use outcomes. Toward this end, the current study characterized predictors of cannabis mode of administration and examined how consumption levels and subjective intoxication vary as a function of mode of administration in daily life. METHOD Participants were 106 young adult cannabis and heavy alcohol users (51% female) who completed up to 14 daily diaries (n = 1,405 person days). Each day, participants reported whether they used any cannabis and, if any, which mode(s) were used, number of hits used per mode, overall subjective intoxication, and the socio-environmental context in which they used cannabis. RESULTS Across all cannabis use days, Bong-Only and Vape-Only days were the most common, followed by Multimode, Joint-, Pipe-, and Blunt-Only days. Participants reporting a greater proportion of cannabis use days were more likely to report Bong-Only and Multimode days than Vape-Only days. Compared to Vape-Only days, participants reported fewer hits on Bong-Only days and more hits on Blunt-Only, Pipe-Only, and Multimode days. Participants felt more intoxicated on Bong-Only days than Vape-Only days. CONCLUSIONS Mode-specific associations with cannabis consumption and subjective intoxication levels suggest assessing modes of administration may be a meaningful way to guide individual and public health intervention efforts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Fischer B, Robinson T, Bullen C, Curran V, Jutras-Aswad D, Medina-Mora ME, Pacula RL, Rehm J, Room R, van den Brink W, Hall W. Lower-Risk Cannabis Use Guidelines (LRCUG) for reducing health harms from non-medical cannabis use: A comprehensive evidence and recommendations update. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 99:103381. [PMID: 34465496 DOI: 10.1016/j.drugpo.2021.103381] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cannabis use is common, especially among young people, and is associated with risks for various health harms. Some jurisdictions have recently moved to legalization/regulation pursuing public health goals. Evidence-based 'Lower Risk Cannabis Use Guidelines' (LRCUG) and recommendations were previously developed to reduce modifiable risk factors of cannabis-related adverse health outcomes; related evidence has evolved substantially since. We aimed to review new scientific evidence and to develop comprehensively up-to-date LRCUG, including their recommendations, on this evidence basis. METHODS Targeted searches for literature (since 2016) on main risk factors for cannabis-related adverse health outcomes modifiable by the user-individual were conducted. Topical areas were informed by previous LRCUG content and expanded upon current evidence. Searches preferentially focused on systematic reviews, supplemented by key individual studies. The review results were evidence-graded, topically organized and narratively summarized; recommendations were developed through an iterative scientific expert consensus development process. RESULTS A substantial body of modifiable risk factors for cannabis use-related health harms were identified with varying evidence quality. Twelve substantive recommendation clusters and three precautionary statements were developed. In general, current evidence suggests that individuals can substantially reduce their risk for adverse health outcomes if they delay the onset of cannabis use until after adolescence, avoid the use of high-potency (THC) cannabis products and high-frequency/-intensity of use, and refrain from smoking-routes for administration. While young people are particularly vulnerable to cannabis-related harms, other sub-groups (e.g., pregnant women, drivers, older adults, those with co-morbidities) are advised to exercise particular caution with use-related risks. Legal/regulated cannabis products should be used where possible. CONCLUSIONS Cannabis use can result in adverse health outcomes, mostly among sub-groups with higher-risk use. Reducing the risk factors identified can help to reduce health harms from use. The LRCUG offer one targeted intervention component within a comprehensive public health approach for cannabis use. They require effective audience-tailoring and dissemination, regular updating as new evidence become available, and should be evaluated for their impact.
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Affiliation(s)
- Benedikt Fischer
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - Tessa Robinson
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Chris Bullen
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; National Institute for Health Innovation (NIHI), The University of Auckland, Auckland, New Zealand
| | - Valerie Curran
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada; Research Centre of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Maria Elena Medina-Mora
- Center for Global Mental Health Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico; Department of Psychiatry and Mental Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Rosalie Liccardo Pacula
- Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, United States
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction & Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Wim van den Brink
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Wayne Hall
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, QLD 4072, Australia; National Addiction Centre, Institute of Psychiatry, Kings College London, United Kingdom
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Cloutier RM, Calhoun BH, Lanza ST, Linden-Carmichael AN. Assessing subjective cannabis effects in daily life with contemporary young adult language. Drug Alcohol Depend 2022; 230:109205. [PMID: 34890928 PMCID: PMC8714699 DOI: 10.1016/j.drugalcdep.2021.109205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/02/2021] [Accepted: 11/06/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Subjective ratings of cannabis effects are important predictors of use-related consequences. However, psychometric research is fairly limited, particularly for measures to capture variability in daily life when diverse modes of cannabis administration and co-substance use are common. METHODS This study evaluated the predictive utility of a revised item to assess perceived cannabis effects and examined modes of cannabis administration and alcohol and nicotine co-use as moderators. Participants were 106 young adults (18-25 years; 51% female) who completed up to 14 consecutive daily reports of substance use (n = 1405 person-days). Two measures of subjective effects were examined: a standard item (0-100 rating of "how high do you feel?") and a revised item that uses four crowd-sourced anchor points ranging from relaxed (0), calm/chill (33), high (67), and stoned/baked (100). The items shared substantial variance (Pseudo-R2 = 59.5%), however, the revised item showed greater within-person variability (77.0% vs. 68.8%) and stronger day-level associations with consumption levels (Pseudo-R2 = 25.0% vs. 16.7%). RESULTS The cannabis consumption-subjective effects link was weaker on blunt-only days compared to vape-only days. Subjective cannabis effects were higher on nicotine co-use days after controlling for cannabis consumption; neither alcohol nor nicotine co-use moderated the cannabis consumption-subjective effects link. DISCUSSION The revised subjective cannabis effects item is a viable alternative to the standard item among young adults who engage in simultaneous alcohol and cannabis use. CONCLUSIONS Future research focused on characterizing the variability in cannabis effects is needed.
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Affiliation(s)
- Renee M. Cloutier
- 314 Biobehavioral Health, The Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Brian H. Calhoun
- The University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Box 354944, Seattle, WA 98105, USA
| | - Stephanie T. Lanza
- 314 Biobehavioral Health, The Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Ashley N. Linden-Carmichael
- 314 Biobehavioral Health, The Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, 16802, USA
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Tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, product use behaviors among adults after the onset of the 2019 outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). Addict Behav 2021; 121:106990. [PMID: 34087764 DOI: 10.1016/j.addbeh.2021.106990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 01/20/2023]
Abstract
INTRODUCTION During the E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) outbreak, patient data on tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, product (EVP) use was collected, but data on non-affected adult product use after the onset of the EVALI outbreak is limited. This study describes adult THC-EVP use after EVALI began. METHODS THC-EVP use data came from an 18-state web-based panel survey of adult THC- and nicotine-containing EVP users conducted February 2020. Unweighted descriptive statistics were calculated; logistic regression assessed correlates of use. RESULTS Among 3,980 THC-EVP users, 23.5% used THC-EVPs daily. Common brands of THC-EVPs used were Dank Vapes (47.7%) and Golden Gorilla (38.7%). Reported substances used included THC oils (69.6%), marijuana herb (63.6%) and THC concentrate (46.4%). Access sources included: recreational dispensaries (41.1%), friend/family member (38.6%) and illicit dealers (15.1%). Respondents aged 45-64 years had lower odds for daily use compared with those aged 25-34 years (aOR = 0.73; 95% CI = 0.60, 0.90). Compared with White respondents, Asian respondents had lower odds (aOR = 0.55; 95% CI = 0.36, 0.84) and Black respondents higher odds (aOR = 1.48; 95% CI = 1.17, 1.86) of daily use. Respondents odds of daily use and accessing THC-EVPs through commercial sources were higher among states with legalized nonmedical adult marijuana use compared to states without. CONCLUSIONS Almost half of respondents reported daily or weekly THC-EVP use, and accessed products through both informal and formal sources, even after EVALI began. Given the potential for future EVALI-like conditions to occur, it is important to monitor the use of THC-EVPs and ensure effective education activities about associated risk.
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Smith DM, Kozlowski L, O'Connor RJ, Hyland A, Collins RL. Reasons for individual and concurrent use of vaped nicotine and cannabis: their similarities, differences, and association with product use. J Cannabis Res 2021; 3:39. [PMID: 34452640 PMCID: PMC8401016 DOI: 10.1186/s42238-021-00097-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding similarities, differences, and associations between reasons people vape nicotine and cannabis may be important for identifying underlying contributors to their co-use. METHODS A cross-sectional survey of 112 co-users of vaped nicotine and cannabis was conducted in 2020. A convenience sample of participants was recruited for the survey using Amazon Mechanical Turk. Participants responded to questions about their reasons for individual nicotine and cannabis product use and co-use and rated their level of agreement using numerical scales. Mean ratings for each reason for use subscale were examined across all participants and compared using paired samples t tests. Associations between reasons for use ratings and product consumption behaviors were examined using linear and logistic regression analyses. RESULTS Cannabis vaping and smoking exhibited similar mean ratings for user experience and product/substance-related reasons for use. Mean ratings for reasons related to product utility were similar for cannabis vaping and nicotine vaping. Mean ratings for utility-related reasons for use were higher for cannabis vaping than cannabis smoking (mean (SD), 3.6 (± 1.0) vs. 2.6 (± 1.2), p < 0.0001). On average, harm reduction-related reasons for use were rated higher for nicotine vaping than cannabis vaping (2.4 (± 1.6) vs. 1.8 (± 1.4), p < 0.0001). Regression models showed higher average ratings for utility-related (b = 0.32; 95% CI, 0.03-0.60) and harm reduction-related (b = 0.21; 95% CI, 0.04-0.37) reasons for nicotine vaping were associated with more frequent nicotine vaping (both p < 0.05). Higher average ratings for instrumentality-related reasons for co-use corresponded with more frequent monthly nicotine vaping (b = 0.26; 95% CI, 0.08-0.44) and higher odds of ever chasing cannabis with nicotine (aOR, 3.06; 95% CI, 1.29-7.30). CONCLUSIONS Vaping serves purposes that differ by substance; nicotine vaping was more closely related to reducing tobacco smoking-related harms, and cannabis vaping was more closely related to circumventing social problems posed by cannabis smoking. Lifetime sequential co-use practices and more frequent nicotine vaping were associated with enhancing the intoxicating effects of cannabis. While replication of these findings using non convenience-based sampling approaches is warranted, results underscore the need to consider shared and unique aspects of nicotine and cannabis vaping, as well as cross-substance interactions between nicotine and cannabis.
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Affiliation(s)
- Danielle M Smith
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, 14214, USA. .,Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA.
| | - Lynn Kozlowski
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, 14214, USA
| | - Richard J O'Connor
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - R Lorraine Collins
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, 14214, USA
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15
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Shi Y. Heterogeneities in administration methods among cannabis users by use purpose and state legalization status: findings from a nationally representative survey in the United States, 2020. Addiction 2021; 116:1782-1793. [PMID: 33217090 PMCID: PMC8134617 DOI: 10.1111/add.15342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/04/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Different cannabis administration methods have differential impacts on health. This study aimed to describe administration methods among cannabis users in the United States categorized by (1) use purpose and (2) state legalization status. DESIGN Cross-sectional, probability-based online survey in 2020. SETTING All 50 states and Washington DC in the United States. PARTICIPANTS A total of 21 903 adults (18+) were recruited from a probability-based online panel to provide nationally representative estimates. METHODS Eleven administration methods were grouped into combustion, vaporization, ingestion and topicals. Weighted prevalence was reported among (1) medical-only, recreational-only and dual-purpose users based on self-reported purposes and (2) users in states that legalized both recreational and medical cannabis (RCL states), legalized medical cannabis only and did not legalize cannabis. FINDINGS Among past-year users, the proportions of medical-only, recreational-only and dual-purpose users were 25.55, 43.81 and 30.64%, respectively. The most common primary methods were combustion (42.08%) and topicals (28.65%) for medical purposes and combustion (72.07%) and ingestion (15.05%) for recreational purposes. Dual-purpose users were more likely to report combustion and vaporization but less likely to report ingestion and topicals as primary methods for medical use than medical-only users (P < 0.001) and more likely to report combustion and topicals but less likely to report ingestion as primary methods for recreational use than recreational-only users (P < 0.041). A higher proportion of dual-purpose users (82.82%) used more than one method than medical-only (40.52%) and recreational-only users (63.91%) (P < 0.001). For both medical and recreational purposes, RCL states had the lowest rate of combustion and the highest rates of ingestion and topicals reported as primary methods (P < 0.033). The rate of using more than one administration method did not differ across states (P > 0.05). CONCLUSION Cannabis users whose purposes are medical, recreational or both tend to differ in their selected administration methods.
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Affiliation(s)
- Yuyan Shi
- Herbert Wertheim School of Public Health and Human Longevity Science University of California San Diego La Jolla CA USA
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16
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Spillane TE, Wong BA, Giovenco DP. Content analysis of instagram posts by leading cannabis vaporizer brands. Drug Alcohol Depend 2021; 218:108353. [PMID: 33109462 PMCID: PMC7750198 DOI: 10.1016/j.drugalcdep.2020.108353] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Cannabis vaporizer companies leverage social media to market their products, but little is known about the content of the messages being delivered to consumers. This study describes characteristics of Instagram posts from three popular cannabis vaporizer brands in the U.S. METHODS A content analysis was performed on posts uploaded between October 2017 and October 2018 by the brands Kandypens (n = 731), G Pen (n = 454), and Pax (n = 71). Posts were coded for: characteristics of individuals pictured, health and risk statements, references to cannabis, co-marketing activities, cartoon images, and product price. Descriptive statistics highlight the prevalence of these characteristics and between-brand differences. RESULTS Posts had a wide reach, with a total of 467,700 followers across brands. Two-thirds (68.0 %) of posts depicted someone using the product. Among posts featuring a person, (83.9 %) depicted female users. Overall, cannabis was rarely mentioned (8.9 %) or depicted (10.0 %) in posts. "Tagging" social media influencers (34.3 % of posts) and other companies or their products (31.9 % of posts) were popular promotional strategies. Few posts mentioned age restrictions (0.3 %), health risks (5.2 %), or health benefits (0.2 %). CONCLUSIONS Cannabis vaporizer companies reach thousands of consumers through brand-owned social media accounts. Strategies to promote their products on these channels include posts that may appeal to sociodemographic groups and leveraging social media influencers and other companies to increase overall reach. As legalized recreational cannabis expands and a range of consumption methods become popular, an understanding of brands' social media marketing practices is needed to inform policies and interventions that promote population health.
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Affiliation(s)
- Torra E Spillane
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 W 168th St, New York, NY 10032, United States.
| | - Bryce A Wong
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 W 168th St, New York, NY 10032, United States.
| | - Daniel P Giovenco
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 W 168th St, New York, NY 10032, United States.
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17
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Gunn RL, Aston ER, Sokolovsky AW, White HR, Jackson KM. Complex cannabis use patterns: Associations with cannabis consequences and cannabis use disorder symptomatology. Addict Behav 2020; 105:106329. [PMID: 32044680 DOI: 10.1016/j.addbeh.2020.106329] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/23/2020] [Accepted: 01/26/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Historically, cannabis researchers have assumed a single mode and product of cannabis (e.g., smoking plant). However, patterns of use, products (e.g., concentrates, edibles), and modes (e.g. blunts, vaporizers) are diversifying. This study sought to: 1) classify cannabis users into groups based on their use of the full range of cannabis products, and 2) examine user group differences on demographics, cannabis consequences and cannabis use disorder (CUD) symptomatology. METHODS In a sample of college students (data collected in Fall 2017), who used cannabis in the past year (N = 1390), latent class analysis (LCA) was used to characterize cannabis users. We then added demographic characteristics, cannabis consequences, and CUD symptomatology scores separately to LCA models to examine class differences. RESULTS Five unique classes emerged: high-frequency all-product users, high-frequency plant/moderate-frequency edible and concentrate users, low-frequency plant users, moderate-frequency plant and edible users, and low-frequency edible users. Demographic characteristics, cannabis consequences, and CUD symptomatology differed across classes characterized by frequency as well as product. CONCLUSIONS Results reflect the increasing variety of cannabis products, modes, and use patterns among college students. In this sample, frequency of use remains a strong predictor of cannabis-related consequences, in addition to type of product. As variation in cannabis use patterns continue to evolve, it is essential for researchers to conduct comprehensive assessments.
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Affiliation(s)
- Rachel L Gunn
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02903, United States.
| | - Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02903, United States
| | - Alexander W Sokolovsky
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02903, United States
| | - Helene R White
- Center of Alcohol Studies, Rutgers, the State University of NJ, Piscataway, NJ 08854, United States
| | - Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02903, United States
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18
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Kastaun S, Hildebrandt J, Kotz D. Electronic Cigarettes to Vaporize Cannabis: Prevalence of Use and Associated Factors among Current Electronic Cigarette Users in Germany (DEBRA Study). Subst Use Misuse 2020; 55:1106-1112. [PMID: 32091941 DOI: 10.1080/10826084.2020.1729197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: In Germany, cannabis is the most widely used illicit drug, and inhalation together with tobacco is most popular. However, it has been described that electronic cigarettes (ECs) are being used to vaporize cannabis (extract). No current data on EC cannabis use in the German population are yet available. Objectives: This study examines the prevalence of EC cannabis consumption for mood changing effects among current EC users, and associated consumer characteristics in Germany. Methods: We used data from the German Study on Tobacco Use (period: 8/2016-01/2019, DEBRA, www.debra-study.info), a nationally representative household survey. EC cannabis use for mood-changing effects was assessed in 504 current EC users (aged ≥ 18 years) of the total sample (N = 32,678). Ever use was defined by: (1) occasional or regular use, or (2) experimental consumption. Associations with socio-demographic consumer characteristics and tobacco smoking were analyzed using multivariable regression analyses. Results: Amongst current EC users, 7.2% had ever vaporized cannabis: 2.3% (95%CI = 1.2-3.9) reported occasional or regular use (1) and 4.8% (95%CI = 3.2-7.1) reported experimental use (2). Age was associated with ever EC cannabis use: highest prevalence rates were found among 18-24-year-olds: 6.5% (95%CI = 2.3-13.1) (1) and 8.0% (95%CI = 3.7-15.8) (2), respectively. The majority (90.2%) of ever EC cannabis users were current tobacco smokers. Conclusions: One in 14 current EC users in Germany has ever vaporized cannabis for mood-changing reasons, and almost all EC cannabis consumers also smoke tobacco. Highest usage rates can be observed among young adults. Hence, trends of EC drug misuse need to be monitored consequently, particularly in young people.
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Affiliation(s)
- Sabrina Kastaun
- Medical Faculty of the Heinrich-Heine-University Düsseldorf, Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Düsseldorf, Germany
| | - Jaqueline Hildebrandt
- Medical Faculty of the Heinrich-Heine-University Düsseldorf, Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Düsseldorf, Germany
| | - Daniel Kotz
- Medical Faculty of the Heinrich-Heine-University Düsseldorf, Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Düsseldorf, Germany.,Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
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19
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Vilches JR, Taylor MB, Filbey FM. A Multiple Correspondence Analysis of Patterns of CBD Use in Hemp and Marijuana Users. Front Psychiatry 2020; 11:624012. [PMID: 33519562 PMCID: PMC7840961 DOI: 10.3389/fpsyt.2020.624012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
Background: With the passing of the 2018 Agriculture Improvement Act that legalized hemp-derived products, i.e., cannabidiol (CBD), the use of CBD has increased exponentially. To date, the few studies that have characterized individuals who use CBD suggest that co-use of CBD and tetrahydrocannabinol (THC)-dominant cannabis, i.e., marijuana, is highly prevalent. It is, therefore, important to investigate the relationship between CBD use and marijuana use to understand the antecedents and consequences of co-use of these two cannabis products. Methods: We conducted an online survey using structured questionnaires to determine differences in CBD users with (CBD+MJ) and without co-morbid marijuana use. Group comparisons were carried out using chi-square tests and ANOVA. Multiple correspondence analysis (MCA) with bootstrap ratio testing was performed to examine the relationship between the categorical data. Results: We received 182 survey responses from current CBD users. CBD+MJ had more types of CBD administration (F = 17.07, p < 0.001) and longer lifetime duration of CBD use (χ2 = 12.85, p < 0.05). Results from the MCA yielded two statistically significant dimensions that accounted for 77% of the total variance. Dimension 1 (representing 57% of the variance) associated CBD+MJ with indication of CBD use for medical ailments, use of CBD for more than once a day for longer than 2 years, applying CBD topically or consuming it via vaping or edibles, being female, and, having lower educational attainment. Dimension 2 (representing 20% of the variance) separated the groups primarily on smoking-related behaviors where CBD+MJ was associated with smoking CBD and nicotine. Conclusions: Identifying the factors that influence use of CBD and marijuana can inform future studies on the risks and benefits associated with each substance as well as the impacts of policies related to cannabis-based products.
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Affiliation(s)
- Joseph R Vilches
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, United States.,Department of Psychology, University of North Texas, Denton, TX, United States
| | - Mackenzie B Taylor
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, United States
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, United States
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20
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Trivers KF, Gentzke AS, Phillips E, Tynan M, Marynak KL, Schauer GL. Substances used in electronic vapor products among adults in the United States, 2017. Addict Behav Rep 2019; 10:100222. [PMID: 31828201 PMCID: PMC6888746 DOI: 10.1016/j.abrep.2019.100222] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 12/31/2022] Open
Abstract
Electronic vapor products are used by adults for a variety of substances. Nicotine was the most commonly reported substance used in electronic vapor products. Many adults also use these devices for flavors and marijuana. Adults younger than 30 years and females were more likely to report flavor use.
Introduction Electronic vapor products (EVPs), including e-cigarettes, can be used to aerosolize many substances. Examination of substances used in EVPs by US adults has been limited; we assessed past-year use of EVPs to deliver various substances. Methods Data came from the 2017 SummerStyles Survey, a web-based survey of US adults (N = 4107). Ever EVP users were asked if they had used nicotine, marijuana, flavors or “something else” in an EVP during the past year. Weighted estimates for any, exclusive, and combined EVP substance use were calculated among ever (n = 586) and current (past 30-day; n = 121) EVP users. Results Past-year use of nicotine, flavors, and marijuana in EVPs was 30.7%, 23.6%, and 12.5% among ever EVP users, respectively; and 72.3%, 54.6%, and 17.8% among current EVP users. Among ever EVP users, the most commonly used substances were nicotine only (29.6%), nicotine plus flavors (27.2%), flavors only (16.4%), and marijuana only (14.9%). Among current EVP users, the most common substances used were nicotine plus flavors (39.1%), nicotine only (29.6%), and flavors only (11.2%). Among ever users, males and 18–29 year olds were more likely to report use of flavors than females and respondents ≥30 years. Conclusions Approximately 7 in 10 current EVP users reported nicotine use, about 1 in 2 used flavors, and nearly 1 in 6 used marijuana. These findings suggest that EVPs are used to consume a variety of substances and could guide efforts to address tobacco and non-tobacco substance use.
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Affiliation(s)
- Katrina F Trivers
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Andrea S Gentzke
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Elyse Phillips
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Michael Tynan
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Gillian L Schauer
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, United States.,McKing Consulting, Atlanta, GA, United States
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21
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Mercurio A, Aston ER, Claborn KR, Waye K, Rosen RK. Marijuana as a Substitute for Prescription Medications: A Qualitative Study. Subst Use Misuse 2019; 54:1894-1902. [PMID: 31179810 PMCID: PMC6625880 DOI: 10.1080/10826084.2019.1618336] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background: Over the past few decades in the United States, marijuana for medical purposes has become increasingly prevalent. Initial qualitative and epidemiological research suggests that marijuana may be a promising substitute for traditional pharmacotherapies. Objectives: This qualitative study examined perceptions relating to (1) using medical marijuana in comparison to other prescription medications and (2) user perception of policy issues that limit adoption of medical marijuana use. Methods: Qualitative interviews were conducted with Rhode Island medical marijuana card holders (N = 25). The interviews followed a semi-structured agenda designed to collect information from participants about their reasons for, and perceptions of, medical marijuana use. All interviews were audio recorded, transcribed verbatim, and de-identified. Qualitative codes were developed from the agenda and emergent topics raised by the participants. Results: Three themes emerged related to medical marijuana use, including (1) comparison of medical marijuana to other medications (i.e., better and/or fewer side effects than prescription medications, improves quality of life), (2) substitution of marijuana for other medications (i.e., in addition to or instead of), and (3) how perception of medical marijuana policy impacts use (i.e., stigma, travel, cost, and lack of instruction regarding use). Conclusions: Several factors prevent pervasive medical marijuana use, including stigma, cost, and the inability for healthcare providers to relay instructions regarding dosing, strain, and method of use. Findings suggest that medical patients consider marijuana to be a viable alternative for opioids and other prescription medications, though certain policy barriers inhibit widespread implementation of marijuana as a treatment option.
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Affiliation(s)
- Alana Mercurio
- a Center for Alcohol and Addiction Studies , Brown University School of Public Health , Providence , Rhode Island , USA.,b Brown University School of Public Health , Providence , Rhode Island , USA
| | - Elizabeth R Aston
- a Center for Alcohol and Addiction Studies , Brown University School of Public Health , Providence , Rhode Island , USA.,c Department of Behavioral and Social Sciences , Brown University School of Public Heath , Providence , Rhode Island , USA
| | - Kasey R Claborn
- d Department of Psychiatry , University of Texas at Austin Dell Medical School , Austin , Texas , USA
| | - Katherine Waye
- b Brown University School of Public Health , Providence , Rhode Island , USA
| | - Rochelle K Rosen
- c Department of Behavioral and Social Sciences , Brown University School of Public Heath , Providence , Rhode Island , USA
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