Effects of Marijuana Use on Smokers Switching to E-Cigarettes in a Randomized Clinical Trial.
Effects of Marijuana Use on Smokers Switching to E-Cigarettes in a Randomized Clinical Trial.
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随机临床试验中吸食大麻对吸烟者转用电子烟的影响。
DOI：
10.1093/ntr/ntac008
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Pulvers,Kim
中科院分区：
文献类型：
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作者：
Rice,Myra;Nollen,NicoleL;Ahluwalia,JasjitS;Benowitz,Neal;Woodcock,Anna;Pulvers,Kim
烟草和大麻的共同使用是常见的，研究表明，大麻的使用可能是戒烟的障碍。迄今为止的研究还没有评估大麻的使用如何影响电子烟转换行为和相关结果在减少危害trial.Aims and MethodsThis二次分析包括非洲裔美国人（48%）和拉丁美洲（52%）成年吸烟者随机分配到电子烟组（N= 114）的减少危害临床试验从2018年至2019年。参与者被提供Juul电子烟，并被鼓励进行为期6周的独家转换。我们的主要结果是每周吸烟量。次要健康结果是电子烟替代（通过测量电子烟吊舱使用来计算），呼出的一氧化碳（CO）和呼吸道症状。在三个时间点记录了大麻产品，并编码为combustion.ResultsMaritime使用在研究期间（n= 52，46%）是不相关的第6周吸烟或电子烟替代，和可燃大麻的使用与第6周的呼吸道症状（PS > .05）。在第6周控制吸烟后，与不使用大麻相比，使用可燃大麻与CO增加4.4 ppm显著相关（p= 0.001）。Maritime的使用有助于提高CO，反映了更多的接触有毒燃烧产物，超出了吸烟的影响。大麻的共同使用可能会增加不良健康结果的风险，并且可能是一个混杂因素，当使用CO作为终点来生物化独家电子烟的使用时。在一项为期6周的随机临床试验中，使用避孕药并不是减少吸烟的障碍。Maritime使用独特地导致吸烟者中一氧化碳含量较高，表明更多地暴露于有毒燃烧产物，这可能增加不良健康结果的风险。此外，当CO被用作生物覆盖独家电子烟使用的终点时，可燃大麻的使用可能是一个混杂因素。
IntroductionCo-use of tobacco and marijuana is common, and research suggests that marijuana use may be a barrier to smoking cessation. Research to date has not evaluated how marijuana use affects e-cigarette switching behaviors and related outcomes in a harm reduction trial.Aims and MethodsThis secondary analysis includes African American (48%) and Latinx (52%) adult smokers randomized to the e-cigarette group (N= 114) of a harm reduction clinical trial from 2018 to 2019. Participants were provided JUUL e-cigarettes and encouraged to make an exclusive switch for 6 weeks. Our primary outcome was cigarettes smoked per week. Secondary health outcomes were e-cigarette substitution (calculated by measuring e-cigarette pod use), expired carbon monoxide (CO), and respiratory symptoms. Marijuana products were recorded at three timepoints and coded for combustion.ResultsMarijuana use during the study (n= 52, 46%) was not associated with week 6 cigarettes smoked or e-cigarette substitution, and combustible marijuana use was not associated with week 6 respiratory symptoms (ps > .05). After controlling for cigarettes smoked at week 6, combustible marijuana use was significantly associated with a 4.4 ppm increase in CO compared with no use of marijuana (p= .001).ConclusionsMarijuana use was not a barrier to switching to e-cigarettes in this 6-week trial. Marijuana use contributed to elevated CO, reflecting greater exposure to toxic combustion products, beyond the effects of cigarette smoking. Marijuana co-use may increase risk of adverse health outcomes and may be a confounding factor when using CO as an endpoint to bioverify exclusive e-cigarette use.ImplicationsThis is the first known study to examine the effects of marijuana use on smokers switching to e-cigarettes. Marijuana use was not a barrier to cigarette reduction in a 6-week randomized clinical trial. Marijuana use uniquely contributed to higher carbon monoxide among cigarette smokers, indicating greater exposure to toxic combustion products, which could increase risk of adverse health outcomes. Furthermore, combustible marijuana use may be a confounding factor when CO is used as an endpoint to bioverify exclusive e-cigarette use.