Leisure time activities that predict initiation, progression and reduction of cannabis use: A prospective, population‐based panel survey

Schaub, Michael P; Gmel, Gerhard; Annaheim, Beatrice; Mueller, Max Perry; Schwappach, David

doi:10.1111/j.1465-3362.2009.00156.x

Cited by 29 publications

(15 citation statements)

References 28 publications

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“…This differs from increases in tobacco use during cannabis abstinence or reductions found in other studies (28,29). Those preliminary studies, however, relied on self-report, were retrospective, and the cannabis quit attempts were most likely unassisted.…”

Section: Discussioncontrasting

confidence: 99%

“…Consistent with those results, a recent review by Peters and colleagues (27) showed that use of tobacco and cannabis, compared to cannabis use alone, was associated with poorer cannabis cessation outcomes, as well as more psychosocial problems, and greater likelihood of a cannabis use disorder. Some preliminary evidence also suggests that tobacco may be substituted and may increase during cannabis reductions or abstinence (28,29). Another study did not find evidence of tobacco substitution, but found that tobacco use only decreased in participants with >50% reduction in cannabis use (30).…”

Section: Introductionmentioning

confidence: 99%

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Cigarette smoking during an N-acetylcysteine-assisted cannabis cessation trial in adolescents

McClure¹,

Baker

Gray³

2014

The American Journal of Drug and Alcohol Abuse

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Background and Objectives Tobacco and cannabis use are both highly prevalent worldwide. Their co-use is also common in adults and adolescents. Despite this frequent co-occurrence, cessation from both substances is rarely addressed in randomized clinical trials. Given evidence that tobacco use may increase during cannabis cessation attempts, and additionally that tobacco users have poorer cannabis cessation outcomes, we explored tobacco outcomes, specifically cigarette smoking, from an adolescent cannabis cessation trial that tested the efficacy of N-acetylesteine (NAC). Methods Cannabis-dependent adolescents (ages 15–21; n=116) interested in cannabis treatment were randomized to NAC (1200 mg bid) or matched placebo for 8 weeks. Participants did not need to be cigarette smokers or be interested in smoking cessation to qualify for inclusion. Results Approximately 59% of enrolled participants were daily and non-daily cigarette smokers, and only differed from non-smoking participants on the compulsion sub-scale of the Marijuana Craving Questionnaire. Among cigarette smokers who were retained in the study, there was no change in cigarettes per day for either NAC or placebo groups during the 8-week treatment phase. Being a cigarette smoker did not appear to influence the effects of NAC on cannabis abstinence, though there was a trend in the placebo group of poorer cannabis outcomes for cigarette smokers vs. non-smokers. Conclusions No evidence was found of compensatory cigarette smoking during this cannabis cessation trial in adolescents. Further work assessing interventions to reduce both cannabis and tobacco use in this population is greatly needed.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cigarette smoking during an N-acetylcysteine-assisted cannabis cessation trial in adolescents

McClure¹,

Baker

Gray³

2014

The American Journal of Drug and Alcohol Abuse

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“…First, during reduction or abstinence from one substance, substitution/compensatory use of the other substance may occur. Data supporting substitution are mixed, with some studies supporting a substitution effect, demonstrated by an increase in tobacco use during cannabis abstinence/reduction (Allsop et al, 2014; Copersino et al, 2006; Levin et al, 2010; Schaub et al, 2010), while others have found no evidence of increases in tobacco use during cannabis cessation (McClure et al, 2014a; Peters and Hughes, 2010). Yet, others have found reductions in tobacco use among those who reduced their cannabis use by more than 50% (Gray et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

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

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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.

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“…Integrating existing data is important to understand the extent to which cannabis use may hinder some individuals' ability to quit tobacco or vice versa [34,35]. Preliminary evidence indicates that tobacco may substitute for reduced cannabis consumption [36,37] and, in some cases, cessation from both cannabis and tobacco may produce more severe withdrawal than cessation from either alone [38]. Furthermore, prior literature with other drug users has suggested that use of two drugs may influence response to treatment [39][40][41][42][43][44], and thus may have important treatment outcome implications.…”

Section: Introductionmentioning

confidence: 99%

Clinical correlates of co‐occurring cannabis and tobacco use: a systematic review

2012

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Aims A growing literature has documented the substantial prevalence of and putative mechanisms underlying co-occurring (i.e., concurrent or simultaneous) cannabis and tobacco use. Greater understanding of the clinical correlates of co-occurring cannabis and tobacco use may suggest how intervention strategies may be refined to improve cessation outcomes and decrease the public health burden associated with cannabis and tobacco use. Methods A systematic review of the literature on clinical diagnoses, psychosocial problems, and outcomes associated with co-occurring cannabis and tobacco use. Twenty-eight studies compared clinical correlates in co-occurring cannabis and tobacco users vs. cannabis or tobacco only users. These included studies of treatment-seekers in clinical trials and non-treatment-seekers in cross-sectional or longitudinal epidemiological or non-population-based surveys. Results Sixteen studies examined clinical diagnoses, four studies examined psychosocial problems, and 11 studies examined cessation outcomes in co-occurring cannabis and tobacco users (several studies examined multiple clinical correlates). Relative to cannabis use only, co-occurring cannabis and tobacco use was associated with a greater likelihood of cannabis use disorders, more psychosocial problems, and poorer cannabis cessation outcomes. Relative to tobacco use only, co-occurring use did not appear to be consistently associated with a greater likelihood of tobacco use disorders, more psychosocial problems, nor poorer tobacco cessation outcomes. Conclusions Cannabis users who also smoke tobacco are more dependent on cannabis, have more psychosocial problems, and have poorer cessation outcomes than those who use cannabis but not tobacco. The converse does not appear to be the case.

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Leisure time activities that predict initiation, progression and reduction of cannabis use: A prospective, population‐based panel survey

Abstract: The influence of persons the leisure time was spent with was of higher relevance to most phases of cannabis use than the type of leisure time activity.

Cited by 29 publications

References 28 publications

Cigarette smoking during an N-acetylcysteine-assisted cannabis cessation trial in adolescents

Cigarette smoking during an N-acetylcysteine-assisted cannabis cessation trial in adolescents

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

Clinical correlates of co‐occurring cannabis and tobacco use: a systematic review

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