Andrea H Weinberger1,2, Cristine D Delnevo3, Katarzyna Wyka4, Misato Gbedemah4,5, Joun Lee1, Jan Copeland6, Renee D Goodwin4,5,7. 1. Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA. 2. Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA. 3. Center for Tobacco Studies, School of Public Health, Rutgers University, New Brunswick, NJ, USA. 4. Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA. 5. Institute for Implementation Science in Population Health, The City University of New York, New York, NY, USA. 6. National Cannabis Prevention and Information Centre, University of New South Wales, Sydney, NSW, Australia. 7. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Abstract
INTRODUCTION: Despite increasing use of cannabis, it is unclear how cannabis use is related to cigarette transitions. This study examined cannabis use and smoking initiation, persistence, and relapse over one year among a nationally representative sample of United States (US) adults. METHODS: Data were from US adults (18+) who completed two waves of longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study (Wave 1, 2013-2014; Wave 2, 2014-2015; n=26,341). Logistic regression models were used to calculate the risk of Wave 2 incident smoking among Wave 1 never smokers, smoking cessation among Wave 1 smokers, and smoking relapse among Wave 1 former smokers by Wave 1 cannabis use. Analyses were adjusted for age, gender, race/ethnicity, income, and education. RESULTS: Among Wave 1 never smokers, cannabis use was associated with increased odds of initiation of non-daily (adjusted odds ratio (AOR)=5.50, 95% confidence limits (CL)= 4.02-7.55) and daily cigarette smoking (AOR=6.70, 95% CL=4.75-9.46) one year later. Among Wave 1 daily smokers, cannabis use was associated with reduced odds of smoking cessation (AOR=0.36, 95% CL=0.20-0.65). Among Wave 1 former smokers, cannabis use was associated with increased odds of relapse to daily and non-daily cigarette smoking (daily AOR=1.90, 95% CL=1.11-3.26; non-daily AOR=2.33, 95% CL=1.61-3.39). CONCLUSIONS: Cannabis use was associated with increased cigarette smoking initiation, decreased smoking cessation, and increased smoking relapse among adults in the US. Increased public education about the relationship between cannabis use and cigarette smoking transitions may be needed as cannabis use becomes more common among US adults. IMPLICATIONS: As cannabis use increases in the US and other countries, an evaluation of the relationships of cannabis use to other health-related behaviors (e.g., cigarette smoking) is needed to understand the population-level impact of legalization. Little is known about associations between cannabis use and cigarette smoking transitions (1) using recent longitudinal data, (2) among adults, and (3) examining transitions other than smoking initiation (e.g., smoking relapse). Our results suggest that among US adults, cannabis use was associated with increased cigarette smoking initiation among never smokers, decreased cigarette smoking cessation among current smokers, and increased cigarette smoking relapse among former smokers.
INTRODUCTION: Despite increasing use of cannabis, it is unclear how cannabis use is related to cigarette transitions. This study examined cannabis use and smoking initiation, persistence, and relapse over one year among a nationally representative sample of United States (US) adults. METHODS: Data were from US adults (18+) who completed two waves of longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study (Wave 1, 2013-2014; Wave 2, 2014-2015; n=26,341). Logistic regression models were used to calculate the risk of Wave 2 incident smoking among Wave 1 never smokers, smoking cessation among Wave 1 smokers, and smoking relapse among Wave 1 former smokers by Wave 1 cannabis use. Analyses were adjusted for age, gender, race/ethnicity, income, and education. RESULTS: Among Wave 1 never smokers, cannabis use was associated with increased odds of initiation of non-daily (adjusted odds ratio (AOR)=5.50, 95% confidence limits (CL)= 4.02-7.55) and daily cigarette smoking (AOR=6.70, 95% CL=4.75-9.46) one year later. Among Wave 1 daily smokers, cannabis use was associated with reduced odds of smoking cessation (AOR=0.36, 95% CL=0.20-0.65). Among Wave 1 former smokers, cannabis use was associated with increased odds of relapse to daily and non-daily cigarette smoking (daily AOR=1.90, 95% CL=1.11-3.26; non-daily AOR=2.33, 95% CL=1.61-3.39). CONCLUSIONS: Cannabis use was associated with increased cigarette smoking initiation, decreased smoking cessation, and increased smoking relapse among adults in the US. Increased public education about the relationship between cannabis use and cigarette smoking transitions may be needed as cannabis use becomes more common among US adults. IMPLICATIONS: As cannabis use increases in the US and other countries, an evaluation of the relationships of cannabis use to other health-related behaviors (e.g., cigarette smoking) is needed to understand the population-level impact of legalization. Little is known about associations between cannabis use and cigarette smoking transitions (1) using recent longitudinal data, (2) among adults, and (3) examining transitions other than smoking initiation (e.g., smoking relapse). Our results suggest that among US adults, cannabis use was associated with increased cigarette smoking initiation among never smokers, decreased cigarette smoking cessation among current smokers, and increased cigarette smoking relapse among former smokers.
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