Clearing the smokescreen: the current evidence on cannabis use

Past-month cannabis use among U.S. individuals from 2002-2015: An age-period-cohort analysis

BACKGROUND

Cannabis is the most commonly used illicit drug among U.S. adolescents and adults, but little is known about factors that drive trends in cannabis use prevalence. To better understand drivers of these trends, we aimed to estimate age, period, and cohort effects on past-month cannabis use among U.S. individuals age 12 and older from 2002 to 2015.

METHODS

We conducted an age-period-cohort analysis on past-month cannabis use among participants ages 12 and older using the National Survey on Drug Use and Health (NSDUH), an annual cross-sectional nationally-representative survey of drug use. Additionally, we examined how age, period, and cohort effects differed across gender. Participants (n = 779,799) self-reported cannabis patterns using a computer-assisted telephone interview (CATI).

RESULTS

Past-month cannabis use in this population increased from 6.0% in 2002 to 8.1% in 2015. Distinct age, period, and cohort effects were observed. Compared to participants ages 12-13, participants ages 18-21 (PR: 16.8, 95% CI: 15.6, 18.1) and 22-25 (PR: 13.2, 95% CI: 12.2, 14.4) had dramatically higher prevalence of past-month cannabis use. Compared to participants in 2002, participants in 2014 (PR: 1.2, 95% CI: 1.1, 1.4) and 2014 (PR: 1.2, 95% CI: 1.1, 1.4) had slightly higher prevalence of past-month cannabis use. Compared to the 1940s birth cohort, the 1950s birth cohort (PR: 1.8, 95% CI: 1.5, 2.2) had a higher prevalence of past-month cannabis use.

CONCLUSIONS

Past-month cannabis use is prevalent and increasing among U.S. adults. Distinct age, period, and cohort effects are at play, though age effects are strongest.

Job exposure to the public in relation with alcohol, tobacco and cannabis use: Findings from the CONSTANCES cohort study

Objectives

To examine the associations between job exposure to the public (e.g., customers, guests, users of a public service, patients) and alcohol, tobacco and cannabis use.

Methods

From the French population-based CONSTANCES cohort, 16,566 men and 17,426 women currently working were included between 2012 and 2016. They reported their exposure to the public (daily versus no daily), and among the daily exposed participants (10,323 men and 13,318 women), the frequency of stressful exposure (often versus rarely). Dependent variables were: chronic alcohol consumption (<1(1), 1-27(1–13), 28-42(14–28), >42(28) drinks per week in men(women)), heavy episodic drinking (never, at most once a month, more than once a month), alcohol use risk with Alcohol Use Disorders Identification Test (mild, dangerous, problematic or dependence), tobacco use (non-smoker, former smoker, 1–9, 10–19, >19 cigarettes per day) and cannabis use (never, not in past year, less than once a month, once a month or more). Logistic regressions provided odds ratios of substance use, stratifying for gender and adjusting for sociodemographic confounders, depression, effort-reward imbalance and perceived health status.

Results

Exposed men had higher risks of alcohol (chronic alcohol consumption, heavy episodic drinking and alcohol use risk), tobacco and cannabis use. Exposed women had higher risks of tobacco and cannabis use. In men, stressful exposure was associated with increased risks of heavy episodic drinking, tobacco and cannabis use. In women, stressful exposure was associated with increased risks of chronic alcohol consumption, alcohol use risk, tobacco and cannabis use. All these findings remained significant in multivariable analyses, taking into account sociodemographic variables, depressive symptoms, perceived health status and effort-reward imbalance.

Conclusions

Interventions to reduce emotional job demand should systematically integrate assessment and prevention measures of addictive behaviors. Vulnerable workers may be offered more specific interventions to reduce the impact of exposure to the public on their substance use.

Online self-help forums on cannabis: A content assessment

OBJECTIVE

To investigate online self-help forums related to cannabis users who were searching for help on the Internet.

METHODS

We analyzed the content of 717 postings by 328 users in three online forums in terms of fields of interest and self-help mechanisms. Only English-language forums that were free of charge and without registration were investigated.

RESULTS

The main self-help mechanisms were disclosure and symptoms, with relatively few posts concerning legal issues and social perceptions. The forums differed significantly in all fields of interest and self-help mechanisms except for social network and financial and vocational issues. Highly involved users more commonly posted on topics related to diagnosis, etiology/research, and provision of information and less commonly on those related to gratitude. Correlation analysis showed a moderate negative correlation between emotional support and illness-related aspects and between emotional support and exchange of information.

CONCLUSIONS

Cannabis forums share similarities with other mental health forums. Posts differ according to user involvement and the specific orientation of the forum.

PRACTICE IMPLICATIONS

The Internet offers a viable source of self-help and social support for cannabis users, which has potential clinical implications in terms of referring clients to specific forums.