Characterizing Cannabis Use and its Impact on Smoking Cessation Among Socioeconomically Disadvantaged Adults Participating in Smoking Cessation Treatment

本申请是为回应特别利益通知(NOSI)而提出的，该通知被确认为非- CA-22-070，检查烟草和大麻使用模式的行政补充资料。疾病的流行 吸烟者，尤其是社会经济地位较低的成年人，吸食大麻的比例更高。 然而，大麻的使用对戒烟的影响仍不清楚。拟议的行政管理 补充剂将利用正在进行的针对低收入成年吸烟者的戒烟干预试验 (R01CA251451)收集新的数据，以确定基线和每日大麻及烟草的使用和联合使用模式， 比较吸食大麻和不吸食大麻对呼吸道症状和身心健康的影响，并评估其影响 每日吸烟的大麻使用情况和戒烟后的戒烟时点流行率。来自135的数据 参加正在进行的父母试验的成年人将被包括在拟议的分析中，将在一年内完成 补充时间框架。所有参与者将提供关于其烟草和大麻使用情况的信息，在此之前 开始戒烟治疗，他们将完成基于智能手机的过期评估 一氧化碳(CO)、自我报告的烟草和大麻使用情况以及7周内的其他相关因素(1- 戒烟前一天至戒烟后4周，以及戒烟后第8周和第12周)。对CO-2的后续评估 经过验证的7天点戒烟盛行率将重点放在戒烟后4、8和12周的随访上，以适应 1年的补充时间范围。该补编将涉及以下具体目标：1)确定大麻的特征 参与戒烟治疗的低收入成年人的使用特征，包括a)基线和 每天使用大麻的流行率、频率、强度和方式(例如，燃烧与非燃烧)以及 使用原因，b)基线大麻依赖严重程度和危害认知，c)每日烟草流行率和 通过基于智能手机的日常日记评估大麻共同使用情况，以及d)基线和后续行动对减少或 戒除大麻；2)在基线上，比较过去30天吸食大麻与不吸食大麻的情况 社会人口学特征、烟草使用史、身心健康、酒精使用、呼吸道 症状、接触大麻二手烟、呼出的一氧化碳水平和香烟依赖；3)评估 大麻使用与戒烟之间的日内和远期关系，包括：a)两者之间的关系 基线大麻使用(过去30天使用与未使用相比)和随访时的戒烟结果(4、8和12 戒烟后几周)，b)大麻使用与吸烟欲望、戒断症状严重程度的日内关系，以及 通过基于智能手机的评估在预定戒烟尝试后的几周内吸烟，以及c)两者之间的关系 在预定吸烟后的头4周内大麻的使用频率(即几乎每天使用、使用的天数) 戒烟尝试与CO验证的点流行吸烟戒烟在后续。调查结果将产生重要的 关于在戒烟治疗期间使用大麻的影响的信息，并确定可能影响戒烟的因素 在戒烟干预中有针对性。

This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT- CA-22-070, Administrative Supplements for Examining Patterns of Tobacco and Cannabis Use. The prevalence of cannabis use is elevated among adults who smoke, and particularly among those with low socioeconomic status. However, the impact of cannabis use on smoking cessation remains unclear. The proposed administrative supplement will leverage an ongoing smoking cessation intervention trial for low-income adult smokers (R01CA251451) to collect new data to characterize baseline and daily cannabis and tobacco use and co-use patterns, compare cannabis users and non-users on respiratory symptoms and mental/physical health, and evaluate the impact of cannabis use on daily smoking and point prevalence smoking abstinence at post-quit follow-up. Data from 135 adults enrolled in the ongoing parent trial will be included in the proposed analyses, to be completed within the 1-year supplement time frame. All participants will provide information about their tobacco and cannabis use at baseline, prior to initiating smoking cessation treatment, and they will complete smartphone-based assessments of their expired carbon monoxide (CO), self-reported tobacco and cannabis use, and other relevant factors over a 7-week period (1- week pre-quit day through 4 weeks post-quit, and during post-quit weeks 8 and 12). Follow-up assessments of CO- verified 7-day point prevalence smoking abstinence will focus on follow-ups at 4, 8, and 12 weeks post-quit to fit within the 1-year supplement time frame. The supplement will address the following specific aims: 1) Characterize cannabis use characteristics among low-income adults participating in tobacco cessation treatment, including a) baseline and daily prevalence, frequency, intensity, and modalities of cannabis use (e.g., combusted vs. non-combusted) as well as reasons for use, b) baseline cannabis dependence severity and harm perceptions, c) daily prevalence of tobacco and cannabis co-use assessed via smartphone-based daily diaries, and d) interest at baseline and follow-up in reducing or abstaining from cannabis use; 2) At baseline, compare past 30-day cannabis users with non-users on sociodemographic characteristics, tobacco use history, physical and mental health, alcohol use, respiratory symptoms, exposure to cannabis secondhand smoke, expired CO levels, and cigarette dependence; 3) Evaluate the within-day and distal relationships between cannabis use and smoking cessation, including: a) the relation between baseline cannabis use (past 30-day use vs. non-use) and smoking cessation outcomes at follow-up (4, 8, and 12 weeks post-quit), b) the within-day relations of cannabis use with cigarette craving, withdrawal symptom severity, and smoking during the weeks following a scheduled quit attempt via smartphone-based assessments, and c) the relation of cannabis use frequency (i.e., near daily use, days of use) during the first 4 weeks following a scheduled smoking quit attempt with CO-verified point prevalence smoking abstinence at follow-ups. Findings will yield important information about the impact of cannabis use during smoking cessation treatment, and identify factors that can be targeted in cessation interventions.