Comparing adult cannabis treatment-seekers enrolled in a clinical trial with national samples of cannabis users in the United States

McClure, Erin A.; King, Jacqueline S.; Wahle, Aimee; Matthews, Abigail; Sonne, Susan C.; Lofwall, Michelle R.; McRae‐Clark, Aimee L.; Ghitza, Udi E.; Martínez, Melissa; Cloud, Kasie; Virk, Harvir S.; Gray, Kevin M.

doi:10.1016/j.drugalcdep.2017.02.024

Cited by 10 publications

(5 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the observed rate in the current study more closely approximates the observed rate in a prior multisite clinical trial for CUD (38%; McClure et al, 2018). It may be the case that those who participate in research studies, even via online recruitment sources, are different from those in the general population (i.e., those who complete household surveys; McClure et al, 2017;Susukida, Crum, Stuart, Ebnesajjad, & Mojtabai, 2016), which may have impacted prevalence rates and the characteristics of the current sample of co-users. Finally, all data in this study were self-reported, which does not allow for the biochemical confirmation of cannabis and tobacco co-use.…”

Section: Limitationssupporting

confidence: 67%

Tobacco and cannabis co-use and interrelatedness among adults

Akbar

Tomko

Salazar

et al. 2019

Addictive Behaviors

Self Cite

View full text Add to dashboard Cite

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 cannabisonly 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.

show abstract

Section: Limitationssupporting

confidence: 67%

Tobacco and cannabis co-use and interrelatedness among adults

Akbar

Tomko

Salazar

et al. 2019

Addictive Behaviors

Self Cite

View full text Add to dashboard Cite

show abstract

“…Finally, given that co-occurring psychiatric disorders were exclusionary in this trial, this study sample may not have been truly representative of the general population of those meeting for a cannabis use disorder. Indeed, in a comparison of the current study sample with national datasets, there was greater representation of non-tobacco users within the current study sample (McClure et al, 2017). Those with cannabis use disorder and other co-occurring disorders may have complex presentations and future studies should work to improve sample representativeness.…”

Section: Discussionmentioning

confidence: 89%

Tobacco use during cannabis cessation: Use patterns and impact on abstinence in a National Drug Abuse Treatment Clinical Trials Network study

McClure

Baker

Sonne

et al. 2018

Drug and Alcohol Dependence

Self Cite

View full text Add to dashboard Cite

Background: It is common for cannabis users to also use tobacco. While data suggest that tobacco users have more difficulty achieving cannabis cessation, secondary analyses of clinical trial data sets may provide insight into the moderating variables contributing to this relationship, as well as changes in tobacco use during cannabis treatment. Those were the aims of this secondary analysis. Methods: The parent study was a multi-site trial of N-acetylcysteine for cannabis dependence conducted within the National Drug Abuse Treatment Clinical Trials Network. Participants were treatment-seeking adults (ages 18–50) who met criteria for cannabis dependence (N=302). For cigarette smokers (n=117), tobacco use was assessed via timeline follow-back and nicotine dependence was assessed via the Fagerström Test for Nicotine Dependence (FTND). Outcome measures included: 1) changes in tobacco use based on treatment assignment, nicotine dependence, and concurrent cannabis reduction/abstinence, and 2) independent associations between nicotine dependence and cannabis abstinence. Results: Cigarette smokers accounted for 39% of the sample (117/302), with a median FTND score of 3.0 (10-point scale). Among those with lower baseline nicotine dependence scores, cigarette smoking was reduced in the active treatment group compared to placebo. Those with moderate/high levels of nicotine dependence showed slight increases in smoking following active treatment. Nicotine dependence did not affect cannabis cessation. Conclusions: Cigarette smoking during cannabis treatment was affected, but depended on baseline nicotine dependence severity, though dependence levels did not impact cannabis abstinence. Interventions that address both tobacco and cannabis are needed, especially due to an increasing prevalence of cannabis use.

show abstract

“…Many trials struggle or fail to meet their target sample size 1 and/or have largely unrepresentative samples. 2 Trials that target lower prevalence behaviors (eg, tobacco use comorbid with a physical or mental health disorder) face even greater challenges, to the point where locally conducted trials may be infeasible. Multisite clinical trials can overcome some of these hurdles but incur their own unique challenges, including the need for sizable and costly infrastructure, site training and monitoring, regulatory hurdles, and centralized versus local data management.…”

Section: Introductionmentioning

confidence: 99%

Remote Methods for Conducting Tobacco-Focused Clinical Trials

Dahne

Tomko

McClure

et al. 2020

Nicotine &Amp; Tobacco Research

View full text Add to dashboard Cite

Abstract Most tobacco-focused clinical trials are based on locally conducted studies that face significant challenges to implementation and successful execution. These challenges include the need for large, diverse, yet still representative study samples. This often means a protracted, costly, and inefficient recruitment process. Multisite clinical trials can overcome some of these hurdles but incur their own unique challenges. With recent advances in mobile health and digital technologies, there is now a promising alternative: Remote Trials. These trials are led and coordinated by a local investigative team, but are based remotely, within a given community, state, or even nation. The remote approach affords many of the benefits of multisite trials (more efficient recruitment of larger study samples) without the same barriers (cost, multisite management, and regulatory hurdles). The Coronavirus Disease 2019 (COVID-19) global health pandemic has resulted in rapid requirements to shift ongoing clinical trials to remote delivery and assessment platforms, making methods for the conduct of remote trials even more timely. The purpose of the present review is to provide an overview of available methods for the conduct of remote tobacco-focused clinical trials as well as illustrative examples of how these methods have been implemented across recently completed and ongoing tobacco studies. We focus on key aspects of the clinical trial pipeline including remote: (1) study recruitment and screening, (2) informed consent, (3) assessment, (4) biomarker collection, and (5) medication adherence monitoring. Implications With recent advances in mobile health and digital technologies, remote trials now offer a promising alternative to traditional in-person clinical trials. Remote trials afford expedient recruitment of large, demographically representative study samples, without undo burden to a research team. The present review provides an overview of available methods for the conduct of remote tobacco-focused clinical trials across key aspects of the clinical trial pipeline.

show abstract

Comparing adult cannabis treatment-seekers enrolled in a clinical trial with national samples of cannabis users in the United States

Cited by 10 publications

References 30 publications

Tobacco and cannabis co-use and interrelatedness among adults

Tobacco and cannabis co-use and interrelatedness among adults

Tobacco use during cannabis cessation: Use patterns and impact on abstinence in a National Drug Abuse Treatment Clinical Trials Network study

Remote Methods for Conducting Tobacco-Focused Clinical Trials

Contact Info

Product

Resources

About