With marijuana on the verge of legalization and commercialization nationwide, comparing its use with that of tobacco is important. Needed are objective studies of whether use of one affects use of the other. Following is an outline such a report.
I. Introduction
II. FREQUENCY OF USING EACH SUBSTANCE AND BOTH SUBSTANCES
This section consists of showing and analyzing frequency counts and cross-tabs from random samples. One can break them down by features such as demographics, education, etc. Though results might become more stable after marijuana has been legal for several years, this exercise can help prepare for longer term studies. Appendix 1 suggests questions to help answer (A)-(C):
- Are marijuana users less, as, or more likely to use tobacco than marijuana non-users and vice versa?
- Does using one of these substances decrease, not influence, or increase the chance of starting to use the other?
- What attitude do users and non-users of each substance have toward second hand smoke?
- Habits in practice. Appendix 2 suggests questions.
III. TOBACCO COMPANIES
Do not tobacco companies hope to boast of marijuana sales exceeding tobacco sales? Yet once that happens, will their profits from tobacco really diminish greatly? They may portray their marijuana as instead of tobacco, but is not it likely to be in addition to? Although volume and revenue figures needed to answer these questions will be available only after tobacco companies have been in the marijuana business for at least a few years, this facet—and the need to prepare to study it—is worth mentioning.
IV. IMPLICATIONS FOR PUBLIC POLICY
This section would discuss specific public policy issues in light of the results of (II) and (III). Such issues could include: (1) Policies toward smoking in public places. (2) How promoting or mandating marijuana use could affect tobacco use. If the goal “no adult left un-high” is so important, and marijuana does not discourage tobacco, will officials rehabilitate tobacco?
V. CONCLUSION
References
Unfortunately, most references focus on the effects of using the substances. Needed in addition are studies of the relationship between habitual usage of each substance with that of the other.
Daniels, Jackie, MSW, LCSW. “Higher Education 2.” (2013).
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Aeberhard, EE; Roth, MD; Sherman, MP; Simmons, MS; Tashkin, DP; and Wong, VZ. “Effects of Smoking Marijuana, Tobacco, or Cocaine Alone or in Combination on DNA Damage in Human Alveolar Macrophages.” (1995) Life Science, 56 (23-24): 2201-7.
US National Library of Medicine, National Institute of Health. (PubMed.gov).
Asssop, DJ; Dunlop, AJ; Copeland, J; McGregor, IS; Rivas, GR; and Saddler, C. “Changes in Cigarette and Alcohol Use During Cannibis Abstinence,” (2014). Ireland: Elsevier, Ltd.
US National Library of Medicine, National Institute of Health. (PubMed.gov).
Benoit, Ellen; Dunlap, Eloise; Johnson, Bruce D.; Ream, Geoffrey, L. “Smoking Tobacco along with Marijuana Increases Symptoms of Cannabis Dependence,” (2008), Drug and Alcohol Dependence, Vol. 95, Issue 3, June 1, Pages 199-208.
US National Library of Medicine, National Institute of Health. (PubMed.gov).
Simmons, MS and Tashkin, DP. “The Relationship of Tobacco and Marijuana Smoking Characteristics.” (1995) Life Science, 56 (23-24): 2185-91.
Texas Department of Mental Health Services, Mental Health and Substance Abuse Division, “Tobacco vs. Marijuana: Clearing the Air.” Brochure. Date not available.
APPENDIX 1
QUESTIONS ABOUT TOBACCO AND MARIJUANA USAGE (II)
- Are marijuana users less, as, or more likely to use tobacco than marijuana non-users and vice versa? Ask each subject:
- a. How frequently do you presently smoke marijuana? Answers could include: at least once a week; at least once a month but < once a week; at least once a year but < once a month; occasionally; < once a year; and never. “Never” could be broken down into quit; tried a few times but did not continue; and never used.
b. How long have you had your present usage pattern for smoking marijuana?
- Same questions about ingesting marijuana. Possibly change “week” to “day.”
- Same questions about smoking tobacco. Change “week” to “day.”
- Same questions about chewing tobacco.
Useful cross-tabs: (1) vs. (3); ((1) or (2)) vs. (3)
- Does using one of these substances decrease, not influence, or increase the chance of starting to use the other? Ask each subject:
- For each of the above four items, at what age (or how long ago) was your first use?
This question will help determine which substance the subject started first.
- At the time of your first use of each item, how frequently did you use each of the three other items? (frequency choices from questions (1)-(4), plus choices “had never used yet,” and “never have used.”)
- What attitude do users and non-users of each substance have toward second hand smoke? Ask each subject:
- “During an hour in which you are not smoking tobacco, would you tolerate or try to avoid second hand smoke from:
- Tobacco? b. Marijuana? c. Both substances intermingled?
- Same question replacing tobacco with “marijuana.”
- “When you are smoking tobacco, would you tolerate or try to avoid second hand smoke from marijuana?”
- Same question, interchanging “tobacco” and “marijuana.”
Possible questions to ask to break down answers to other questions by include subject’s current age, demographic features, education level, and state of residence.
APPENDIX 2
QUESTIONS RELEVANT TO HABITS IN PRACTICE
These questions could be studied through anecdotes or random samples. The reporter should specify which. All start with Do/have you or do you know anyone who has
- smoked tobacco in a place where smoking tobacco is not allowed but smoking marijuana is, in the hope that the marijuana smoke will obscure the tobacco smoke?
- same question interchanging “tobacco” and “marijuana.” Maybe omitting last clause.
- been “punished” for refusing to smoke or ingest marijuana, by (check all that apply). Choices should include: denied medical care (specify condition), charged higher medical insurance premium, lost job, expelled from club or activity, made to drop college course, and other (specify).
- in order to avoid smoking or ingesting marijuana, done the following (check all that apply): Choices should include: moved, changed jobs, avoided medical care, avoided doctors, avoided pre-natal care during “morning sickness” months, and other (specify).
- been “punished” for smoking tobacco by (check all that apply). Choices should include: charged higher medical insurance premium, and other (specify).
- tried to avoid second hand tobacco smoke by (specify)
- tried to avoid second hand marijuana smoke by (specify)
- In addition, for each of the four substance/form combinations mentioned in Appendix 1, A, ask: “Under what circumstance was your first use?” For marijuana, the choices should include: “Required or forced by social worker, doctor, insurance company, parent, teacher, and/or professor.” For ingested marijuana, the choices should include, “cannabis-free varieties of my favorite snack/dessert, baked good became harder to find.”
