No Smoke without Tobacco: A Global Overview of Cannabis and Tobacco Routes of Administration and Their Association with Intention to Quit

Chandni Hindocha, Tom P Freeman, Jason A Ferris, Michael T Lynskey, Adam R Winstock

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Cannabis and tobacco are common drugs of abuse worldwide and are often used in combination through various routes of administration (ROAs). Here, we aimed to provide an overview of how cannabis and tobacco routes varied across countries and assess the impact of tobacco-based ROAs on motivation to use less cannabis, and less tobacco, in different models. A cross-sectional online survey (Global Drugs Survey 2014) was completed by 33,687 respondents (mean age = 27.9; % female = 25.9) who smoked cannabis at least once in the last 12 months. Most common ROA, frequency of cannabis/tobacco use, and questions about motivation to use less cannabis/tobacco were recorded. Tobacco-based ROA were used by 65.6% of respondents. These were most common in Europe (77.2-90.9%) and Australasia (20.7-51.6%) and uncommon in the Americas (4.4-16.0%). Vaporizer use was most common in Canada (13.2%) and the United States (11.2%). Using a non-tobacco ROA was associated with a 10.7% increase in odds for "desire to use less" tobacco (OR: 1.107, 95% CI: 1.003, 1.221), 80.6% increase in odds for "like help to use less tobacco" (OR: 1.806, 95% CI: 1.556, 2.095), and a 103.9% increase in the odds for "planning to seek help to use less tobacco" (OR: 2.039, 95% CI: 1.638, 2.539), in comparison to using a tobacco-based ROA. Associations between ROA and intentions to use less cannabis were inconsistent. Results support considerable global variation in cannabis and tobacco ROA. Tobacco routes are common, especially "joints with tobacco," especially in Europe, but not in the Americas. Non-tobacco-based routes are associated with increased motivation to change tobacco use. Interventions addressing tobacco and cannabis need to accommodate this finding and encourage non-tobacco routes.

LanguageEnglish
Article number104
JournalFrontiers in Psychiatry
Volume7
Early online date5 Jul 2016
DOIs
StatusPublished - Jul 2016

Fingerprint

Cannabis
Smoke
Tobacco
Tobacco Use
Motivation
Australasia
Nebulizers and Vaporizers
Street Drugs
Canada
Cross-Sectional Studies
Joints

Cite this

No Smoke without Tobacco : A Global Overview of Cannabis and Tobacco Routes of Administration and Their Association with Intention to Quit. / Hindocha, Chandni; Freeman, Tom P; Ferris, Jason A; Lynskey, Michael T; Winstock, Adam R.

In: Frontiers in Psychiatry , Vol. 7, 104, 07.2016.

Research output: Contribution to journalArticle

@article{e0077b0fe1794c1cbc4fde5a45329ac3,
title = "No Smoke without Tobacco: A Global Overview of Cannabis and Tobacco Routes of Administration and Their Association with Intention to Quit",
abstract = "Cannabis and tobacco are common drugs of abuse worldwide and are often used in combination through various routes of administration (ROAs). Here, we aimed to provide an overview of how cannabis and tobacco routes varied across countries and assess the impact of tobacco-based ROAs on motivation to use less cannabis, and less tobacco, in different models. A cross-sectional online survey (Global Drugs Survey 2014) was completed by 33,687 respondents (mean age = 27.9; {\%} female = 25.9) who smoked cannabis at least once in the last 12 months. Most common ROA, frequency of cannabis/tobacco use, and questions about motivation to use less cannabis/tobacco were recorded. Tobacco-based ROA were used by 65.6{\%} of respondents. These were most common in Europe (77.2-90.9{\%}) and Australasia (20.7-51.6{\%}) and uncommon in the Americas (4.4-16.0{\%}). Vaporizer use was most common in Canada (13.2{\%}) and the United States (11.2{\%}). Using a non-tobacco ROA was associated with a 10.7{\%} increase in odds for {"}desire to use less{"} tobacco (OR: 1.107, 95{\%} CI: 1.003, 1.221), 80.6{\%} increase in odds for {"}like help to use less tobacco{"} (OR: 1.806, 95{\%} CI: 1.556, 2.095), and a 103.9{\%} increase in the odds for {"}planning to seek help to use less tobacco{"} (OR: 2.039, 95{\%} CI: 1.638, 2.539), in comparison to using a tobacco-based ROA. Associations between ROA and intentions to use less cannabis were inconsistent. Results support considerable global variation in cannabis and tobacco ROA. Tobacco routes are common, especially {"}joints with tobacco,{"} especially in Europe, but not in the Americas. Non-tobacco-based routes are associated with increased motivation to change tobacco use. Interventions addressing tobacco and cannabis need to accommodate this finding and encourage non-tobacco routes.",
author = "Chandni Hindocha and Freeman, {Tom P} and Ferris, {Jason A} and Lynskey, {Michael T} and Winstock, {Adam R}",
year = "2016",
month = "7",
doi = "10.3389/fpsyt.2016.00104",
language = "English",
volume = "7",
journal = "Frontiers in Psychiatry",
issn = "1664-0640",
publisher = "Frontiers Media S.A.",

}

TY - JOUR

T1 - No Smoke without Tobacco

T2 - Frontiers in Psychiatry

AU - Hindocha, Chandni

AU - Freeman, Tom P

AU - Ferris, Jason A

AU - Lynskey, Michael T

AU - Winstock, Adam R

PY - 2016/7

Y1 - 2016/7

N2 - Cannabis and tobacco are common drugs of abuse worldwide and are often used in combination through various routes of administration (ROAs). Here, we aimed to provide an overview of how cannabis and tobacco routes varied across countries and assess the impact of tobacco-based ROAs on motivation to use less cannabis, and less tobacco, in different models. A cross-sectional online survey (Global Drugs Survey 2014) was completed by 33,687 respondents (mean age = 27.9; % female = 25.9) who smoked cannabis at least once in the last 12 months. Most common ROA, frequency of cannabis/tobacco use, and questions about motivation to use less cannabis/tobacco were recorded. Tobacco-based ROA were used by 65.6% of respondents. These were most common in Europe (77.2-90.9%) and Australasia (20.7-51.6%) and uncommon in the Americas (4.4-16.0%). Vaporizer use was most common in Canada (13.2%) and the United States (11.2%). Using a non-tobacco ROA was associated with a 10.7% increase in odds for "desire to use less" tobacco (OR: 1.107, 95% CI: 1.003, 1.221), 80.6% increase in odds for "like help to use less tobacco" (OR: 1.806, 95% CI: 1.556, 2.095), and a 103.9% increase in the odds for "planning to seek help to use less tobacco" (OR: 2.039, 95% CI: 1.638, 2.539), in comparison to using a tobacco-based ROA. Associations between ROA and intentions to use less cannabis were inconsistent. Results support considerable global variation in cannabis and tobacco ROA. Tobacco routes are common, especially "joints with tobacco," especially in Europe, but not in the Americas. Non-tobacco-based routes are associated with increased motivation to change tobacco use. Interventions addressing tobacco and cannabis need to accommodate this finding and encourage non-tobacco routes.

AB - Cannabis and tobacco are common drugs of abuse worldwide and are often used in combination through various routes of administration (ROAs). Here, we aimed to provide an overview of how cannabis and tobacco routes varied across countries and assess the impact of tobacco-based ROAs on motivation to use less cannabis, and less tobacco, in different models. A cross-sectional online survey (Global Drugs Survey 2014) was completed by 33,687 respondents (mean age = 27.9; % female = 25.9) who smoked cannabis at least once in the last 12 months. Most common ROA, frequency of cannabis/tobacco use, and questions about motivation to use less cannabis/tobacco were recorded. Tobacco-based ROA were used by 65.6% of respondents. These were most common in Europe (77.2-90.9%) and Australasia (20.7-51.6%) and uncommon in the Americas (4.4-16.0%). Vaporizer use was most common in Canada (13.2%) and the United States (11.2%). Using a non-tobacco ROA was associated with a 10.7% increase in odds for "desire to use less" tobacco (OR: 1.107, 95% CI: 1.003, 1.221), 80.6% increase in odds for "like help to use less tobacco" (OR: 1.806, 95% CI: 1.556, 2.095), and a 103.9% increase in the odds for "planning to seek help to use less tobacco" (OR: 2.039, 95% CI: 1.638, 2.539), in comparison to using a tobacco-based ROA. Associations between ROA and intentions to use less cannabis were inconsistent. Results support considerable global variation in cannabis and tobacco ROA. Tobacco routes are common, especially "joints with tobacco," especially in Europe, but not in the Americas. Non-tobacco-based routes are associated with increased motivation to change tobacco use. Interventions addressing tobacco and cannabis need to accommodate this finding and encourage non-tobacco routes.

U2 - 10.3389/fpsyt.2016.00104

DO - 10.3389/fpsyt.2016.00104

M3 - Article

VL - 7

JO - Frontiers in Psychiatry

JF - Frontiers in Psychiatry

SN - 1664-0640

M1 - 104

ER -