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Woloshchuk CJ, Carlos Portillo, Lerma M, Villegas D, Fregoso R, Posada E, Torres J, Frietze GA, Cooper TV. Characteristics associated with marijuana use in Latinx college students. J Ethn Subst Abuse 2020; 21:923-938. [PMID: 32857681 DOI: 10.1080/15332640.2020.1808872] [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: 10/23/2022]
Abstract
While marijuana use rates are significantly high within college students, less is known about use patterns and correlates in Latinx groups. This study assessed the relationships between ever use and frequency of use of marijuana, polysubstance use, expectancies, motives, and mental illness symptoms among Latinx college students (n = 345). Results indicated more frequent marijuana use was positively associated with: enjoyment, celebration, social anxiety, low risk, sleep and availability and was negatively associated with: experimentation, boredom, altered perception, and anxiety. Other dual use with tobacco expectancies were also observed. These constructs should be explored prospectively and inform prevention and intervention efforts.
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Affiliation(s)
- Claudia J Woloshchuk
- Prevention and Treatment of Clinical Health Laboratory Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
| | - Carlos Portillo
- Prevention and Treatment of Clinical Health Laboratory Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
| | - Marcos Lerma
- Prevention and Treatment of Clinical Health Laboratory Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
| | - Diana Villegas
- Prevention and Treatment of Clinical Health Laboratory Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
| | - Roman Fregoso
- Prevention and Treatment of Clinical Health Laboratory Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
| | - Emilio Posada
- Prevention and Treatment of Clinical Health Laboratory Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
| | - Joshua Torres
- Prevention and Treatment of Clinical Health Laboratory Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
| | - Gabriel A Frietze
- School of Pharmacy, The University of Texas at El Paso, El Paso, TX, USA
| | - Theodore V Cooper
- Prevention and Treatment of Clinical Health Laboratory Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
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Doran N, Myers MG, Correa J, Strong DR, Tully L, Pulvers K. Marijuana use among young adult non-daily cigarette smokers over time. Addict Behav 2019; 95:91-97. [PMID: 30875533 DOI: 10.1016/j.addbeh.2019.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 01/15/2023]
Abstract
Recent data regarding growth in concurrent use of nicotine and marijuana have raised concern that reductions in legal restrictions on marijuana use may increase risk for tobacco-related harms. Previous studies have shown cross-sectional links between use of both substances, but less is known about associations over time. The goal of the present study was to test the hypothesis that there is a bidirectional relationship between use of marijuana and use of tobacco products over time, such that increasing use of either substance would predict increasing use of the other. Participants (n = 391, 52% male) were 18-24 year-old Californians who were non-daily cigarette smokers at enrollment and had never been daily smokers. They reported nicotine/tobacco and marijuana use quarterly over 2 years. Longitudinal negative binomial and logistic regression models indicated that each additional timepoint at which participants reported recent marijuana use predicted 9-11% increases in tobacco quantity and frequency. Additionally, each additional timepoint at which cigarette or tobacco use was reported predicted 19-22% greater marijuana frequency. Data suggest that young adults who use marijuana more frequently are likely at risk for greater tobacco exposure, and vice versa. These findings suggest a need for preventive measures that focus on concurrent use of both substances rather than either individually.
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Akbar SA, Tomko RL, Salazar CA, Squeglia LM, McClure EA. Tobacco and cannabis co-use and interrelatedness among adults. Addict Behav 2019; 90:354-361. [PMID: 30522075 DOI: 10.1016/j.addbeh.2018.11.036] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/05/2018] [Accepted: 11/24/2018] [Indexed: 10/27/2022]
Abstract
Cannabis and tobacco co-use is prevalent, but consensus regarding the reasons for co-use among adults and the degree of interrelatedness between these substances is lacking. Reasons for co-use have been explored with younger users, but little data exists for more experienced users with entrenched patterns of co-use. The goal of this study was to examine characteristics and patterns of cannabis-tobacco co-use among adults in the Southeastern United States (US), where there is a legal landscape of generally restrictive cannabis legislation coupled with more permissive tobacco control compared to other US regions. Participants (N = 432) were regular cannabis users recruited through Amazon Mechanical Turk. Measures included demographics, patterns of cannabis and tobacco use, and reasons for co-use. Within this sample, 42% were current users of tobacco (n = 182). Cannabis-tobacco co-users were older and had more years of cannabis use than cannabis-only users. Among the co-using sub-sample, there was little consistency in the reasons for co-use, suggesting individual differences in the use of both substances. High levels of cannabis-tobacco interrelatedness (i.e., temporally concurrent use) were associated with smoking more cigarettes (tobacco) per day and greater nicotine dependence scores when compared to users with low levels of interrelatedness. Though these results are limited by a small sample size and generalizability issues, there were individual differences in cannabis-tobacco relatedness, which may be of importance when considering treatment strategies for cannabis, tobacco, or both. With additional research, personalized strategies adapted to cannabis-tobacco relatedness profiles among co-users may be warranted as a treatment strategy.
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Seaman EL, Howard DE, Green KM, Wang MQ, Fryer CS. A Sequential Explanatory Mixed Methods Study of Young Adult Tobacco and Marijuana Co-Use. Subst Use Misuse 2019; 54:2177-2190. [PMID: 31328616 DOI: 10.1080/10826084.2019.1638409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The co-occurring use of tobacco and marijuana among young adults is an important behavioral phenomenon within the field of substance use. Studying tobacco and marijuana use together among young adults can provide important insight into patterns of initiation and continuation. Objectives: The primary goal of this study was to examine characteristics associated with co-use among young adults and to discover the ways experiences of co-users can help contextualize trends in co-use. Methods: This study employed a sequential explanatory mixed methods design. Quantitative analyses used 12 years of nationally representative National Health and Nutrition Examination Survey (NHANES) data (2005-2016) to assess the characteristics and experiences of young adult (21-30) co-users. Results from analyses of NHANES, prior literature, and theoretical constructs were used to develop a guide for 20 in-depth, semi-structured interviews with young adult co-users living in the state of Maryland. Interviews were analyzed using thematic analysis. Quantitative results and qualitative findings were integrated. The original NHANES analysis occurred during October and November 2017, interviews took place during December 2017 and January 2018, and all mixed methods integration was conducted in 2018. Results: Tobacco and marijuana co-users have unique characteristics and experiences compared to single product users; the experiences of co-users can offer unique insights on co-use. Meta-inferences emerged from integration. Conclusions/importance: Co-users conceptualize tobacco and marijuana differently and hold different risk perceptions for each substance. Co-users may be at risk for polytobacco product use. These findings highlight the profound influence these two substances have on young adult co-users' experiences and behaviors.
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Affiliation(s)
- Elizabeth L Seaman
- Department of Behavioral and Community Health, University of Maryland , College Park , Maryland , USA
| | - Donna E Howard
- Department of Behavioral and Community Health, University of Maryland , College Park , Maryland , USA
| | - Kerry M Green
- Department of Behavioral and Community Health, University of Maryland , College Park , Maryland , USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, University of Maryland , College Park , Maryland , USA
| | - Craig S Fryer
- Department of Behavioral and Community Health, University of Maryland , College Park , Maryland , USA
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Dierker L, Braymiller J, Rose J, Goodwin R, Selya A. Nicotine dependence predicts cannabis use disorder symptoms among adolescents and young adults. Drug Alcohol Depend 2018; 187:212-220. [PMID: 29680677 PMCID: PMC5959804 DOI: 10.1016/j.drugalcdep.2018.02.037] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE We evaluate if cigarette smoking and/or nicotine dependence predicts cannabis use disorder symptoms among adolescent and young adult cannabis users and whether the relationships differ based on frequency of cannabis use. METHODS Data were drawn from seven annual surveys of the NSDUH to include adolescents and young adults (age 12-21) who reported using cannabis at least once in the past 30 days (n = 21,928). Cannabis use frequency trends in the association between cigarette smoking, nicotine dependence and cannabis use disorder symptoms were assessed using Varying Coefficient Models (VCM's). RESULTS Over half of current cannabis users also smoked cigarettes in the past 30 days (54.7% SE 0.48). Cigarette smoking in the past 30 days was associated with earlier onset of cannabis use, more frequent cannabis use and a larger number of cannabis use disorder symptoms compared to those who did not smoke cigarettes. After statistical control for socio-demographic characteristics and other substance use behaviors, nicotine dependence but not cigarette smoking quantity or frequency was positively and significantly associated with each of the cannabis use disorder symptoms as well as the total number of cannabis symptoms endorsed. Higher nicotine dependence scores were consistently associated with the cannabis use disorder symptoms across all levels of cannabis use from 1 day used (past month) to daily cannabis use, though the relationship was strongest among infrequent cannabis users. CONCLUSION Prevention and treatment efforts should consider cigarette smoking comorbidity when addressing the increasing proportion of the US population that uses cannabis.
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Affiliation(s)
- Lisa Dierker
- Psychology Department, Wesleyan University, United States.
| | | | | | - Renee Goodwin
- Department of Psychology, Queens College and the Graduate Center, City University of New York (CUNY),Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Arielle Selya
- Department of Population Health, University of North Dakota
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Abstract
Objective In this study, we examined: (1) differences among never, current, and former young adult marijuana users; and (2) reasons for use and cessation. Methods We conducted interviews with 57 young adults (including 46 marijuana users) enrolled in a longitudinal study of 3418 young adults and a survey in this cohort (N = 2866). Participants reporting former but not current use on the survey (N = 607) completed the Reasons for Marijuana Cessation section. Results Interview data indicated reasons for initiating (or not initiating) use, continued use, and quitting. The Reasons for Marijuana Cessation scale included 2 factors: (1) Instrumentality and 2) Social/Legal reasons. Conclusions These findings might inform theoretical frameworks upon which marijuana cessation occurs and direct future intervention studies.
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Strong DR, Myers MG, Pulvers K, Noble M, Brikmanis K, Doran N. Marijuana use among US tobacco users: Findings from wave 1 of the population assessment of tobacco health (PATH) study. Drug Alcohol Depend 2018. [PMID: 29529455 DOI: 10.1016/j.drugalcdep.2017.12.044] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND With an increase in marijuana use among adults in the United States (US), understanding the potential impact of marijuana use on tobacco use and associated behavioral and health consequences, including respiratory conditions, is necessary. METHOD Survey responses from Wave 1 of the nationally representative Population Assessment of Tobacco and Health (PATH) Study were used to assess tobacco use and marijuana use among non-current tobacco users (n = 17,952) and current established tobacco-users classified as: cigarette only users (n = 8689), e-cigarette only users (n = 437), cigar only (traditional, cigarillo, or filtered) users (n = 706), hookah only users (n = 461), smokeless tobacco only users (n = 971), cigarette + e-cigarette users (n = 709), and users of multiple tobacco products (n = 2314). RESULTS When compared to non-current tobacco users, each tobacco user group except smokeless only users had higher odds (odds ratios ranging from 3.86-8.07) of reporting current marijuana use. Among current tobacco users, higher levels of tobacco dependence did not explain the relationship between tobacco use and marijuana use. Additionally, concurrent marijuana use was associated with lower odds of attempts to quit tobacco (OR = 0.86, 95% CI = 0.79, 0.94, p < 0.001) and a higher probability (OR = 1.35, 95CI = 1.21, 1.51, p < 0.01) of reporting a history of respiratory disease. CONCLUSIONS The association between concurrent use of tobacco and marijuana and higher tobacco dependence and lower rates of quit attempts suggests the potential for sustained tobacco use and deleterious health effects. Further, marijuana use may represent an additive risk for respiratory harm among concurrent users of tobacco and marijuana.
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Affiliation(s)
- David R Strong
- Cancer Prevention and Control Program, Moores Cancer Center, University of California, 9500 Gilman Dr., La Jolla, CA, 92093-0631, USA; Department of Family Medicine and Public Health, University of California, 9500 Gilman Dr., La Jolla, CA, 92093-0631, USA.
| | - Mark G Myers
- Department of Psychiatry, University of California, 9500 Gilman Dr., La Jolla, CA, 92093-0631, USA; VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA, 92161, USA
| | - Kim Pulvers
- Department of Psychology, California State University, 333 S. Twin Oaks Valley Rd., San Marcos, CA, 92096, USA
| | - Madison Noble
- Cancer Prevention and Control Program, Moores Cancer Center, University of California, 9500 Gilman Dr., La Jolla, CA, 92093-0631, USA; Department of Family Medicine and Public Health, University of California, 9500 Gilman Dr., La Jolla, CA, 92093-0631, USA
| | - Kristin Brikmanis
- Department of Psychiatry, University of California, 9500 Gilman Dr., La Jolla, CA, 92093-0631, USA; VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA, 92161, USA
| | - Neal Doran
- Department of Psychiatry, University of California, 9500 Gilman Dr., La Jolla, CA, 92093-0631, USA; VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA, 92161, USA
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Berg CJ, Payne J, Henriksen L, Cavazos-Rehg P, Getachew B, Schauer GL, Haardörfer R. Reasons for Marijuana and Tobacco Co-use Among Young Adults: A Mixed Methods Scale Development Study. Subst Use Misuse 2018; 53:357-369. [PMID: 28792283 PMCID: PMC5890801 DOI: 10.1080/10826084.2017.1327978] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Marijuana-tobacco co-use has increased recently, particularly in young adults. OBJECTIVES We conducted a mixed-methods study to: (1) examine reasons for co-use; and (2) develop a scale assessing reasons for co-use among participants in a longitudinal cohort study of 3,418 students aged 18-25 from 7 Georgia colleges and universities. METHODS Phone-based semi-structured interviews were conducted in Summer 2015 among 46 current (past 30-day, n = 26) or lifetime (n = 20) marijuana users. Subsequently, scale items were developed and included at Wave 3. Participants reporting past 4-month tobacco and marijuana use (n = 328) completed the Reasons for Marijuana-Tobacco Co-use section. RESULTS Per qualitative data, reasons for marijuana-tobacco co-use included synergistic effects, one triggering or preceding the other's use, using one to reduce the other's use, co-administration, social context, and experimentation. The survey subsample included 37.1% who used cigarettes, 30.4% LCCs, 9.4% smokeless, 23.7% e-cigarettes, and 30.4% hookah. Four subscale factors emerged: (1) Instrumentality, indicating synergistic effects; (2) Displacement, indicating using one product to reduce/quit the other; (3) Social context, indicating use in different settings/social situations; and (4) Experimentation, indicating experimentation with both but no specific reasons for co-use. These subscales demonstrated distinct associations with tobacco type used; nicotine dependence; marijuana and alcohol use frequency; tobacco and marijuana use motives, respectively; perceptions of tobacco and marijuana; and parental and friend use. Including these subscales in regressions predicting nicotine dependence and days of marijuana use significantly contributed to each model. CONCLUSIONS These findings might inform theoretical frameworks upon which marijuana-tobacco co-use occurs and direct future intervention studies.
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Affiliation(s)
- Carla J Berg
- a Department of Behavioral Sciences and Health Education, Rollins School of Public Health , Emory University , Atlanta , Georgia , USA
| | - Jackelyn Payne
- a Department of Behavioral Sciences and Health Education, Rollins School of Public Health , Emory University , Atlanta , Georgia , USA
| | - Lisa Henriksen
- b Stanford Prevention Research Center, Department of Medicine , Stanford University School of Medicine , Palo Alto , California , USA
| | - Patricia Cavazos-Rehg
- c Department of Psychiatry , Washington University School of Medicine in St. Louis , St. Louis , Missouri , USA
| | - Betelihem Getachew
- a Department of Behavioral Sciences and Health Education, Rollins School of Public Health , Emory University , Atlanta , Georgia , USA
| | - Gillian L Schauer
- d Department of Health Services, School of Public Health , University of Washington , Seattle , Washington , USA
| | - Regine Haardörfer
- a Department of Behavioral Sciences and Health Education, Rollins School of Public Health , Emory University , Atlanta , Georgia , USA
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Masters MN, Haardörfer R, Windle M, Berg C. Psychosocial and cessation-related differences between tobacco-marijuana co-users and single product users in a college student population. Addict Behav 2018; 77:21-27. [PMID: 28941933 DOI: 10.1016/j.addbeh.2017.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/17/2017] [Accepted: 09/14/2017] [Indexed: 01/11/2023]
Abstract
Limited research has examined psychosocial factors that differ among cigarette users, marijuana users, and co-users and influence their cessation efforts. We examined: 1) sociodemographic, mental health, and other substance use in relation to user category; and 2) associations among these factors in relation to recent quit attempts and readiness to quit among single product versus co-users. We used a cross-sectional design to study college students aged 18-25 from seven Georgia campuses, focusing on the 721 reporting cigarette and/or marijuana use in the past 4months (238 cigarette-only; 331 marijuana-only; 152 co-users). Multinomial logistic regression showed that correlates (p's<0.05) of cigarette-only versus co-use included attending public or technical colleges (vs. private) and not using little cigars/cigarillos (LCCs), e-cigarettes, and alcohol. Correlates of marijuana-only versus co-use included being Black or Hispanic (vs. White), not attending technical school, and not using LCCs and e-cigarettes. Importance was rated higher for quitting cigarettes versus marijuana, but confidence was rated lower for quitting cigarettes versus marijuana (p's<0.001). Co-users were more likely to report readiness to quit and quit attempts of cigarettes versus marijuana (p's<0.001). While 23.26% of marijuana-only and 15.13% of cigarette-only users reported readiness to quit, 41.18% of cigarette-only and 21.75% of marijuana-only users reported recent quit attempts (p's<0.001). Binary logistic regressions indicated distinct correlates of readiness to quit and quit attempts of cigarettes and marijuana. Cessation efforts of the respective products must attend to co-use with the other product to better understand relative perceptions of importance and confidence in quitting and actual cessation efforts.
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Montgomery L, Ramo D. What Did You Expect?: The Interaction Between Cigarette and Blunt vs. Non-Blunt Marijuana Use among African American Young Adults. JOURNAL OF SUBSTANCE USE 2018; 22:612-616. [PMID: 29333104 DOI: 10.1080/14659891.2017.1283452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background Marijuana and tobacco co-use is highly prevalent among African American young adults. In an effort to inform prevention and treatment interventions, the current study examined the expectancies around the co-use of marijuana and cigarettes among African American young adults. Methods An anonymous online survey recruited African American adults (N = 111) age 18 to 29 who reported past-month marijuana and cigarette co-use. Participants completed the 14-item Nicotine and Marijuana Interaction Expectancy (NAMIE) Questionnaire, with three scales: (1) marijuana use increases tobacco use and urges, (2) tobacco use increases marijuana use and urges and (3) smoking to cope with marijuana urges. Participants also answered questions about marijuana and tobacco initiation and use. Analyses were conducted separately for blunt co-users (i.e., blunt and cigarette use) and non-blunt co-users (i.e., non-blunt marijuana and cigarette use). Results A majority of co-users (66%) used blunts as a form of co-use. Non-blunt co-users had higher expectancy scores on NAMIE scales 2 and 3 than blunt co-users. However, only blunt co-users showed a positive association between severity of marijuana use and NAMIE scales 2 (p <.01) and 3 (p <.01). Conclusions Findings provide further evidence for the use of the NAMIE and suggest a need to assess and address expectations regarding marijuana and tobacco co-use in prevention and treatment interventions, especially among young African American adults who co-use blunts and cigarettes.
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Affiliation(s)
- LaTrice Montgomery
- Assistant Professor, Addiction Sciences Division, University of Cincinnati College of Medicine, Department of Psychiatry & Behavioral Neuroscience, 3131 Harvey Avenue, Suite 104, Cincinnati, OH 45229
| | - Danielle Ramo
- Assistant Professor in Residence, University of California, San Francisco, Department of Psychiatry & Langley Porter Psychiatric Institute, Weill Institute for Neurosciences, Helen Diller Comprehensive Cancer Center, 530 Parnassus Avenue, San Francisco, CA 94143
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Tsai J, Rolle IV, Singh T, Boulet SL, McAfee TA, Grant AM. Patterns of marijuana and tobacco use associated with suboptimal self-rated health among US adult ever users of marijuana. Prev Med Rep 2017; 6:251-257. [PMID: 28392993 PMCID: PMC5382028 DOI: 10.1016/j.pmedr.2017.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/23/2017] [Accepted: 03/20/2017] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to examine the patterns of marijuana and tobacco use and their associations with suboptimal self-rated health (SRH) among US adults who reported "ever, even once, using marijuana or hashish." Data came from the 2009-2012 National Health and Nutrition Examination Survey, restricting to respondents aged 20 years and older who reported using marijuana at least once in their lifetime (n = 3,210). We assessed the age-adjusted prevalence of mutually exclusive groups of regular (at least once a month for more than one year) and non-regular marijuana smoking by current (serum cotinine ≥ 3.08 ng/mL) and not current use of tobacco. Suboptimal SRH status was defined as "fair" or "poor" in response to the question "Would you say that in general your health is excellent, very good, good, fair, or poor?" We produced prevalence ratios with multivariable log-linear regression models. Among ever users of marijuana, the age-adjusted prevalence of regular marijuana smoking with current tobacco use, non-regular marijuana smoking with current tobacco use, and regular marijuana smoking without current tobacco use was 24.7%, 15.2%, and 21.1%, respectively. When compared to non-regular marijuana smokers without current tobacco use, the adjusted prevalence ratio for reporting suboptimal SRH was 1.98 (95% CI: 1.50-2.61), 1.82 (95% CI: 1.40-2.37), and 1.34 (95% CI: 1.05-1.69), respectively. In conclusion, among adult ever users of marijuana, current tobacco use is high and strongly associated with suboptimal SRH; regular marijuana smoking with or without current tobacco use is significantly associated with suboptimal SRH.
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Affiliation(s)
- James Tsai
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Italia V. Rolle
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tushar Singh
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education, and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sheree L. Boulet
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy A. McAfee
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Althea M. Grant
- Office of Non-communicable Disease, Injury, and Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Gubner NR, Thrul J, Kelly OA, Ramo DE. Young adults report increased pleasure from smoking cigarettes when drinking alcohol but not when using marijuana. ADDICTION RESEARCH & THEORY 2017; 26:71-76. [PMID: 29371859 PMCID: PMC5779098 DOI: 10.1080/16066359.2017.1311877] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/22/2017] [Accepted: 03/23/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Among young adults, cigarette smoking is strongly associated with alcohol and marijuana use. The present study compared self-reported co-use of cigarettes and alcohol versus cigarettes and marijuana among young adults using cross-sectional survey data. METHODS Participants were young adult cigarette smokers (age 18 to 25) who also reported past month alcohol or marijuana use enrolled in a randomized trial testing a smoking cessation intervention on Facebook. Participants self-reported extent of cigarette smoking under the influence of alcohol or marijuana and differences in perceived pleasure from cigarette smoking when drinking alcohol compared to using marijuana. RESULTS Among cigarette smokers who drank alcohol and used marijuana in the past month (n=200), a similar percentage of cigarettes were smoked under the influence of alcohol (42.4%±31.2%) and marijuana (43.1% ±30.0%). Among alcohol + marijuana users, perceived pleasure from smoking cigarettes was significantly greater when drinking alcohol versus when using marijuana (t(199)=7.05, p<0.001). There was, on average, an increase in perceived pleasure from smoking cigarettes when drinking alcohol, though perceived pleasure did not differ by binge drinking frequency. In contrast, there was on average no change in perceived pleasure from smoking cigarettes when using marijuana. Results from the cigarette smokers who used alcohol + marijuana were similar to cigarette smokers who only used alcohol (n=158) or only used marijuana (n=54). CONCLUSION Findings highlight greater perceived reward from smoking cigarettes when drinking alcohol compared to when using marijuana, informing smoking cessation interventions that target users of multiple substances.
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Affiliation(s)
- Noah R. Gubner
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Johannes Thrul
- Center for Tobacco Control Research & Education, University of California, San Francisco, CA, USA
| | - Oona A. Kelly
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Danielle E. Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Center for Tobacco Control Research & Education, University of California, San Francisco, CA, USA
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Twyman L, Bonevski B, Paul C, Kay-Lambkin FJ, Bryant J, Oldmeadow C, Palazzi K, Guillaumier A. The association between cannabis use and motivation and intentions to quit tobacco within a sample of Australian socioeconomically disadvantaged smokers. HEALTH EDUCATION RESEARCH 2016; 31:771-781. [PMID: 27923866 DOI: 10.1093/her/cyw049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 09/23/2016] [Indexed: 06/06/2023]
Abstract
This study aimed to (i) describe concurrent and simultaneous tobacco and cannabis use and (ii) investigate the association between cannabis use and motivation and intentions to quit tobacco in a sample of socioeconomically disadvantaged smokers. A cross-sectional survey was conducted in 2013 and 2014 with current tobacco smokers receiving aid from two community service organizations in New South Wales, Australia. At least weekly cannabis use for the month prior to survey, motivation to quit tobacco and intentions to quit tobacco were measured in 369 participants (77% consent rate). Regressions were carried out to investigate associations between weekly cannabis use and motivation and intentions to quit tobacco.Concurrent tobacco and cannabis use was reported by 19% (n = 71) of the sample and of these users, 100% reported simultaneous use. Although regular cannabis use was significantly associated with lower motivation to quit tobacco, it was not significantly associated with intentions to quit tobacco in the next 30 days. Concurrent cannabis use is common in disadvantaged smokers and may play a role in decreased motivation to quit tobacco; however, it does not appear to be associated with intentions to quit in a sample of disadvantaged smokers.
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Affiliation(s)
- Laura Twyman
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Christine Paul
- Priority Research Centre for Health Behaviour and Health Behaviour Research Group, University of Newcastle & Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Frances J Kay-Lambkin
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2000, Australia
| | - Jamie Bryant
- Priority Research Centre for Health Behaviour and Health Behaviour Research Group, University of Newcastle & Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - C Oldmeadow
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Clinical Research Design, IT and Statistical Support, Hunter Medical Research Institute, Newcastle, NSW 2308, Australia
| | - K Palazzi
- Clinical Research Design, IT and Statistical Support, Hunter Medical Research Institute, Newcastle, NSW 2308, Australia
| | - A Guillaumier
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
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Berg CJ, Haardörfer R, Schauer G, Betelihem G, Masters M, McDonald B, Shah J, Payne J, Sarmah R, Thomas M, Windle M. Reasons for Polytobacco Use among Young Adults: Scale Development and Validation. Tob Prev Cessat 2016; 2. [PMID: 28111637 PMCID: PMC5242507 DOI: 10.18332/tpc/64238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Limited research has examined reasons for polytobacco use, an increasing public health problem, particularly among young adults. We examined reasons for polytobacco use among users of more than one tobacco product in the past 4 months enrolled in an ongoing six-wave longitudinal study of 3,418 students aged 18-25 from seven US colleges and universities. METHODS An expert panel generated items related to reasons for polytobacco use, included in Wave 3 (administered in Summer 2015). Participants reporting use of more than one tobacco product in the past four months (n=540) were asked to complete the Reasons for Polytobacco Use scale and measures related to tobacco/nicotine use/dependence, use motives, perceptions of tobacco, parental/friend use, other substance use, and mental health. We conducted a factor analysis and then examined convergent and discriminant validity for the derived factors. RESULTS Our sample was an average age of 20.40 (SD=1.84), 48.0% male, and 21.9% Black. Four factors were identified: Instrumentality, Social Context, Displacement, and Experimentation. Instrumentality was the only factor associated with little cigar/cigarillo and marijuana use. Displacement and Social Context showed similar associations; however, Social Context was associated with having friends who used tobacco while Displacement was not. Experimentation was associated with greater perceived addictiveness and harm of using tobacco products as well as greater perceived social acceptability of tobacco use. CONCLUSIONS Each of the four factors identified demonstrated unique convergent and discriminant validity. The use of this scale to characterize polytobacco using young adults may help inform and target cessation or prevention interventions.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322
| | - Gillian Schauer
- Battelle Public Health Center for Tobacco Research, 1100 Dexter Avenue North, Suite 400 Seattle, WA 98109-3598
| | - Getachew Betelihem
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322
| | - Matthew Masters
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322
| | - Bennett McDonald
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322
| | - Jill Shah
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322
| | - Jackelyn Payne
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322
| | - Raina Sarmah
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322
| | - Matthew Thomas
- ICF Macro, 1725 I (Eye) Street NW, 10th Floor, International, Washington, DC 20006
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322
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15
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Validation of the Marijuana Effect Expectancies Questionnaire (MEEQ) in a Non-Clinical French-Speaking Adolescent Sample. Psychol Belg 2016; 56:23-41. [PMID: 30479428 PMCID: PMC5853819 DOI: 10.5334/pb.263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Teenagers commonly use cannabis. Expectancies related to the effects of cannabis play an important role in its consumption and are frequently measured with the Marijuana Effect Expectancies Questionnaire (MEEQ). This study aims to assess the psychometric properties (factor structure, internal consistency reliability, criterion validity) of the French MEEQ. A sample of 1,343 non-clinical teenagers (14–18 years) were recruited to answer a self-report questionnaire; 877 of them responded twice (one-year interval). A four-factor structure was obtained: Cognitive Impairment and Negative, Relaxation and Social Facilitation, Perceptual Enhancement and Craving and Negative Behavioral Effect Expectancies. It is concluded that the French MEEQ constitutes an appropriate tool to measure cannabis effect expectancies among adolescents.
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Schmits E, Maurage P, Thirion R, Quertemont E. Dissociation between implicit and explicit expectancies of cannabis use in adolescence. Psychiatry Res 2015; 230:783-91. [PMID: 26575651 DOI: 10.1016/j.psychres.2015.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 07/30/2015] [Accepted: 11/02/2015] [Indexed: 10/22/2022]
Abstract
Cannabis is one of the most commonly drugs used by teenagers. Expectancies about its effects play a crucial role in cannabis consumption. Various tools have been used to assess expectancies, mainly self-report questionnaires measuring explicit expectancies, but implicit measures based on experimental tasks have also been developed, measuring implicit expectancies. The aim of this study was to simultaneously assess implicit/explicit expectancies related to cannabis among adolescent users and non-users. 130 teenagers attending school (55 girls) were enrolled (Age: M=16.40 years); 43.84% had never used cannabis ("non-users") and 56.16% had used cannabis ("users"). They completed self-report questionnaires evaluating cannabis use, cannabis-related problems, effect expectancies (explicit expectancies), alcohol use, social and trait anxiety, depression, as well as three Implicit Association Tests (IAT) assessing implicit expectancies. Adolescents manifested more implicit affective associations (relaxation, excitation, negative) than neutral ones regarding cannabis. These were not related to explicit expectancies. Cannabis users reported more implicit relaxation expectancies and less negative explicit expectancies than non-users. The frequency of use and related problems were positively associated with the explicit expectancies regarding relaxation and enhancement, and were negatively associated with negative explicit expectancies and negative implicit expectancies. Findings indicate that implicit and explicit expectancies play different roles in cannabis use by adolescents. The implications for experimentation and prevention are discussed.
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Affiliation(s)
- Emilie Schmits
- Département de Psychologie, Cognition et Comportement, Université de Liège, Boulevard du Rectorat 5/B32, B-4000 Liège, Belgium; Fonds National de la Recherche Scientifique, Belgium.
| | - Pierre Maurage
- Institut de Psychologie, LEP, Université Catholique de Louvain, Place Cardinal Mercier, 10/bte L3.05.01, B-1348 Louvain-La-Neuve, Belgium; Fonds National de la Recherche Scientifique, Belgium.
| | - Romain Thirion
- Département de Psychologie, Cognition et Comportement, Université de Liège, Boulevard du Rectorat 5/B32, B-4000 Liège, Belgium.
| | - Etienne Quertemont
- Département de Psychologie, Cognition et Comportement, Université de Liège, Boulevard du Rectorat 5/B32, B-4000 Liège, Belgium.
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Assessing the overlap between tobacco and marijuana: Trends in patterns of co-use of tobacco and marijuana in adults from 2003-2012. Addict Behav 2015; 49:26-32. [PMID: 26036666 DOI: 10.1016/j.addbeh.2015.05.012] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 05/05/2015] [Accepted: 05/16/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND As marijuana legalization and acceptability increase in the U.S., it is important to understand the potential impact on tobacco use. Accordingly, we assessed prevalence, correlates, and ten-year trends in co-use of marijuana and tobacco among U.S. adults. METHODS Data came from 378,459 adults participating in the 2003-2012 National Survey on Drug Use and Health, an annual, cross-sectional, household survey. Data from 2011-2012 were used to compute the most recent prevalence of past 30-day marijuana and tobacco use (co-use). Data from 2003-2012 were used to compute demographic correlates of co-use, overall trends in co-use, and trends by age, race, and sex. We also assessed trends in tobacco use among marijuana users and marijuana use among tobacco users. RESULTS From 2011 to 2012, 5.2% of participants were past month co-marijuana and tobacco users, 24.0% were tobacco-only users, and 2.3% were marijuana-only users. From 2003 to 2012, prevalence of co-use increased overall (p<.0001), and among males and females (p<.001, p<.05), those ages 26-34 (p<.001) and 50+years (p<.0001), and Whites (p<.01), Blacks (p<.05), and Hispanics (p<.01); there were no changes among adults 18-25 years. Tobacco use among marijuana users decreased between 2003 and 2012 (from 74.3% to 69.6%, p<.0001), while marijuana use increased among tobacco users (from 14.2% to 17.8, p<.0001). CONCLUSIONS Co-use of tobacco and marijuana increased from 2003-2012, with marijuana use increasing among past-month tobacco users and tobacco use declining among past-month marijuana users. Improved surveillance of co-use is needed as marijuana legalization policies expand and become more integrated in communities.
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18
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Pokhrel P, Herzog TA, Muranaka N, Regmi S, Fagan P. Contexts of cigarette and e-cigarette use among dual users: a qualitative study. BMC Public Health 2015; 15:859. [PMID: 26341634 PMCID: PMC4560069 DOI: 10.1186/s12889-015-2198-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 08/27/2015] [Indexed: 11/10/2022] Open
Abstract
Background Not much is currently understood regarding the contexts of cigarette and e-cigarette use among dual users. Proper application of e-cigarettes to smoking cessation or tobacco harm reduction would require an understanding of when and why dual users use cigarettes versus e-cigarettes. This study sought to elucidate the contexts of cigarette versus e-cigarette use among dual users. Methods Twelve focus group discussions were conducted with 62 young adult current daily e-cigarette users [63 % men; mean age = 25.1 (Standard Deviation = 5.5)]. Almost all participants either concurrently smoked cigarettes or had been recent dual users. Data were analyzed following principles of inductive deduction. Results Results indicated that dual users’ use of cigarettes is influenced by particular activities (e.g., before/after eating), strong craving or need for stimulation (e.g., in response to stress), places/situations (e.g., when cigarette smokers are nearby; outdoors), use of other substances (alcohol, coffee), and unavailability of an e-cigarette when needed. In addition to particular activities and places/situations that are conducive to e-cigarette use, use of e-cigarette when cigarette is not available or where cigarette smoking is not permitted emerged as contexts specific to e-cigarette use. Conclusions For habitual cigarette smokers wanting to quit tobacco smoking, switching over completely to e-cigarettes may require skills of cognitive-behavioral management. Future research needs to ascertain the characteristics of dual users who use e-cigarettes as cessation aids versus as cigarette alternative when cigarette is unavailable or smoking is not permitted.
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Affiliation(s)
- Pallav Pokhrel
- Cancer Prevention & Control Program, University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI, 96822, USA.
| | - Thaddeus A Herzog
- Cancer Prevention & Control Program, University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI, 96822, USA.
| | - Nicholas Muranaka
- Cancer Prevention & Control Program, University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI, 96822, USA.
| | - Sakshi Regmi
- School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA.
| | - Pebbles Fagan
- Cancer Prevention & Control Program, University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI, 96822, USA.
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Schauer GL, Berg CJ, Kegler MC, Donovan DM, Windle M. Differences in Tobacco Product Use Among Past Month Adult Marijuana Users and Nonusers: Findings From the 2003-2012 National Survey on Drug Use and Health. Nicotine Tob Res 2015; 18:281-8. [PMID: 26009578 DOI: 10.1093/ntr/ntv093] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 04/23/2015] [Indexed: 01/15/2023]
Abstract
INTRODUCTION This study assessed differences in individual tobacco product use between past month marijuana users and nonusers, and trends in overall tobacco use and use of specific tobacco products among marijuana users. METHODS Data were obtained from 378 459 adults participating in the 2003-2012 National Survey on Drug Use and Health, a cross-sectional, household interview survey conducted annually. Data from the most recent 2 years (2011-2012) were used to assess differences in the prevalence of various tobacco products by past month marijuana status. Data from all years were used to assess historical trends in overall tobacco use, and use of cigarettes, cigars, and blunts among marijuana users; trend significance was assessed using orthogonal polynomials. RESULTS From 2011-2012, the prevalence of any past month tobacco use among the 9727 past month marijuana users was 68.6% excluding blunts, and 78.3% including blunts (vs. 25.3% for nonusers, P < .0001); 77.3% of past month marijuana users reported past month combusted tobacco use (vs. 23.4% of non-MJ users, P < .0001). By product, 60.1% of past month marijuana users reported past month cigarette use, 42.0% reported past month blunt use, and 20.6% reported past month cigar use. Overall, adjusted trends in past month cigarette use decreased, while trends in past month blunt use increased; cigar use did not change. DISCUSSION Tobacco use is highly prevalent among adult marijuana users and represents an important potential comorbidity of marijuana use. In light of increasing policies legalizing marijuana, it is critical to monitor changes in overall and specific tobacco product use.
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Affiliation(s)
- Gillian L Schauer
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA;
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
| | - Dennis M Donovan
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
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20
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Young adults who smoke cigarettes and marijuana: analysis of thoughts and behaviors. Addict Behav 2014; 39:77-84. [PMID: 24090626 DOI: 10.1016/j.addbeh.2013.08.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 08/05/2013] [Accepted: 08/30/2013] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Smoking both cigarettes and marijuana is increasingly common among young adults, yet little is known about use patterns, motivations, or thoughts about abstinence. In a U.S. sample, this study explored young adults' severity of cigarette and marijuana co-use, quit attempts, and thoughts about use. METHODS Young adults age 18-to-25 who had smoked at least one cigarette in the past 30 days completed an anonymous online survey. RESULTS Of 1987 completed surveys, 972 participants reported both past-month cigarette and marijuana use (68% male, 71% Caucasian, mean age 20.4 years [SD=2.0]). Frequency of use, temptations to use, measures of dependence, decisional balance, and past-year quit attempts were associated across the two substances (all p<.05), but not motivation to quit. Relative to marijuana, participants reported greater desire and a later stage of change for quitting cigarettes and were more likely to endorse a cigarette abstinence goal, yet they had lower expectancy of success with quitting cigarettes and with staying quit (all p<.001). CONCLUSIONS Cigarette and marijuana use, temptations to use, and pros/cons of using were related in this young adult sample. Differences in motivation and thoughts about abstinence, however, suggest that young adults may be more receptive to interventions for tobacco than marijuana use. Use patterns and cognitions for both substances should be considered in prevention and intervention efforts.
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