Short communicationFrequent marijuana use is associated with greater nicotine addiction in adolescent smokers
Section snippets
Background
Marijuana is the most widely used illicit substance worldwide (UNDOC, 2010). In 2010, more US high school students used marijuana in the prior 30 days than tobacco (Johnston et al., 2011). Co-use with tobacco is of increasing interest (Akre et al., 2010, Ramo et al., 2012, Soldz et al., 2003). Smoking marijuana with tobacco, either in a tobacco leaf (i.e. blunt) or mixed with tobacco, is an increasingly common practice among adolescents (Golub et al., 2005) thought by some users to prolong the
Participants
Adolescents between the ages of 13–17 from the San Francisco Bay Area who smoked at least 1 cigarette in the past 30 days were recruited as part of an ongoing smoking trajectory study detailed elsewhere (Rubinstein et al., 2013). Adolescents responding to online, school and clinic-based advertising were invited to complete the study visit. Participants were screened to exclude those who had used any form of nicotine replacement in the prior month. Females with positive pregnancy tests were
Results
Two hundred adolescents were consented into the study and completed the baseline visit. Of those, 28 denied smoking cigarettes in the past 30 days and 7 declined to answer the question about marijuana use and were thus excluded from the analysis. The resulting sample (N = 165, 64% female) had a mean age of 16.1 years (SD = 0.95) and was racially diverse, with 28% participants identifying as White, 19% African American, 19% Hispanic and 34% other. Participants averaged 3.01 CPD (SD = 3.0) for a
Discussion
Marijuana smoking was prevalent in this adolescent sample of tobacco smokers: 80% reported past month marijuana use and more than a third smoked marijuana daily. Notably, among adolescent tobacco smokers who also smoked marijuana, the frequency of marijuana use was associated with greater levels of nicotine addiction on all three major scales used in studies with adolescents plus the ICD-10. Moreover, models incorporating age, frequency and years of tobacco smoking with marijuana accounted for
Role of funding source
Funding for this study was provided by NIDA Grant R01 DA036508; the NIDA had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
Contributors
All authors made: (1) substantial contributions to the conception and analysis and interpretation of data; (2) drafting the article and revising it critically for important intellectual content; and (3) gave final approval of the version to be published.
Conflict of interest
All authors declare that they have no conflicts of interest. None of the authors have sources of funding, direct or indirect, and/or any connection with the tobacco industry.
Acknowledgments
The authors would like to thank Ms. Jennifer Simington, Ms. Grace Wu and Mr. Max Berlyant for their assistance with data collection and participant recruitment.
References (32)
- et al.
Transitions from first substance use to substance use disorders in adolescence: is early onset associated with a rapid escalation?
Drug Alcohol Depend.
(2009) - et al.
Comparison of subjective, pharmacokinetic, and physiological effects of marijuana smoked as joints and blunts
Drug Alcohol Depend.
(2009) - et al.
History of alcohol or drug problems, current use of alcohol or marijuana, and success in quitting smoking
Addict. Behav.
(1999) - et al.
Adolescents’ self-defined tobacco use status, marijuana use, and tobacco dependence
Addict. Behav.
(2008) - et al.
Measuring nicotine dependence among high-risk adolescent smokers
Addict. Behav.
(1996) - et al.
Tobacco and marijuana use among adolescents and young adults: a systematic review of their co-use
Clin. Psychol. Rev.
(2012) - et al.
Validation of the nicotine dependence syndrome scale (NDSS): a criterion-group design contrasting chippers and regular smokers
Drug Alcohol Depend.
(2005) - et al.
Examining the psychometric properties and predictive validity of a youth-specific version of the Nicotine Dependence Syndrome Scale (NDSS) among teens with varying levels of smoking
Addict. Behav.
(2009) - et al.
Progression from marijuana use to daily smoking and nicotine dependence in a national sample of U.S. adolescents
Drug Alcohol Depend.
(2007) - et al.
The co-occurring use and misuse of cannabis and tobacco: a review
Addiction
(2012)