Psychosocial and cessation-related differences between tobacco-marijuana co-users and single product users in a college student population

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.

Tobacco and cannabis co-use: Drug substitution, quit interest, and cessation preferences.

“…This is among the first studies in adult cannabis-tobacco cousers to explore quitting intentions and interest, as well as selfreported drug substitution. Quit interest and confidence in quitting was similar to previous studies that have been conducted among young adult co-users (Masters et al, 2018;Ramo et al, 2014). Important findings from the current study include: (a) while nearly all of the sample of co-users were interested in and had attempted to quit smoking cigarettes at least once, a much smaller proportion were interested in or had ever tried to quit using cannabis, and (b) approximately 50 -60% of participants perceived increases in their use of the substance they were not trying to quit (cannabis or cigarettes, respectively) during past quit attempts.…”

“…While preliminary work has been conducted on the evaluation of interventions to address cannabis and tobacco co-use (Becker, Haug, Sullivan, & Schaub, 2014; Beckham et al, 2018; Hill et al, 2013; Lee et al, 2015), little is known regarding quit interest and treatment preferences among co-users. Among young adults (ages 18–25), previous studies have found that the desire to quit smoking cigarettes is greater than for cannabis, the perceived importance of quitting is greater for cigarettes, but confidence in quitting smoking cigarettes is lower (Masters, Haardorfer, Windle, & Berg, 2018; Ramo, Delucchi, Liu, Hall, & Prochaska, 2014). Extending this work to adult co-users is an important contribution to the treatment literature.…”

Types of cannabis and tobacco/nicotine co-use and associated outcomes in young adulthood.

“…Overall, youth who reported coadministration and sequential use, either alone or in combination, also reported poorer outcomes compared to youth using only one product or using both products independently. There is some literature on psychosocial and physical health correlates of co-use in young adults (Masters, Haardörfer, Windle, & Berg, 2018; Ramo et al, 2012); however, further longitudinal research is needed to examine how outcomes may differ across types of co-use over time and to identify mechanisms underlying these differences. For example, differences across types of co-use may be due to the manner in which cannabis and tobacco/nicotine are co-used, characteristics of the person who chooses to co-use in a particular way, or other factors.…”

Cigarette smoking quit ratios among adults in the USA with cannabis use and cannabis use disorders, 2002–2016

“…Persons who smoke cigarettes are significantly more likely to report cannabis use and CUDs8 19 25 26 and, conversely, persons who use cannabis and have CUDs are more likely to report cigarette smoking 6 24 26–28. The use of cannabis and cigarettes together is associated with a range of adverse physical, psychological, cognitive and social consequences as well as an increased likelihood of CUDs, less confidence in quitting and readiness to quit cannabis, and less success with abstinence from cannabis 29–33. Over the past decade, there has been an increase in the use of cannabis among cigarette smokers19 and prevalence of cigarettes and cannabis co-use,34 suggesting that the negative consequences of cigarette–cannabis co-use may also become more prevalent over time.…”