Do early experiences with cannabis vary in cigarette smokers?
We examine whether regular cigarette smokers were more likely to be exposed to and use cannabis at an earlier age, and further, upon initiation, whether their initial experiences with cannabis varied from those reported by never/non-regular cigarette smokers.
A sample of 3797 Australian twins and siblings aged 21-46 years was used. Survival analyses examined whether cigarette smokers were at increased likelihood of early opportunity to use cannabis and early onset of cannabis use. Logistic regression examined whether cigarette smokers reported greater enjoyment of their cannabis experience, inhaling on the first try, differing positive and negative initial subjective reactions, smoked cigarettes with cannabis the first time and were more likely to try cannabis again within a week.
Regular cigarette smokers were more likely to report an earlier opportunity to use cannabis and early onset of cannabis use. Regular cigarette smokers were also considerably more likely to have enjoyed their first experience with cannabis and reported higher rates of positive initial reactions. They were more likely to report inhaling on the first try and smoking cigarettes with cannabis. Potentially negative subjective reactions were also elevated in regular cigarette smokers. Importantly, cigarette smokers were at 1.87 increased odds of smoking cannabis within a week of their initial use.
These findings indicate that the well-known overlap in cannabis and cigarette smoking behaviors may evolve as early as opportunity to use and extend through the course of the substance use trajectory.
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ABSTRACT: Initial subjective reactions to cannabis and tobacco, broadly classified as positive or negative, have previously been explored for their associations with onset and maintenance of subsequent abuse/dependence. We examine (a) the factorial architecture of self-reported initial reactions to cannabis and tobacco; (b) whether these factors associate with concurrently reported age at onset of DSM-IV diagnosis of nicotine dependence and cannabis abuse/dependence; and (c) estimate heritable variation in and covariation between the factors. Factorial and exploratory structural equation modeling was conducted to examine the factor structure of initial reactions. Cox proportional hazards modeling was employed to examine their association with time to onset of diagnosis of DSM-IV nicotine dependence and cannabis abuse/dependence. Classical twin modeling, using univariate and multivariate models, was used to parse variance in each factor (and the covariance between factors) to their additive genetic, shared environmental and non-shared environmental sources. General population sample of Caucasian female twins aged 18-32 years, with a lifetime history of tobacco [N=2393] and cannabis [N=1445] use. Self-report of initial subjective reactions to tobacco (cigarettes) and cannabis the first time they were used and time to onset of lifetime history of DSM-IV diagnosis of abuse (cannabis) and dependence (cannabis or nicotine). Factors representing putatively positive and negative reactions to cannabis and tobacco emerged. Initial reactions to tobacco were associated with onset of DSM-IV diagnosis of nicotine dependence and cannabis abuse/dependence while initial reactions to cannabis were associated with onset of DSM-IV diagnosis of cannabis abuse/dependence alone. Genetic factors played a moderate role in each factor (heritability of 27-35%, p < 0.05) with the remaining variance attributed to individual-specific environment. Covariation across the factors indexing positive and negative initial reactions was attributable to genetic sources (rg=0.09-0.55, p < 0.05), and in some instances, to overlapping individual-specific environmental factors (re=0.17-0.28, p < 0.05). Initial subjective reactions to tobacco are associated with later onset of DSM-IV diagnosis of nicotine dependence and cannabis abuse/dependence while initial subjective reactions to cannabis are only associated with onset of diagnosis of DSM-IV cannabis abuse/dependence. Genetic factors underpin the overlap across the factors representing initial reactions, both positive and negative.Addiction 12/2013; 109(4). DOI:10.1111/add.12449 · 4.74 Impact Factor
Chapter: Prevention Strategies and Basics[Show abstract] [Hide abstract]
ABSTRACT: Prevention has the potential to be effective in changing substance use and related behaviors such as delinquency, violence, and sexual behavior. Interventions that achieve this do not solely inform people about the dangers of drugs but also focus on the key determinants of successful socialization, now confirmed by neuropsychological research: social norms and control, executive and social skills, as well as impulse control. Thus, universal prevention addresses the population at large and targets the development of skills and values, norm perception, and interaction with peers and social life; selective prevention addresses the vulnerable groups where substance use is often concentrated and focuses on improving their opportunities in difficult living and social conditions; and indicated prevention addresses vulnerable individuals and helps them to deal and cope with the individual personality traits that make them more vulnerable to escalating drug use. While these prevention types predominantly use persuasion, prevention can complementarily and effectively change human behavior by modifying its social, physical, and economic context. Environmental prevention uses these means to subtly alter social cues and norms and their perception. Effective examples range from intervening at society level through market regulations of alcohol and tobacco, changing the physical environment of party settings, to more rule setting and monitoring within families. The challenge for drug prevention lies therefore in helping people to adjust their behavior, capacities, and well-being in fields of multiple influences – such as social norms, interaction with peers, living conditions, and their own personality traits – in order to reduce risk behaviors related to substances.Textbook of Addiction Treatment: International Perspectives, Edited by el-Guebaly N, Carrà G, Galanter M, 01/2015: chapter Prevention Strategies and Basics: pages 115-142; Springer., ISBN: 978-88-470-5321-2
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ABSTRACT: Background: According to the gateway hypothesis, tobacco use is a gateway of cannabis use. However, there is increasing evidence that cannabis use also predicts the progression of tobacco use (reverse gateway hypothesis). Unfortunately, the importance of cannabis use compared to other predictors of tobacco use is less clear. The aim of this study was to examine which variables, in addition to cannabis use, best predict the onset of daily cigarette smoking in young men. Methods: A total of 5,590 young Swiss men (mean age = 19.4 years, SD = 1.2) provided data on their substance use, socio-demographic background, religion, health, social context, and personality at baseline and after 18 months. We modelled the predictors of progression to daily cigarette smoking using logistic regression analyses (n = 4,230). Results: In the multivariate overall model, use of cannabis remained among the strongest predictors for the onset of daily cigarette use. Daily cigarette use was also predicted by a lifetime use of at least 50 cigarettes, occasional cigarette use, educational level, religious affiliation, parental situation, peers with psychiatric problems, and sociability. Conclusions: Our results highlight the relevance of cannabis use compared to other potential predictors of the progression of tobacco use and thereby support the reverse gateway hypothesis.BMC Public Health 09/2015; 15(1):843. DOI:10.1186/s12889-015-2194-3 · 2.26 Impact Factor