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Research Summary

Characteristics of Adolescents Who Use Cannabis But Not Tobacco

Cannabis is associated with tobacco use and has been described as a “gateway” drug. But, whether adolescents who use cannabis only differ from those who use both cannabis and tobacco is unclear. To explore these possible differences, researchers assessed social and academic performance among a nationally representative sample of 5263 Swiss adolescents who either used cannabis only, cannabis and tobacco, or neither.

  • Subjects who used cannabis only, compared with subjects who used both cannabis and tobacco, were

    • more likely to practice sports (adjusted odds ratio [AOR], 2.4), be on an academic track (AOR, 2.6), and get good grades (AOR, 1.6);
    • less likely in the past month to use cannabis ≥10 times [AOR, 0.3] and get drunk ≥3 times [AOR, 0.6]).
  • Subjects who used cannabis only, compared with subjects who never used cannabis or tobacco, were

    • more likely to practice sports (AOR, 1.4), be on an academic track (AOR, 1.4), and report good peer relationships (AOR, 1.6) as well as be truant (AOR, 2.3), get drunk ≥3 times in the last month (AOR, 4.5), and use other illegal drugs in last month (AOR, 2.3);
    • less likely to report a good relationship with their parents (AOR, 0.6).

Comments:

Unexpectedly, this cross-sectional study found that adolescents who smoked cannabis only were more likely than adolescents who never used cannabis or tobacco to be engaged in sports, in an academic track, and to report good peer relationships. At the same time, cannabis only users were more likely to be truant, to get drunk, and to use other drugs. Prospective longitudinal analyses are needed to determine whether cannabis use is a cause or effect of these outcomes and how the interaction between tobacco and cannabis smoking influences adolescent development.

Alexander Y. Walley, MD, MSc

Reference:

Suris JC, Akre C, Berchtold A, et al. Some go without a cigarette: characteristics of cannabis users who have never smoked tobacco. Arch Pediatr Adolesc Med. 2007;161(11):1042–1047.


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