Context, Subjective and Cognitive Experiences with Patterns of Tobacco and Cannabis Co-Use in Young Adults

烟草和大麻的共同使用一直在增加，特别是在美国的年轻人中， 20%的18-24岁的年轻人报告在过去一个月使用这两种物质。越来越多的证据 这些物质的共同使用增加了健康后果和有问题的心理社会后果， 或者单独使用，并且使用一种产品会增加使用和无法阻止另一种产品的可能性。共同使用是 广义的术语并且可以包括在给定的时间范围内使用两种物质（例如，一个月内， 给定事件（同时使用），顺序（追逐），或在同一输送装置中混合在一起（共同使用） 管理）。直到最近，共同使用通常也仅限于可燃方法，要么吸烟， 产品分开或组合它们（例如，以钝头或尖头的形式）。随着电子尼古丁输送的增加 系统（ENDS）以及使娱乐性大麻合法化的州的增加，有新的选择， 使用，以及含有尼古丁的电子烟液体的ENDS设备正在成为更受欢迎的消费方法 大麻虽然关于共同使用的研究正在增加，但在方法上存在许多局限性， 先前的工作，包括缺乏关于共同使用的具体模式和提供方式的差异的详细数据， 特别是考虑到替代烟草产品越来越受欢迎，以及对调查数据的依赖。少 已知可能导致年轻人共同使用不同模式的因素， 保持共同使用，这可能与不同的结果有关。本研究的总体目标是检查 与烟草和大麻共同使用的不同模式相关的情境性、瞬时性因素， 它们可以根据递送模式，以及它们如何与行为结果的变化相关联而变化（例如， 依赖性、使用率变化、问题行为）。该项目将利用生态瞬间 评估（EMA）收集了425名年轻成年人（18-25岁）的深入，实时自然报告， 大麻共同使用者的日常经历和产品使用行为。在两波EMA中，我们将捕捉到 年轻人单独使用每种产品以及同时使用这些产品的情况（在 相同的发作），或者在共同的输送装置中（例如，钝头或汽化器）或连续。我们将研究 产品使用的组合以及个人的主观，情感， 对这些使用体验的神经认知反应因输送模式（可燃或汽化）而异， 这些因素如何影响未来的烟草和大麻使用模式。知识 获得将提供有关共同使用的行为和神经认知后果的必要证据， 将有助于更好地为预防、干预和政策方法提供信息，以减少这两种产品的危害。这 该项目也是及时的，因为它的数据收集发生在一个州（伊利诺伊州），将刚刚合法化的娱乐 大麻使用（2020年1月生效）。

Co-use of tobacco and cannabis has been increasing, especially among young adults in the US, with more than 20% of young adults aged 18-24 reporting use of both substances in the past month. There is growing evidence that co-use of these substances increases the health consequences and problematic psychosocial outcomes of either alone, and that use of one product increases the probability of use and failure to stop the other. Co-use is a broad term and may encompass using both substances within a given time frame (e.g., past month), within a given episode (concurrent use), in sequence (chasing), or mixed together in the same delivery device (co- administration). Until recently, co-use was also generally limited to combustible methods, either smoking each product separately or combining them (e.g., in blunts or spliffs). With the increase in electronic nicotine delivery systems (ENDS) as well as the increase in states legalizing recreational cannabis, there are new options for co- use, and ENDS devices that vape e-liquids containing nicotine are becoming more popular methods to consume cannabis. Although research on co-use is growing, there have been numerous methodological limitations of prior work, including a lack of detailed data about differences in specific patterns of co-use and modes of delivery, especially given the rising popularity of alternative tobacco products, as well as a reliance on survey data. Less is known about the factors that may contribute to the different patterns of co-use in young adults, that may maintain co-use, and that may be associated with different outcomes. The overall goal of this study is to examine the situational, momentary factors associated with the different patterns of tobacco and cannabis co-use, how they may vary by delivery mode, and how they are associated with changes in behavioral outcomes (e.g., dependence, changes in rates of use, problem behaviors). This project will use ecological momentary assessment (EMA) to gather in-depth, real-time naturalistic reports of 425 young adult (aged 18-25) tobacco and cannabis co-users’ daily experiences and product use behaviors. Across two waves of EMA, we will capture episodes in which young adults use each product alone as well as when they use them concurrently (during the same episode), either in a common delivery device (e.g., blunt or vaporizer) or in succession. We will examine how the proximal context in which the combination of product use occurs and the individual's subjective, affective, and neurocognitive reactions to those use experiences vary by delivery mode (combustible or vaporized) and individual characteristics, and how these factors influence future tobacco and cannabis use patterns. Knowledge gained will provide needed evidence about the behavioral and neurocognitive consequences of co-use use that will help better inform prevention, intervention, and policy approaches to reducing harms of both products. This project is also timely in that its data collection occurs in a state (Illinois) that will have just legalized recreational cannabis use (effective January, 2020).