Disclosures: The authors report no relevant financial disclosures.
August 04, 2021
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Cigarette use linked to onset of, relapse to cannabis use disorder among adults

Disclosures: The authors report no relevant financial disclosures.
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Cigarette use was linked to increased onset and persistence of and relapse to cannabis use disorder 3 years later among adults, according to study results published in Journal of Clinical Psychiatry.

“Beyond understanding that an association exists between cigarette use and [cannabis use disorder], little is known about the role of cigarette use in transitions in [cannabis use disorder] status over time (eg, onset, persistence, relapse),” Andrea H. Weinberger, PhD, of the Ferkauf Graduate School of Psychology at Yeshiva University in New York, and colleagues wrote. “In prospective longitudinal studies, earlier nicotine use onset was correlated with earlier cannabis initiation among those aged 14 to 24 years in Germany, while earlier cigarette use onset predicted incident [cannabis use disorder] in young adulthood among U.S. adolescents. Similarly, repeated cross-sectional data from U.S. youth and young adults (aged 12 to 21 years) found that nicotine dependence was associated with earlier onset of cannabis use, heavier cannabis use and more symptoms of [cannabis use disorders].”

Smoking cigarette and ashtray
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However, data are sparse regarding the association between cigarette use and cannabis use disorder onset among adults. Weinberger and colleagues aimed to prospectively examine the link between cigarette use and the onset of, persistence of and relapse to cannabis use disorder 3 years later among adults in the U.S. They analyzed data of 34,653 participants of waves one (2001 to 2002) and two (2004 to 2005) of the National Epidemiologic Survey on Alcohol and Related Conditions who responded to questions regarding cigarette use, cannabis use and cannabis use disorder. Participants’ cannabis use disorders were defined according to DSM-IV criteria via the Alcohol Use Disorder and Associated Disabilities Interview Schedule-Diagnostic Version IV.

Weinberger and colleagues calculated the risk for cannabis use disorder onset, persistence and relapse at wave two by wave one cigarette use status using multivariable logistic regression models. They adjusted analyses for sociodemographic data, psychiatric disorders, nicotine dependence and alcohol and other substance use disorders.

Results showed an association between cigarette use at wave one and onset of cannabis use disorder at wave two among participants without wave one cannabis use (adjusted OR = 1.62; 95% CI, 1.35-1.94) but not among participants with wave one cannabis use (aOR = 1; 95% CI, 0.83-1.19). They also observed an association between cigarette use at wave one and persistence of cannabis use disorder at wave two among those with cannabis use disorder at wave one (aOR = 1.63; 95% CI, 1.3-2), as well as relapse to cannabis use disorder at wave two among those with remitted cannabis use disorder at wave one (aOR = 1.23; 95% CI, 1.09-1.45).

“Attention to tobacco use is warranted in clinical and public health efforts to reduce the incidence, prevalence and negative consequences of [cannabis use disorders],” Weinberger and colleagues wrote.