Changes in cigarette and alcohol use during cannabis abstinence
Changes in cigarette and alcohol use during cannabis abstinence
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DOI：
10.1016/j.drugalcdep.2014.01.022
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发表时间：
2014-05-01
影响因子：
4.2
通讯作者：
Copeland, Jan
中科院分区：
文献类型：
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作者：
Allsop, David J.;Dunlop, Adrian J.;Copeland, Jan
目的：与酒精和烟草相比，大麻导致的死亡率和发病率较低，因此戒除大麻是否与用这些物质替代有关具有临床意义。这项研究测试了在大麻戒断期间大麻是否被酒精和/或烟草替代，以及预测这种替代的因素。方法：对一项基于社区的前瞻性研究进行二次分析，通过时间线随访对未寻求治疗的大麻使用者（n = 45）在两周自愿大麻戒断期间和一个月随访期间的大麻、酒精和烟草的使用进行了量化。大麻的使用通过尿液 THC-COOH 水平进行验证。结果：在大麻戒断期间，酒精使用量增加了 8 个标准单位（SU；d=0.48）/周，香烟使用量增加了 14 支香烟/周（d=0.29）。那些在基线时使用较少每种物质的人在大麻戒断期间有更大的增加（酒精 P < 0.0001，烟草 P = 0.01）。当大多数参与者（87％，n = 39）恢复使用大麻时，随访期间酒精（-4.8 SU，d = -0.29）和烟草（-13支香烟/周，d = -0.26）的使用量有所减少。与大麻戒断相关的睡眠困难（失眠）（P = 0.05）、烦躁不安（P = 0.03）和身体症状（P = 0.02）预测吸烟量增加。在随访期间一直戒除大麻的人（13.3%，n = 6）中，酒精和香烟的使用均没有显着增加。结论：戒除大麻与酒精和烟草使用的增加有关，随着大麻使用的恢复，酒精和烟草的使用会减少；然而，在一个月的随访中，仍然戒除大麻的人数没有增加。那些经历较轻大麻戒断症状的人的烟草使用量并未增加。需要对门诊大麻戒断期间寻求治疗者的替代进行研究。 (C) 2014 年，爱思唯尔爱尔兰有限公司出版。
Objective: Cannabis causes lower mortality and morbidity than alcohol and tobacco so it is clinically important if quitting cannabis is associated with substitution with these substances. This study tests if cannabis is substituted with alcohol and/or tobacco during cannabis abstinence, and factors predicting such substitution. Method: A secondary analysis of a prospective community based study quantified cannabis, alcohol and tobacco use with Timeline Follow-back during a two-week voluntary cannabis abstinence and at one-month follow-up in non-treatment seeking cannabis users (n =45). Cannabis use was verified by urine THC-COOH levels.Results: Alcohol use increased by 8 standard units (SU; d=0.48)/week and cigarette use by 14 cigarettes/week (d= 0.29) during cannabis abstinence. Those using less of each substance at baseline had greater increases during cannabis abstinence (alcohol P < 0.0001, tobacco P= 0.01). There was a decrease in alcohol (-4.8 SU, d= -0.29) and tobacco (-13 cigarettes/week, d = -0.26) use at follow-up, when most participants (87%, n=39) had resumed cannabis use. Increased cigarette use was predicted by cannabis withdrawal related sleep difficulty (insomnia) (P= 0.05), restlessness (P= 0.03) and physical symptoms (P= 0.02). Neither alcohol nor cigarette use increased significantly in those (13.3%, n= 6) who remained abstinent from cannabis through to follow-up.Conclusions: Abstaining from cannabis was associated with increases in alcohol and tobacco use that decreased with resumption of cannabis use; however there were no increases in individuals who remained abstinent from cannabis at one-month follow-up. Tobacco use did not increase in those experiencing milder cannabis withdrawal symptoms. Research on substitution in treatment seeker's during outpatient cannabis abstinence is needed. (C) 2014 Published by Elsevier Ireland Ltd.