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Randomized Controlled Trial
. 2014 Jul;40(4):285-91.
doi: 10.3109/00952990.2013.878718. Epub 2014 Apr 10.

Cigarette smoking during an N-acetylcysteine-assisted cannabis cessation trial in adolescents

Erin A McClure  1 , Nathaniel L Baker, Kevin M Gray
Affiliations
Randomized Controlled Trial

Cigarette smoking during an N-acetylcysteine-assisted cannabis cessation trial in adolescents

Erin A McClure et al. Am J Drug Alcohol Abuse. 2014 Jul.

Abstract

Background and objectives: Tobacco and cannabis use are both highly prevalent worldwide. Their co-use is also common in adults and adolescents. Despite this frequent co-occurrence, cessation from both substances is rarely addressed in randomized clinical trials. Given evidence that tobacco use may increase during cannabis cessation attempts, and additionally that tobacco users have poorer cannabis cessation outcomes, we explored tobacco outcomes, specifically cigarette smoking, from an adolescent cannabis cessation trial that tested the efficacy of N-acetylesteine (NAC).

Methods: Cannabis-dependent adolescents (ages 15-21; n = 116) interested in cannabis treatment were randomized to NAC (1200 mg bid) or matched placebo for 8 weeks. Participants did not need to be cigarette smokers or be interested in smoking cessation to qualify for inclusion.

Results: Approximately 59% of enrolled participants were daily and non-daily cigarette smokers, and only differed from non-smoking participants on the compulsion sub-scale of the Marijuana Craving Questionnaire. Among cigarette smokers who were retained in the study, there was no change in cigarettes per day for either NAC or placebo groups during the eight-week treatment phase. Being a cigarette smoker did not appear to influence the effects of NAC on cannabis abstinence, though there was a trend in the placebo group of poorer cannabis outcomes for cigarette smokers vs. non-smokers.

Conclusions: No evidence was found of compensatory cigarette smoking during this cannabis cessation trial in adolescents. Further work assessing interventions to reduce both cannabis and tobacco use in this population is greatly needed.

Keywords: N-acetylcysteine; adolescents; cannabis; cessation; cigarette; marijuana; smoking; tobacco.

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Conflict of interest statement

Declaration of Interest. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper. All authors contributed to the design and execution of the study, analyses of data, and manuscript preparation. All authors have read and approved the manuscript.

Figures

Figure 1
Figure 1
Self-reported cigarettes per day collected the 30 days prior to screening (S) and across the 8-week treatment phase for NAC and placebo (PBO) groups. Averaged cigarettes per day include smoking and non-smoking days. Only participants that completed at least one treatment phase study visit were included here (n=49). Error bars represent standard error of the mean.
Figure 2
Figure 2
Mean ratings on the Questionnaire on Smoking Urges-Brief (QSU-B) and the Modified Fagerström Tolerance Questionnaire (mFTQ) from the screening visit to the end of treatment (EOT; Week 8) for NAC (n=15) and Placebo (PBO; n=17) groups. Error bars represent standard error of the mean.
Figure 3
Figure 3
Proportion of participants abstinent from cannabis at screening (S) and across study week for cigarette smokers and non-smokers separated by NAC and PBO groups. All participants were included in this analysis (NAC cigarette smokers, n=34; NAC cigarette non-smokers, n=34; PBO cigarette smokers, n=24; PBO cigarette non-smokers, n=24).
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention (CDC) Smoking-attributable mortality, years of potential life lost, and productivity losses--united states, 2000–2004. MMWR Morb Mortal Wkly Rep. 2008;57(45):1226–1228. - PubMed
    1. U.S. Department of Health and Human Services. Preventing tobacco use among youth and young adults: A report of the surgeon general. 2012 - PubMed
    1. Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE. Monitoring the future national results on drug use: 2012 overview, key findings on adolescent drug use. 2013
    1. Budney AJ, Moore BA, Vandrey R. Health consequences of marijuana use. In: Brick J, editor. Handbook of the medical consequences of drug abuse. Binghamton, NY: Haworth Press; 2008. pp. 171–218.
    1. Chen CY, Anthony JC. Possible age-associated bias in reporting of clinical features of drug dependence: Epidemiological evidence on adolescent-onset marijuana use. Addiction. 2003;98(1):71–82. - PubMed

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