Determining the impact of cannabis use and severity on tobacco cessation outcomes: A prospective tobacco treatment trial

确定大麻使用及其严重程度对戒烟结果的影响：前瞻性烟草治疗试验

基本信息

批准号：
10652480
负责人：
Erin A McClure
金额：
$ 59.28万
依托单位：
MEDICAL UNIVERSITY OF SOUTH CAROLINA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10652480
关键词：
Abstinence Address Adult Adverse effects Affect Age Behavior Therapy Biochemical Cannabis Consensus Counseling Dairying Data Disparity Dose General Population Health Individual Differences Literature Medical Methodology Methods Nicotine Dependence Outcome Participant Patient Self-Report Perception Pharmacotherapy Population Positioning Attribute Prevalence Prospective Studies Provider Recommendation Relaxation Research Sampling Sampling Studies Severities Smoker Statutes and Laws Substance Use Disorder Tobacco Tobacco Use Cessation Tobacco Use Disorder Tobacco use United States Variant cannabis cessation clinical care contingency management diaries efficacious treatment improved long term abstinence marijuana use marijuana user prospective psychosocial recruit smoking cessation substance use therapy development tobacco abstinence tobacco cessation intervention tobacco user treatment comparison treatment trial varenicline

项目摘要

PROJECT SUMMARY/ABSTRACT Tobacco use rates in the United States (US) have been steadily declining over the past several decades, though the burden resulting from tobacco continues to be staggering. Tobacco use rates are disproportionately high among those with co-occurring substance use disorders and psychiatric conditions compared to the general population. In particular, cannabis co-use among tobacco users is exceedingly common and rates of co-use appear to be increasing among adults in the US, which is consistent with overall increases in cannabis use rates among US adults. Given the current cannabis landscape, further increases in cannabis use are likely and may result in continued increases in the co-use of cannabis and tobacco. Despite high rates of co-use, there is little consensus regarding treatment recommendations for this population and an understanding of the impact of co-use on successful cessation. The literature on the impact of cannabis on tobacco cessation outcomes specifically has been mixed and fraught with limitations, including methodological variation, lack of biochemical verification to confirm cannabis use status and severity, and variations in study samples. Currently, no prospective studies have been conducted to evaluate the impact of cannabis use on tobacco cessation. Further, no studies have collected cannabis use changes during tobacco treatment to assess for reductions, abstinence, or of greater concern, compensatory (i.e., increased) use as a result of tobacco reduction/abstinence. This proposed application is a prospective 12-week tobacco cessation trial using established methods and outcomes typical of tobacco cessation trials, but specifically recruiting co-users of cannabis. Co-users will be oversampled (2:1) and will be compared to tobacco only participants. All participants (ages 18-40; N=172) will receive active tobacco cessation treatment (varenicline, contingency management, and psychosocial counseling) for 12 weeks, while cannabis use will not be specifically addressed. Biochemical verification of tobacco and cannabis use will be collected throughout the 12-week treatment, in addition to self-reports of use through mobile daily dairies. The aims of this proposed study are to; 1) examine the impact of cannabis co-use on tobacco cessation outcomes among co-users compared to tobacco only participants (Aim #1), 2) among cannabis co-users, assess changes in cannabis use during tobacco treatment (Aim #2), and 3) assess for a dose-dependent impact of cannabis co-use severity on tobacco cessation (Exploratory Aim #1). The results from this proposed application have the potential to impact the treatment of tobacco use disorder among those concurrently using cannabis and will contribute to treatment recommendations for providers. As cannabis use rates continue to increase, the presence of co- users in tobacco cessation trials and presenting in clinical care will continue to be common and results from this study will help to guide their treatment and provide them with the best chances of long-term abstinence.

项目概要/摘要过去几十年来，美国的烟草使用率一直在稳步下降，尽管烟草带来的负担仍然令人震惊。烟草使用率不成比例与同时患有物质使用障碍和精神疾病的人相比，该比例较高一般人群。特别是，烟草使用者中同时使用大麻的现象极为普遍，并且美国成年人中共同使用大麻的现象似乎有所增加，这与大麻的总体增长是一致的美国成年人的使用率。鉴于目前的大麻形势，大麻使用量可能会进一步增加并可能导致大麻和烟草的共同使用持续增加。尽管共同使用率很高，对于这一人群的治疗建议以及对这一问题的理解几乎没有达成共识共同使用对成功戒烟的影响。关于大麻对戒烟影响的文献具体而言，结果参差不齐且充满局限性，包括方法差异、缺乏生化验证，以确认大麻使用状况和严重程度以及研究样本的变化。目前，尚未进行前瞻性研究来评估大麻使用对烟草的影响停止。此外，没有研究收集烟草治疗期间大麻使用的变化来评估由于烟草而导致的减少、戒断或更令人担忧的补偿性（即增加）使用减少/禁欲。本提议的应用是一项为期 12 周的前瞻性戒烟试验，使用建立了戒烟试验的典型方法和结果，但特别招募了共同使用者大麻。共同使用者将被过采样 (2:1)，并将与仅吸烟的参与者进行比较。全部参与者（18-40 岁；N=172）将接受主动戒烟治疗（伐尼克兰、应急管理和心理社会咨询）为期 12 周，而大麻的使用不会受到特别限制已解决。将在整个 12 周内收集烟草和大麻使用的生化验证除了通过移动日报自我报告使用情况外，还包括治疗。这项拟议研究的目的是： 1) 比较大麻共同使用对共同使用者戒烟结果的影响大麻共同使用者中仅吸烟的参与者（目标#1）、2）评估大麻使用期间的变化烟草治疗（目标#2）和 3）评估大麻共同使用严重程度对剂量依赖性的影响戒烟（探索性目标#1）。该提议应用的结果有可能影响治疗同时使用大麻的人的烟草使用障碍，并将有助于为提供者提供治疗建议。随着大麻使用率持续增加，戒烟试验中的使用者和临床护理中的使用者将继续很常见，其结果是这项研究将有助于指导他们的治疗，并为他们提供长期禁欲的最佳机会。