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，超过 在18-24岁的年轻人中，有20%的人报告在过去的一个月里同时使用了这两种物质。有越来越多的证据表明 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，且一种产品使用会增加使用另一种产品的可能性和无法阻止另一种产品。共同使用的是 一个广义的术语，可以包括在给定的时间范围内(例如，过去的一个月)使用这两种物质 给定情节(同时使用)、按顺序(追逐)、或在同一传送设备中混合在一起(共同使用 行政管理)。直到最近，联合使用通常也仅限于易燃方法，要么各自吸烟 单独生产或将它们组合在一起(例如，在钝体或拼接中)。随着电子尼古丁递送的增加 系统(结束)以及越来越多的州将娱乐性大麻合法化，有了新的选择来联合 使用和结束含有尼古丁的电子液体蒸气的设备正在成为更受欢迎的消费方式 大麻。尽管关于共同使用的研究正在增长，但在方法学上存在许多局限性。 先前的工作，包括缺乏关于共同使用的具体模式和交付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。较少 已知可能导致年轻人共同使用不同模式的因素，这可能 保持共同使用，这可能与不同的结果相关。这项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有关的情况和瞬间因素，如何 它们可以根据交付模式以及它们如何与行为结果的改变相关联而变化(例如， 依赖、使用率的变化、问题行为)。本项目将利用生态瞬间 评估(EMA)收集425名年轻人(18-25岁)烟草和烟草的深入、实时的自然报告 大麻共同使用者的日常体验和产品使用行为。跨越两波均线，我们将捕获 年轻人单独使用每种产品以及同时使用这些产品的场景(在 相同的情节)，或者在公共输送装置中(例如，钝化或汽化器)或连续。我们将研究 产品使用和个体的主观，情感， 对这些使用体验的神经认知反应因交付方式(燃烧或蒸发)而异 个人特征，以及这些因素如何影响未来烟草和大麻的使用模式。知识 Gain将提供必要的证据，说明共同使用的行为和神经认知后果 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 Project也是及时的，因为它的数据收集发生在一个刚刚将娱乐合法化的州(伊利诺伊州) 大麻使用(自2020年1月起生效)。

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).