Sifting through the weeds: Relationships between cannabis use frequency measures and delay discounting

Estimating THC Consumption from Smoked and Vaped Cannabis Products in an Online Survey of Adults Who Use Cannabis

Introduction: Quantification of consumption patterns of the primary psychoactive compounds in cannabis, which cause euphoria or intoxication, is sorely needed to identify potential risks and benefits of use and to provide meaningful safety information to the public. The diversity of products available, multiple methods of administration, and lack of labeling of products have made such quantification challenging. Our group is developing a survey instrument for estimating the quantity of delta 9-tetrahydrocannabinol (THC) consumed in population samples, which is flexible and incorporates individualized reports of patterns of consumption. This study provides an illustration of a procedure for translating self-reported consumption into milligrams of THC (mgTHC), which may serve as a working model for future quantification efforts. Methods: Social media advertising was leveraged to enroll 5627 adults who use cannabis into an online, anonymous survey study. Only those who used cannabis in the past 7 days, used flower or concentrate products, and who chose to report their quantity of use in hits per day or grams per week (n=3211) were included in this report. Formulas were used to estimate mgTHC used per day, in hits per day or grams per week; potency (%THC); constants for estimating the amount of material consumed for each hit; and a method of administration efficiency constant to account for THC loss due to the administration method. Results: The estimate for mgTHC used per day was M=92.8 mg/day (SD=97.2 mg; 1st-3rd quartile range=25-132 mg). The estimated quantity of use was much lower for those reporting in hits (M=43.7 mg, SD=43.8) than for those reporting in grams (M=115.1 mg, SD=107.0). The estimated rate of binge use in the past week, arbitrarily defined as more than 50 mgTHC within any one daily time quadrant, was 6.8%, which increased to 29.3% if 25 mgTHC was used. Conclusions: The approach illustrated in this study goes beyond existing cannabis measures by asking participants to provide highly detailed estimates of their past 7-day use patterns and then applying a logical formula to translate this information into mgTHC. This initial procedure has limitations and lacks generalization; however, we hope this demonstration stimulates testing of similar approaches and relevant laboratory experiments that will enhance the validity of cannabis consumption estimation procedures.

Smoking Dependence, Time-Discounting, and Sustained Cessation Behavior: A Longitudinal Study of Predominantly Light Smokers

INTRODUCTION

This study aimed to assess whether two established psychosocial predictors of smoking abstinence, nicotine dependence and time-discounting, also apply to a population of predominantly cigarette light smokers, which is the dominant pattern of smoking in countries like Mexico. Relatively infrequent smoking is increasingly prevalent, yet still harmful, making it important to understand the predictors of cessation in this population.

AIMS AND METHODS

Mexican adult smokers recruited from an online consumer panel were surveyed every 4 months between November 2018 and July 2020. We considered respondents who reported a quit attempt in between surveys (n = 1288). Dependence was measured with a 10-item version of the Wisconsin Inventory of Smoking Dependence Motives (WISDM). Time-discounting was assessed with five branching questions about hypothetical reward scenarios. Logistic models regressed sustained quit attempts (≥30 days of abstinence) at time t + 1 on study variables at time t.

RESULTS

We found strong interitem reliability (α = 0.92) and intraindividual consistency of our brief WISDM (ρ = 0.68), but moderate intraindividual consistency of the time-discounting measure (ρ = 0.48). Forty-eight percent of the sample reported sustained quit attempts, and 79% were non-daily or light daily smokers (≤5 cigarettes per day). Smokers with higher WISDM-10 had lower odds of sustained quitting and this result remained when controlling for smoking frequency and the Heaviness of Smoking Index (adjusted odds ratio [AOR] = 0.768). Time-discounting was unassociated with sustained quitting.

CONCLUSIONS

Our findings suggest that a brief, 10-item multidimensional measure of dependence is useful for predicting sustained quitting in a context of relatively light smoking; time-discounting appears less relevant, although our results are not conclusive because of the low test-retest reliability of our measure.

IMPLICATIONS

Given the increase in non-daily and light daily cigarette smoking in many countries, including in Mexico, and the health risks this still poses, it is important to understand the predictors of cessation among relatively light smokers. The WISDM-10 multidimensional measure seems to be a good instrument to assess dependence and predict successful quitting in this population, and possibly more appropriate than physical dependence measures. As such, it could help design and target more suitable cessation treatments for non-daily and daily light cigarette smokers. While this study did not find time-discounting to be a relevant predictor of smoking abstinence, future studies should explore other measures.

Australian daily cannabis users' use of police avoidance strategies and compensatory behaviours to manage the risks of drug driving

INTRODUCTION

Daily use of cannabis is increasing in Australia, yet there is limited understanding of the driving behaviours within this cohort, including how they perceive and manage the risks of being apprehended for drug driving and involved in a crash after consumption.

METHODS

An online survey was completed by 487 Australians who reported daily cannabis use (30% medically prescribed patients, 58% male).

RESULTS

Current drug driving (i.e., driving within 4 h of consuming cannabis each week) was reported by 86% of participants. Future drug driving was anticipated by 92% of the sample. While most participants (93%) disagreed that their risk of crash increased following cannabis use, participants reported that they would drive more carefully (89%), leave greater headway (79%) and/or drive slower (51%) following cannabis consumption. Half of the sample (53%) perceived the risk of apprehension for drug driving to be likely to some extent. Strategies to reduce the likelihood of being detected were used by 25% of participants, and included using Facebook police location sites (16%), driving on back roads (6%) and/or consuming substances to mask the presence of drugs (13%). The regression analysis revealed that individuals who reported more occasions of cannabis use per day, and who perceived that cannabis does not reduce driving ability, reported a greater extent of current drug driving.

DISCUSSION AND CONCLUSIONS

Interventions and education which aim to challenge this perception that 'cannabis does not reduce driving ability' may prove important for reducing drug driving among the most frequent consumers of cannabis.

The Effects of Cannabis Use Frequency and Episodic Specificity Training on the Recall of Specific and Rewarding Events

Background: Growing evidence implicates subjective episodic memory, the retrieval of detailed, integrated, and personally relevant past events, as a marker of cognitive vulnerability in mental disorders. Frequent and problematic cannabis use is associated with deficits in objective episodic memory (verbal memory), but the relationship between subjective episodic memory deficits and frequency of cannabis use is unknown. Further, whether a brief intervention designed to enhance the specificity of event retrieval, such as the Episodic Specificity Induction (ESI), might effectively target such deficits among regular cannabis users is unexamined. This study was designed to examine subjective episodic memory as a potential marker of cognitive vulnerability among frequent cannabis users. Methods: Active cannabis users (n = 133) recruited from Amazon Mechanical Turk or Qualtrics Panels were randomized to receive an ESI-control or ESI session and were separated into those who used cannabis 1-25 days in the past month (low to moderate frequency group) and those who used 26-30 days (high frequency group), which facilitated a low to moderate use/ESI-control group (n = 78), low to moderate use/ESI group (n =15), high-use/ESI-control group (n = 20), and high-use/ESI group (n = 20). Following the ESI or ESI-control intervention, participants selected four, positive events from the prior day, described the who, what, and where of the events, and rated how specific (vividness) and rewarding (enjoyable, importance, and exciting) each event was on a 0-100 scale. Four two-way ANCOVAs (demographics and problematic cannabis use covariates) were performed to examine the effects of frequency of cannabis use group and ESI group on the specificity and reward ratings. Results: Lower vividness and excitement ratings were reported for those with high relative to low to moderate cannabis use frequency patterns (p < 0.05). Those who received ESI reported greater vividness, excitement, and importance ratings than the ESI-control group (p < 0.01). No significant interactions between frequency and ESI were found. Conclusion: Findings from the current exploratory study provide initial evidence suggesting that more frequent cannabis use may be associated with the retrieval of less specific and rewarding events relative to less frequent users. Further, ESI may improve such deficits. Future studies that recruit larger and more clinically serious samples of cannabis users appear warranted.