Reverse gateways? Frequent cannabis use as a predictor of tobacco initiation and nicotine dependence
Reverse gateways? Frequent cannabis use as a predictor of tobacco initiation and nicotine dependence
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DOI：
10.1111/j.1360-0443.2005.01220.x
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发表时间：
2005-10-01
期刊：
影响因子：
6
通讯作者：
Lynskey, M
中科院分区：
文献类型：
--
作者：
Patton, GC;Coffey, C;Lynskey, M
目的研究大麻使用对年轻人烟草使用障碍造成的风险。具体来说，我们研究了非吸烟者使用大麻是否预示着以后开始使用烟草，以及大麻使用是否预示着烟草使用者以后对尼古丁的依赖。澳大利亚.参与者1943名最初年龄为14-15岁的参与者的社区样本。在青少年中使用计算机化访谈评估和在年轻成人中使用CATI评估评估烟草和大麻使用的报告。尼古丁依赖的Fagerstrom测试被用来定义尼古丁dependence.Findings青少年非吸烟者，至少有一个报告，每周使用大麻的青少年预测超过八倍的几率增加后开始使用烟草（OR 8.3; 95%CI 1.9-36）。对于21岁的吸烟者来说，还没有尼古丁依赖，每天使用大麻使24岁时尼古丁依赖的几率增加了三倍多（OR 3.6，1.2，10）在控制可能的混杂因素后，包括烟草使用水平和尼古丁依赖的亚综合征体征。结论青少年和青年时期每周或更多地使用大麻与吸烟的风险增加有关。烟草使用开始较晚，并进展为尼古丁依赖。如果这种影响是因果关系，那么尼古丁依赖的风险增加可能是早期频繁使用大麻的最重要的健康后果。
Aims To examine the risk posed by cannabis use in young people for tobacco use disorders. Specifically we examined whether cannabis use in non-smokers predicted later initiation of tobacco use and whether cannabis use predicted later nicotine dependence in tobacco users.Design A 10-year eight-wave cohort study.Setting State of Victoria, Australia.Participants A community sample of 1943 participants initially aged 14-15 years.Measuerments Self-report of tobacco and cannabis use was assessed in the teens using a computerized interview assessment and in young adulthood with a CATI assessment. The Fagerstrom Test for Nicotine Dependence was used to define nicotine dependence.Findings For teen non-smokers, at least one report of weekly cannabis use in the teens predicted a more than eightfold increase in the odds of later initiation of tobacco use (OR 8.3; 95% CI 1.9-36). For 21-year-old smokers, not yet nicotine-dependent, daily cannabis use raised the odds of nicotine dependence at the age of 24 years more than threefold (OR 3.6, 1.2, 10) after controlling for possible confounders, including level of tobacco use and subsyndromal signs of nicotine dependence.Conclusions Weekly or more cannabis use during the teens and young adulthood is associated with an increased risk of late initiation of tobacco use and progression to nicotine dependence. If this effect is causal, it may be that a heightened risk of nicotine dependence is the most important health consequence of early frequent cannabis use.