The relationship between cannabis and nicotine use: A systematic review and meta-analysis.

IF 5.2 1区医学 Q1 PSYCHIATRY Addiction Pub Date : 2024-12-01 Epub Date: 2024-08-12 DOI:10.1111/add.16642

Tesfa Mekonen Yimer, Caitlin McClure-Thomas, Daniel Stjepanovic, Jack Wilson, Gary Chung Kai Chan, Wayne Denis Hall, Janni Leung

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Abstract

Background and aims: Cannabis and nicotine (tobacco or e-cigarettes) use commonly co-occurs and understanding their relationship can help to inform public health strategies to prevent their harms. We conducted a systematic review and meta-analysis to estimate the association of cannabis use given prior nicotine use and vice versa.

Methods: PubMed, Embase, PsycINFO, Google Scholar and a hand-search were conducted in 2023 for longitudinal studies of the general population with no restrictions in settings (locations). Random-effects meta-analysis was conducted to estimate odds ratios between cannabis and nicotine use in both directions. The impact of unmeasured confounding was assessed using E-values.

Results: From 5387 identified records, we included 20 studies. Among cannabis-naïve youths, baseline use of any nicotine products was positively associated with initiation of any cannabis use at follow-up [odds ratio (OR) = 5.39, 95% confidence interval (CI) = 3.19, 9.11; adjusted OR (aOR) = 2.59, 95% CI = 2.01, 3.32]. In nicotine-naïve participants (youths + adults), baseline cannabis use was positively associated with the initiation of any nicotine use at follow-up (OR = 4.08, 95% CI = 2.05, 8.11; aOR = 2.94, 95% CI =1.54, 5.61). There were no significant associations between baseline cannabis use and subsequent initiation of any nicotine (aOR = 3.29, 95% CI = 0.85, 12.76) or daily nicotine use (aOR = 2.63, 95% CI = 0.41, 16.95) among youths. The median E-values were 5.5 for nicotine exposure and cannabis use initiation and 4.1 for cannabis exposure and nicotine use initiation, indicating that substantial unmeasured confounding would need to have a strong association with both outcomes to fully explain away the cannabis and nicotine relationship.

Conclusion: Although the evidence for associations between cannabis use and tobacco use is mixed, a majority of studies to date have found that cannabis use is associated with prior nicotine use and vice versa.

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大麻与尼古丁使用之间的关系：系统回顾和荟萃分析。

背景和目的：大麻和尼古丁（烟草或电子烟）的使用通常会同时发生，了解它们之间的关系有助于为预防其危害的公共卫生策略提供信息。我们进行了一项系统综述和荟萃分析，以估算大麻使用与尼古丁使用之间的关系，反之亦然：在 2023 年期间，我们在 PubMed、Embase、PsycINFO、Google Scholar 和人工搜索中对普通人群的纵向研究进行了检索，对研究环境（地点）没有限制。进行了随机效应荟萃分析，以估算大麻和尼古丁双向使用的几率比。使用 E 值评估了未测量混杂因素的影响：从 5387 份已识别记录中，我们纳入了 20 项研究。在未吸食大麻的青少年中，基线使用任何尼古丁产品与随访时开始吸食任何大麻呈正相关[几率比（OR）= 5.39，95% 置信区间（CI）= 3.19，9.11；调整后的几率比（aOR）= 2.59，95% 置信区间（CI）= 2.01，3.32]。在尼古丁无效的参与者（青少年+成人）中，基线大麻使用与随访时开始使用任何尼古丁呈正相关（OR = 4.08，95% CI = 2.05，8.11；aOR = 2.94，95% CI = 1.54，5.61）。基线使用大麻与青少年随后开始使用任何尼古丁（aOR = 3.29，95% CI = 0.85，12.76）或每日使用尼古丁（aOR = 2.63，95% CI = 0.41，16.95）之间没有明显关联。尼古丁暴露和开始吸食大麻的 E 值中位数为 5.5，大麻暴露和开始吸食尼古丁的 E 值中位数为 4.1，这表明要完全解释大麻和尼古丁之间的关系，需要大量未测量的混杂因素与这两种结果有很强的关联：尽管大麻使用与烟草使用之间的关联证据不一，但迄今为止的大多数研究发现，大麻使用与之前的尼古丁使用相关，反之亦然。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.