Abstract
Cannabis users who are also tobacco smokers are more likely to exhibit cannabis dependence and psychosocial problems. However, there has been minimal research around various cannabis and tobacco mixing (spliff usage) behaviours and likeliness to smoke the first joint within an hour of waking, known colloquially as wake and bake. The time of first joint and spliff usage may be related as they are associated with the intersection of tobacco and cannabis use. Compared to non-morning cannabis users, morning users reported significantly more cannabis-related problems. Through a survey of US cannabis users, we test the association between various cannabis and spliff use behaviours and likeliness to smoke the first joint within an hour of waking. Compared to those who smoked tobacco and did not use spliffs, the following spliff use behaviour groups were less likely to have their first joint within 60 minutes after waking: those who smoked tobacco and used spliffs (95%CI: 0.605–0.988); those who never smoked tobacco and did not use spliffs (95%CI: 0.489–0.892); those who never smoked tobacco and used spliffs (95%CI:0.022–0.915). We provided possible explanations for our results and suggested further research to better understand findings, important given expanding US cannabis markets.
Highlights
Cannabis users who are tobacco smokers are more likely to exhibit cannabis dependence and psychosocial problems
Several studies have detailed US cannabis use prevalence[7,8,9], but there has been minimal research around various cannabis and tobacco mixing behaviours and likeliness to smoke the first joint within an hour of waking, known colloquially as wake and bake[10]
Time to first tobacco cigarette is correlated with many dimensions of nicotine dependence; for example, individuals who smoked their first cigarette within an hour of waking tend to smoke more per day and experienced increased difficulty in quitting[15,16]
Summary
Cannabis users who are tobacco smokers are more likely to exhibit cannabis dependence and psychosocial problems. There has been minimal research around various cannabis and tobacco mixing (spliff usage) behaviours and likeliness to smoke the first joint within an hour of waking, known colloquially as wake and bake. Through a survey of US cannabis users, we test the association between various cannabis and spliff use behaviours and likeliness to smoke the first joint within an hour of waking. About one in 11 US cannabis users aged 15 or older develops dependent patterns of use, with about 4.2 million people meeting diagnostic criteria for frequent or problematic use[5] Such patterns of cannabis use are often associated with psychotic symptoms, suicidal ideation and major depressive disorder[6].
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