Cannabis use and co-use in tobacco smokers and nonsmokers: prevalence and associations with mental health in a cross-sectional, nationally representative sample ofadults in Great Britain, 2020

2020 · doi:10.32388/2f4aq1.2
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This study found that tobacco smokers had higher odds of past-year and daily cannabis use, with co-users reporting the most mental health issues compared to cannabis-only, tobacco-only, and non-users.

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This cross-sectional analysis used a nationally representative sample of adults in Great Britain (2020) to examine prevalence of cannabis use and patterns of co-use with tobacco, and to assess associations with mental health outcomes in both smokers and nonsmokers. The study reports how common cannabis use and cannabis–tobacco co-use were across groups and evaluates correlations between these cannabis-related behaviors and measures of mental health. A key limitation of the design is that, because it is cross-sectional, it cannot establish temporal order or causality between cannabis use/co-use and mental health status. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

This study has published https://onlinelibrary.wiley.com/doi/abs/10.1111/add.15381  BACKGROUND AND AIMS: In Great Britain, cannabis and tobacco are commonly used substances, both independently and together. Use of either substance is associated with mental health problems, but prevalence of co-use within these populations is unknown. We aimed to 1) estimate prevalence of cannabis use, frequency of use and routes of administration (ROA) among tobacco smokers and non-smokers and 2) investigate mental health problems amongst non-users, tobacco-only, cannabis-only and co-users of both substances.    DESIGN: Cross-sectional national online survey (Action on Smoking and Health) fielded in February–March 2020. SETTING: Great Britain PARTICIPANTS: Adults in Great Britain aged ≥ 18 year (n = 12,809) MEASUREMENTS: Tobacco use status (smoker [daily or non-daily] or non-smoker [never or ex-smoker]), cannabis use frequency (never to daily), detailed ROAs of cannabis, self-reported treatment for mental health disorders (depression, anxiety, and any). Statistically weighted prevalence estimates were computed to ensure representativeness. Correlates were assessed using chi-squared tests and logistic regression.  FINDINGS: In Great Britain in 2020, 7.1% of the sample had used cannabis in the past year. Tobacco smokers had greater odds of using cannabis in the past year (21.9%) and using cannabis daily (8.7%) than non-smokers (past-year: 4.7%; aOR=10.07, [95% CI: 8.4 -12.0]; daily: 0.7%; aOR=24.6, [95% CI: 17.96-35.55]). Co-administration with tobacco was common (46.2% of non-smokers, 80.8% of tobacco smokers). Co-users reported the highest prevalence of any treatment for mental health problems (54.2%) in comparison to cannabis-only (45.8%), tobacco-only (33.2%) and non-users (22.7%; all p≤0.05). CONCLUSION:  Approximately one in 13 adults in Great Britain reports having used cannabis in the past year, approximately four times as many among cigarette smokers as non-smokers. Co-administration of cannabis and tobacco, via smoking, appears to be common, including among self-identified non-smokers. Mental health problems appear to be particularly common among dual users. 
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