The co-occurring use and misuse of cannabis and tobacco: a review.
The co-occurring use and misuse of cannabis and tobacco: a review.
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DOI：
10.1111/j.1360-0443.2012.03837.x
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发表时间：
2012-07
期刊：
影响因子：
--
通讯作者：
Lynskey MT
中科院分区：
文献类型：
--
作者：
Agrawal A;Budney AJ;Lynskey MT
大麻和烟草的使用和滥用经常同时发生。本审查审查了支持大麻和烟草使用终身共存的流行病学证据，并概述了将这些药物相互联系起来的机制。机制包括：(A)共同的遗传因素；(B)共同的环境影响，包括(C)给药途径(通过吸烟)、(D)共同给药和(E)共同使用的模式。我们还讨论了与共同使用大麻和烟草相关的呼吸损害，重叠的戒断综合征，并概述了同时使用的治疗影响。对已发表的研究进行选择性审查。大麻和烟草的使用和滥用都受到遗传因素的影响，其中一部分遗传因素对大麻和烟草的使用和滥用都有影响。环境因素，如可获得性，发挥着重要作用，经济模型表明，一种药物的价格上涨减少了另一种药物的使用，这是一种互补关系。给药途径和吸烟提示可能有助于它们的持续使用。类似的戒断综合征有许多共同的症状，可能具有重要的治疗意义。新出现的证据表明，双重禁欲可能预示着更好的戒烟结果，但缺乏针对共生使用的经验性研究治疗。越来越多的证据表明，将大麻和烟草使用联系起来的一些机制有别于那些促成毒品共生使用的机制。迫切需要进行研究，以确定潜在的机制并利用其潜在的病因学影响，为这一严重的公共卫生挑战量身定做治疗方案。
Cannabis and tobacco use and misuse frequently co-occur. This review examines the epidemiological evidence supporting the lifetime co-occurrence of cannabis and tobacco use and outlines the mechanisms that link these drugs to each other. Mechanisms include (a) shared genetic factors; (b) shared environmental influences, including (c) route of administration (via smoking), (d) co-administration and (e) models of co-use. We also discuss respiratory harms associated with co-use of cannabis and tobacco, overlapping withdrawal syndromes and outline treatment implications for cooccurring use. Selective review of published studies. Both cannabis and tobacco use and misuse are influenced by genetic factors and a proportion of these genetic factors influence both cannabis and tobacco use and misuse. Environmental factors such as availability play an important role, with economic models suggesting a complementary relationship where increases in price of one drug decrease the use of the other. Route of administration and smoking cues may contribute to their sustained use. Similar withdrawal syndromes, with many symptoms in common, may have important treatment implications. Emerging evidence suggests that dual abstinence may predict better cessation outcomes, yet empirically researched treatments tailored for co-occurring use are lacking. There is accumulating evidence that some mechanisms linking cannabis and tobacco use are distinct from those contributing to co-occurring use of drugs in general. There is an urgent need for research to identify the underlying mechanisms and harness their potential etiological implications to tailor treatment options for this serious public health challenge.
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6.9
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