A review of the additive health risk of cannabis and tobacco co-use

•Few co-use studies examine toxicant exposure.•It is unclear whether co-use causes additive toxicant exposure.•“Chasing” marijuana with a tobacco cigarette does not appear to affect CO.•Marijuana dosage does not appear to affect CO or topography.•Prevalence of ENDs and marijuana co-use is low, but m...

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Vydané v:Drug and alcohol dependence Ročník 166; s. 6 - 12
Hlavní autori: Meier, Ellen, Hatsukami, Dorothy K.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Ireland Elsevier B.V 01.09.2016
Predmet:
Blunts
Cannabis
Cannabis - adverse effects
Carbon Monoxide - administration & dosage
Carbon Monoxide - adverse effects
Co-use
Comorbidity
Dual use
E-cigarettes
Electronic Nicotine Delivery Systems - adverse effects
Electronic Nicotine Delivery Systems - trends
Humans
Marijuana Smoking - adverse effects
Marijuana Smoking - epidemiology
Marijuana Smoking - trends
Nicotine
Nicotine - administration & dosage
Nicotine - adverse effects
Psychiatry
Risk Factors
Risk-Taking
Smoking - adverse effects
Smoking - epidemiology
Smoking - trends
Tobacco
Tobacco Products - adverse effects
Co-use
Dual use
Cannabis
Tobacco
E-cigarettes
Blunts
Nicotine
ISSN:0376-8716, 1879-0046, 1879-0046
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Shrnutí:•Few co-use studies examine toxicant exposure.•It is unclear whether co-use causes additive toxicant exposure.•“Chasing” marijuana with a tobacco cigarette does not appear to affect CO.•Marijuana dosage does not appear to affect CO or topography.•Prevalence of ENDs and marijuana co-use is low, but may be growing. Cannabis and tobacco are the most widely used substances, and are often used together. The present review examines the toxicant exposure associated with co-use (e.g., carbon monoxide, carcinogens), co-use via electronic nicotine delivery systems (ENDS), and problematic methodological issues present across co-use studies. An extensive literature search through PubMed was conducted and studies utilizing human subjects and in vitro methods were included. Keywords included tobacco, cigarette, e-cigarette, ENDS, smoking, or nicotine AND marijuana OR cannabis OR THC. Co-use may pose additive risk for toxicant exposure as certain co-users (e.g., blunt users) tend to have higher breath carbon monoxide levels and cannabis smoke can have higher levels of some carcinogens than tobacco smoke. Cannabis use via ENDS is low and occurs primarily among established tobacco or cannabis users, but its incidence may be increasing and expanding to tobacco/cannabis naïve individuals. There are several methodological issues across co-use research including varying definitions of co-use, sample sizes, lack of control for important covariates (e.g., time since last cigarette), and inconsistent measurement of outcome variables. There are some known additive risks for toxicant exposure as a result of co-use. Research utilizing consistent methodologies is needed to further establish the additive risk of co-use. Future research should also be aware of novel technologies (e.g., ENDS) as they likely alter some toxicant exposure when used alone and with cannabis.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
content type line 23
ISSN:0376-8716
1879-0046
1879-0046
DOI:10.1016/j.drugalcdep.2016.07.013