Predictors and Consequences of Nicotine and Cannabis Vaping Co-use in Young Adults: A Longitudinal and EMA Analysis

同时使用烟草和大麻制品在年轻人（18-24岁）中很常见，最近 数据显示，随着监管和零售环境的变化， 药物（例如，娱乐性大麻合法化;“vape商店”在全国范围内蔓延）。这是一个严肃的公众 健康问题，因为个人谁从事共同使用-特别是那些谁使用烟草和大麻的 相同的使用场合（例如，在同一输送装置中混合在一起）-可能更严重地使用两种药物， 在心理健康和身体疾病等领域表现出较差的功能结果。虽然绝 迄今为止，大多数关于共同使用的研究都集中在可燃产品上，电子产品的日益普及， 尼古丁输送系统和类似的装置，以“vape”尼古丁和大麻（以下简称vaping产品）， 导致了共同使用这些药物的新方法。这是令人担忧的，因为尽管对健康的风险低于 可燃产品，vaping不是无害的。然而，人们对日常模式、相关因素和 尼古丁和大麻vaping在年轻人中共同使用的后果。目前的研究将解决这些问题。 知识库中的重大差距，1）使用生态瞬时评估（EMA）进行日常评估 尼古丁和大麻vaping和产品共同使用的模式和2）利用13年的年度调查数据 跨越青春期早期到成年期，研究相关的预测因素和后果， 年轻人在日常生活中使用尼古丁/大麻的模式。我们计划招募240名参与者， 正在进行的多波STRATA队列研究主要针对加州的约2,500名年轻人， 自2008年以来一直在收集关于药物使用和其他风险因素的年度数据。我们将使用EMA 通过智能手机应用程序在三周内进行管理，以评估 尼古丁/大麻电子烟，检查一天内和一天中的情境因素以及与之相关的功能 尼古丁/大麻电子烟我们还将EMA数据与纵向STRATA调查数据联系起来， 青少年的风险因素与现实世界（EMA）模式之间的前瞻性关联 尼古丁/大麻vaping在年轻的成年人。最后，我们将比较从事以下活动的个人的调查结果： 同时使用尼古丁和大麻vaping产品（NV+CV; n=80）与仅使用尼古丁vape的人相比 (NV; n=80）或仅使用大麻（CV; n=80），以探索共同使用的模式、预测因素和后果 可能不同于单一产品使用。这项研究的结果将大大提高人们对 与年轻人中尼古丁和大麻电子烟相关的因素，可以为监管工作和 制定预防/干预计划，以减轻与使用这些药物相关的潜在危害 新型药物输送系统。

Co-use of both tobacco and cannabis products is common among young adults (ages 18-24), and recent data suggest that rates of co-use may be rising in line with changes in regulatory and retail landscapes for these drugs (e.g., recreational cannabis legalization; the spread of “vape shops” nationwide). This is a serious public health problem, as individuals who engage in co-use –especially those who use tobacco and cannabis on the same use occasion (e.g., mixed together in the same delivery device)– may use both drugs more heavily and show poorer functional outcomes in domains such as mental health and physical ailments. Although the vast majority of studies on co-use to date have focused on combustible products, the rising popularity of electronic nicotine delivery systems and similar devices to “vape” nicotine and cannabis (hereafter, vaping products) has led to novel methods for co-using these drugs. This is concerning because although less risky to health than combustible products, vaping is not harm-free. Yet, little is known about daily patterns, correlates, and consequences of nicotine and cannabis vaping co-use in young people. The current study will address these substantial gaps in the knowledge base by 1) using Ecological Momentary Assessment (EMA) to assess daily patterns of nicotine and cannabis vaping and product co-use and 2) leveraging 13 years of annual survey data spanning early adolescence through emerging adulthood to examine predictors and consequences associated with young adults’ patterns of nicotine/cannabis vaping in daily life. We plan to recruit 240 participants from the ongoing, multi-wave STRATA cohort study of ~ 2,500 young people based primarily in California, for which annual data on substance use and other risk factors has been collected since 2008. We will use EMA administered via a smartphone application over a three-week period to assess daily patterns of nicotine/cannabis vaping, examine within- and across-day situational factors and functioning associated with nicotine/cannabis vaping. We will also link EMA data with longitudinal STRATA survey data to examine prospective associations between risk factors in adolescence and real-world (EMA) patterns of nicotine/cannabis vaping in young adulthood. Finally, we will compare findings for individuals who engage in co-use of both nicotine and cannabis vaping products (NV+CV; n=80) against those who vape nicotine only (NV; n=80) or cannabis only (CV; n=80) to explore how patterns, predictors, and consequences of co-use may differ from single-product use. Findings from this study will significantly improve the understanding of factors associated with nicotine and cannabis vaping in young adults and can inform regulatory efforts and the development of prevention/ intervention programs to mitigate potential harms associated with use of these novel drug delivery systems.