Factors affecting tobacco, nicotine, and cannabis product use among California young adults during the COVID-19 pandemic: A qualitative study

Yang, Joshua; Pacheco, Claudia; Mackey, Tim K.

doi:10.1016/j.abrep.2022.100470

Cited by 2 publications

(3 citation statements)

References 65 publications

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“…Participants identified cannabis use as a coping mechanism and described how pandemic-related increases in prenatal cannabis use corresponded directly with changes in pandemic-related stress. Similar increases in cannabis use as a result of coping with COVID-19-related emotional and psychological distress have been found in qualitative studies of other vulnerable populations, including young adults (31), and our findings complement prior research showing that pregnant individuals report using cannabis to cope with medical and mental health symptoms during pregnancy (5)(6)(7).…”

Section: Discussionsupporting

confidence: 87%

Pregnant individual’s lived experience of cannabis use during the COVID-19 pandemic: a qualitative study

et al. 2023

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IntroductionQuantitative studies indicate that the COVID-19 pandemic has contributed to increased rates of prenatal cannabis use. However, little is known about how the pandemic has impacted cannabis use from the perspective of pregnant individuals themselves. Our objective was to characterize COVID-19-related changes in cannabis use among pregnant individuals who used cannabis during the pandemic.MethodsWe conducted 18 focus groups (from 11/17/2021 to 12/17/2021) with Black and White pregnant individuals aged 18+ who self-reported prenatal cannabis use during universal screening at entrance to prenatal care (at ~8 weeks gestation) in Kaiser Permanente Northern California. Virtual focus groups were transcribed and analyzed using thematic analysis.ResultsThe sample of 53 pregnant individuals (23 Black, 30 White) was 30.3 years old (SD = 5.2) on average, and most (70%) self-reported daily versus weekly or monthly prenatal cannabis use. Major themes regarding the impact of the pandemic on cannabis use included increases in use (resulting from depression, anxiety, stress, boredom), and changes in social use (less sharing of smoked cannabis products), modes of use (from smoking to other modes due to respiratory concerns) and source (from storefront retailers to delivery).ConclusionCoping with mental health symptoms and stress were identified drivers of perceived pandemic-related increases in prenatal cannabis use in 2021. Pregnant individuals adapted their use in ways consistent with public health recommendations to decrease social contact and reduce or quit smoking to mitigate COVID-19 transmission and harms. Proactive, mental health outreach for pregnant individuals during future pandemic waves may reduce prenatal cannabis use.

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Section: Discussionsupporting

confidence: 87%

Pregnant individual’s lived experience of cannabis use during the COVID-19 pandemic: a qualitative study

et al. 2023

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“…1,[39][40][41] The lower prevalence of tobacco, cannabis use, and concurrent use reported in 2021 could also be a temporary drop due to the impact of the COVID-19 pandemic (eg, effects of lockdown or disrupted supply chains). 42,43 Studies have shown that tobacco and cannabis can be a gateway or reverse gateway for each other, 44 and as a consequence, a rise in the use of one substance could lead to an increase in the concurrent use of both substances. In addition, as the legalization of cannabis has been expanding in the US, 45 more youths may have access to cannabis, which may increase both cannabis use and concurrent use of cannabis and tobacco.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of concurrent use of tobacco and cannabis (3.4%) in this study seemed to be lower compared with 5.4% among youths in 2014 from the NSDUH data or 12.4% among middle and high school students in California in 2019, which is consistent with a decreasing trend in tobacco and cannabis use observed among youths in recent years . The lower prevalence of tobacco, cannabis use, and concurrent use reported in 2021 could also be a temporary drop due to the impact of the COVID-19 pandemic (eg, effects of lockdown or disrupted supply chains) . Studies have shown that tobacco and cannabis can be a gateway or reverse gateway for each other, and as a consequence, a rise in the use of one substance could lead to an increase in the concurrent use of both substances.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Use of Tobacco and Cannabis and Internalizing and Externalizing Problems in US Youths

Do,

Ling,

Chaffee

et al. 2024

JAMA Netw Open

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ImportanceLittle is known about whether concurrent use of tobacco and cannabis is associated with higher or lower levels of mental health problems than use of either substance alone among youths.ObjectiveTo examine the association between concurrent use of tobacco and cannabis and mental health problems in a national sample of US youths.Design, Setting, and ParticipantsThis cross-sectional study analyzed publicly available wave 6 data within the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort study of US youths aged 14 to 17 years, collected from March to November 2021. This analysis used wave 6 single-wave weights to obtain statistically valid estimates for cross-sectional analyses generalizable to the wave 4 cohort sample. Data were analyzed from November 15, 2023, to April 20, 2024.ExposurePast 30-day use of any tobacco and cannabis products was self-reported and categorized into 4 exclusive patterns: concurrent, tobacco only, cannabis only, and nonuse.Main Outcomes and MeasuresSelf-reported past-year internalizing and externalizing mental health problems were measured using the modified version of the Global Appraisal of Individual Needs–Short Screener and separately categorized into 3 levels: low (0-1 symptoms), moderate (2-3 symptoms), and high (≥4 symptoms).ResultsA total of 5585 youths were included in the study, with a weighted proportion of 51.3% being male and 72.5% aged 15 to 17 years. In terms of race and ethnicity, 1606 youths (25.7%) were Hispanic, 626 (12.7%) were non-Hispanic Black, 2481 (50.5%) were non-Hispanic White, and 555 (11.0%) were non-Hispanic other. The prevalence of concurrent use (3.4% [95% CI, 2.9%-4.0%]) was comparable to tobacco-only use (3.9% [95% CI, 3.2%-4.6%]), but greater than cannabis-only use (2.5% [95% CI, 2.1%-2.9%]). High levels of internalizing and externalizing problems were most common for the concurrent use group (internalizing: 47.4% [95% CI, 39.2%-55.9%]; externalizing: 61.6% [95% CI, 54.1%-68.7%]), followed by the cannabis-only use group (internalizing: 44.8% [95% CI, 35.7%-54.1%]; externalizing: 48.5% [95% CI, 39.1%-57.9%]), the tobacco-only use group (internalizing: 41.4% [95% CI, 33.7%-49.5%]; externalizing: 46.3% [95% CI, 38.3%-54.5%]), and the nonuse group (internalizing: 22.4% [95% CI, 21.1%-23.8%]; externalizing: 30.4% [95% CI, 28.9%-31.9%]). After controlling for covariates in ordinal logistic regression models, concurrent use of tobacco and cannabis was associated with greater odds of reporting higher levels of externalizing problems compared with tobacco-only use (adjusted odds ratio [AOR], 1.83 [95% CI, 1.15-2.91]) and cannabis-only use (AOR, 1.85 [95% CI, 1.11-3.06]). However, there were no statistically significant differences in the odds of internalizing problems between concurrent use and use of tobacco or cannabis alone.Conclusions and RelevanceIn this cross-sectional study of the PATH Study wave 6 youth data, concurrent use of tobacco and cannabis was linked to higher levels of externalizing mental health problems than use of single substances, indicating a potential need to combine mental health support with tobacco and cannabis cessation interventions for youths.

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Factors affecting tobacco, nicotine, and cannabis product use among California young adults during the COVID-19 pandemic: A qualitative study

Cited by 2 publications

References 65 publications

Pregnant individual’s lived experience of cannabis use during the COVID-19 pandemic: a qualitative study

Pregnant individual’s lived experience of cannabis use during the COVID-19 pandemic: a qualitative study

Concurrent Use of Tobacco and Cannabis and Internalizing and Externalizing Problems in US Youths

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