The impact of cannabis and tobacco/nicotine product co-use in young adults: Prospective cessation evaluation and substitution

大麻和烟草/尼古丁产品同时使用对年轻人的影响：预期戒烟评估和替代

• 批准号: 10735046
• 负责人: Erin A McClure
• 金额: $ 68.97万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10735046
• 关键词: Abstinence; Address; Affect; Age; Behavioral; Biochemical; Biological Markers; Cannabis; Cigarette; Clinical; Collaborations; Collection; Complement; Data; Evaluation; Goals; Health; Individual; Individual Differences; Intervention; Liquid substance; Literature; Measures; Medical; Methods; Nicotine; Oral; Outcome; Participant; Patient Self-Report; Pattern; Pharmaceutical Preparations; Positioning Attribute; Prevalence; Prospective Studies; Public Health; Publishing; Recommendation; Research; Role; Sampling; Smoking; South Carolina; Time; Tobacco; Tobacco Use Cessation; Treatment outcome; United States; Universities; Withdrawal; Youth; adverse outcome; age group; behavioral economics; clinical care; contingency management; diaries; experience; individualized medicine; innovation; marijuana use; nicotine cessation; nicotine treatment; nicotine use; prolonged abstinence; prospective; recruit; remote administration; secondary analysis; substance use; success; tobacco products; vaping; vaping nicotine; virtual therapy; young adult

PROJECT SUMMARY/ABSTRACT The co-use of nicotine/tobacco products and cannabis among young adults is prevalent and varies widely in terms of patterns and products of use. Nicotine-cannabis co-use among this age group may adversely affect treatment and other clinical outcomes, yet little is known regarding the underlying relationship between nicotine and cannabis and the resulting treatment implications, particularly during an attempt to quit or reduce use of one or both substances. Prior literature on the treatment implications of co-use, including results from our group, suggest that cannabis serves as an obstacle to nicotine cessation for a sub-set who use both products, though the literature is mixed. Past studies also suffer from important limitations, resulting in critical gaps in our understanding, with only 2 secondary analyses published from youth tobacco trials on the impact of co-use. To date, there are no prospective studies that have examined the treatment implications of nicotine-cannabis co- use or the underlying relationship between substances among young adults when engaged in a quit attempt. [[[Therefore, the overall goal of this project is to characterize and evaluate the underlying relationship between nicotine/tobacco and cannabis and its impact on nicotine cessation through a behavioral economics framework. This study will determine how impactful cannabis co-use may be on nicotine cessation and which individuals who co-use experience greater difficulty achieving cessation. To accomplish this goal, we propose a completely remote, prospective, 12-week nicotine cessation trial among young adults (ages 18-25; N=350) from across the United States who use nicotine (vaping, cigarettes or both) and cannabis products regularly. We will leverage our ongoing collaboration with DynamiCare Health to administer remote contingency management (CM) as the nicotine/tobacco treatment intervention, while cannabis use will not be addressed. Biochemical verification (through oral fluid samples) and self-reports (mobile daily diaries) of substance use will be collected. The aims of this proposed study are to: 1) evaluate the impact of behavioral economically derived measures of substance substitutability on end of treatment nicotine abstinence (Aim 1); 2) determine if treatment-induced nicotine abstinence, reduction, and/or withdrawal (a) is associated with co-occurring changes in cannabis demand and use and (b) if substance substitutability modifies this relationship (Aim 2); and 3) assess the reciprocal prospective relationship between patterns of nicotine and cannabis use during nicotine treatment (Aim 3). Evaluating nicotine-cannabis co-use as part of a prospective treatment study through a behavioral economics framework has never been conducted and will be important to informing the literature regarding individual co- use pattern differences, compensatory cannabis use, and treatment success.]]] Nicotine cessation treatment in young adults is a growing body of work and the role of cannabis co-use, and results from the proposed study, will inform clinical care and guide tailored treatment recommendations to promote successful and sustained abstinence.

项目总结/摘要 年轻人同时使用尼古丁/烟草制品和大麻的情况很普遍，而且在以下国家和地区差异很大： 使用模式和产品的条款。在这个年龄组中同时使用尼古丁和大麻可能会对 治疗和其他临床结果，但很少有人知道尼古丁之间的潜在关系， 以及由此产生的治疗影响，特别是在试图戒烟或减少使用大麻的过程中， 或两种物质。关于联合用药治疗意义的既往文献，包括我们小组的结果， 这表明，大麻作为一个障碍，尼古丁戒烟的子集谁使用这两种产品，虽然 文学是混合的。过去的研究也受到重要的限制，导致我们的关键差距 只有2份关于青年烟草试验对共同使用影响的二次分析发表。到 迄今为止，还没有前瞻性研究检查尼古丁-大麻联合治疗的意义， 使用或潜在的关系，物质之间的年轻人时，从事戒烟尝试。 [[[因此，本项目的总体目标是描述和评价 尼古丁/烟草和大麻及其通过行为经济学框架对尼古丁戒断的影响。 这项研究将确定大麻共同使用对尼古丁戒烟的影响，以及哪些人 共同使用的人更难实现戒烟。为了实现这一目标，我们提出了一个完全 一项在年轻成人（年龄18-25岁; N=350）中进行的远程、前瞻性、12周尼古丁戒烟试验， 经常使用尼古丁（电子烟，香烟或两者）和大麻产品的美国人。我们将利用 我们正在与DynamiCare Health合作，管理远程应急管理（CM）， 尼古丁/烟草治疗干预，而大麻的使用将不涉及。生化验证 （通过口腔液样本）和自我报告（移动的每日日记）。目标 这项拟议的研究是：1）评估的影响，行为经济衍生措施的物质 治疗结束时尼古丁戒断的替代性（目的1）; 2）确定治疗诱导的尼古丁 戒断、减少和/或戒断（a）与大麻需求的共同发生的变化有关， 使用和（B）物质替代性是否改变了这种关系（目标2）;和3）评估互惠 尼古丁治疗期间尼古丁和大麻使用模式之间的前瞻性关系（目标3）。 通过行为经济学评估尼古丁-大麻联合使用作为前瞻性治疗研究的一部分 框架从来没有进行，将是重要的通知文学关于个人共同的， 使用模式差异、补偿性大麻使用和治疗成功。]]戒烟治疗 年轻的成年人是一个越来越多的工作和大麻共同使用的作用，并从拟议的研究结果， 将为临床护理提供信息，并指导量身定制的治疗建议，以促进成功和持续的 禁欲