Abstract：
BACKGROUND: Polysubstance use is associated with adverse health outcomes, yet little research has measured changes in polysubstance use. We aimed to 1) estimate trends in marijuana and heavy alcohol use by cigarette smoking and demographic subgroups, and 2) examine patient factors associated with concurrent use among adults who were smoking.
METHODS: We conducted a repeated cross-sectional analysis of 687,225 non-institutionalized US adults ≥18 years from the 2002-2019 National Survey on Drug Use and Health. Participants were stratified into current, former, and never smoking groups. Main outcomes were prevalence of heavy alcohol use, marijuana use, and concurrent use of both substances.
RESULTS: From 2002-2019, heavy alcohol use declined from 7.8 % to 6.4 %, marijuana use rose from 6.0 % to 11.8 %, and concurrent use of alcohol and marijuana remained stable. Among adults who were smoking from 2005 to 2019, higher education was associated with higher odds of heavy alcohol use, while older ages, female gender, non-White race/ethnicity, and government-provided health insurance were associated with lower odds. The odds of marijuana use decreased in females, older ages, and higher incomes while increasing in people with poorer health status, higher education, government-provided or no health insurance, and serious mental illness. Compared to White adults who were smoking, Black counterparts had higher odds of marijuana use (OR=1.23; 95 %CI: 1.15-1.29), while Hispanic (OR=0.68; 95 %CI: 0.63-0.72) and other racial/ethnic identities (OR=0.83; 95 %CI: 0.77-0.90) had lower odds.
CONCLUSIONS: Our study suggests marijuana use might not be sensitive to changes in the use of tobacco and alcohol.
METHODS: We conducted a repeated cross-sectional analysis of 687,225 non-institutionalized US adults ≥18 years from the 2002-2019 National Survey on Drug Use and Health. Participants were stratified into current, former, and never smoking groups. Main outcomes were prevalence of heavy alcohol use, marijuana use, and concurrent use of both substances.
RESULTS: From 2002-2019, heavy alcohol use declined from 7.8 % to 6.4 %, marijuana use rose from 6.0 % to 11.8 %, and concurrent use of alcohol and marijuana remained stable. Among adults who were smoking from 2005 to 2019, higher education was associated with higher odds of heavy alcohol use, while older ages, female gender, non-White race/ethnicity, and government-provided health insurance were associated with lower odds. The odds of marijuana use decreased in females, older ages, and higher incomes while increasing in people with poorer health status, higher education, government-provided or no health insurance, and serious mental illness. Compared to White adults who were smoking, Black counterparts had higher odds of marijuana use (OR=1.23; 95 %CI: 1.15-1.29), while Hispanic (OR=0.68; 95 %CI: 0.63-0.72) and other racial/ethnic identities (OR=0.83; 95 %CI: 0.77-0.90) had lower odds.
CONCLUSIONS: Our study suggests marijuana use might not be sensitive to changes in the use of tobacco and alcohol.
摘要：
背景：多物质使用与不良健康结果相关，然而，很少有研究测量多物质使用的变化。我们的目的是1)估计吸烟和人口亚组对大麻和重度酒精使用的趋势，和2）检查与吸烟成年人并发使用相关的患者因素。
方法：我们从2002-2019年全国药物使用和健康调查中对687,225名≥18岁的非机构化美国成年人进行了重复的横断面分析。参与者被分层为当前，前者,从不吸烟的团体。主要结果是大量饮酒的患病率，使用大麻,同时使用这两种物质。
结果：从2002年到2019年，大量饮酒从7.8％下降到6.4％，大麻使用量从6.0%上升至11.8%,同时使用酒精和大麻保持稳定。在2005年至2019年吸烟的成年人中，高等教育与大量饮酒的可能性更高。虽然年龄较大，女性性别,非白人种族/种族，和政府提供的健康保险与较低的几率相关.女性使用大麻的几率降低了，年龄较大,和更高的收入，而健康状况较差的人却在增加，高等教育,政府提供或没有医疗保险，和严重的精神疾病。与吸烟的白人相比，黑人同行使用大麻的几率更高（OR=1.23；95CI：1.15-1.29），而西班牙裔（OR=0.68;95CI：0.63-0.72）和其他种族/族裔身份（OR=0.83;95CI：0.77-0.90）的几率较低。
结论：我们的研究表明，使用大麻可能对烟草和酒精使用的变化不敏感。
方法：我们从2002-2019年全国药物使用和健康调查中对687,225名≥18岁的非机构化美国成年人进行了重复的横断面分析。参与者被分层为当前，前者,从不吸烟的团体。主要结果是大量饮酒的患病率，使用大麻,同时使用这两种物质。
结果：从2002年到2019年，大量饮酒从7.8％下降到6.4％，大麻使用量从6.0%上升至11.8%,同时使用酒精和大麻保持稳定。在2005年至2019年吸烟的成年人中，高等教育与大量饮酒的可能性更高。虽然年龄较大，女性性别,非白人种族/种族，和政府提供的健康保险与较低的几率相关.女性使用大麻的几率降低了，年龄较大,和更高的收入，而健康状况较差的人却在增加，高等教育,政府提供或没有医疗保险，和严重的精神疾病。与吸烟的白人相比，黑人同行使用大麻的几率更高（OR=1.23；95CI：1.15-1.29），而西班牙裔（OR=0.68;95CI：0.63-0.72）和其他种族/族裔身份（OR=0.83;95CI：0.77-0.90）的几率较低。
结论：我们的研究表明，使用大麻可能对烟草和酒精使用的变化不敏感。
