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Co-occurring use (co-use) of nicotine and cannabis is common, and represents a broad range of use behaviors, including concurrent use, sequential use, and co-administration. Co-use has primarily been examined through the lens of smoked tobacco and cannabis. Little is known about those who co-use vaped nicotine and cannabis, and the degree to which specific co-use behaviors are associated, based on mode of use and/or substance. We conducted an online pilot survey on use behaviors related to inhaled modes of nicotine and cannabis. The survey was administered to 112 concurrent vapers of these substances. Descriptive analyses examined sample characteristics and co-administered vaping and smoking behaviors. Logistic regressions examined associations in use behaviors by mode and substance. Participants who vaped nicotine and cannabis monthly also reported monthly smoking of cannabis (100%), and cigarettes (58%). Most exhibited moderate-to-high degrees of mental health and substance use problems requiring clinical intervention. Monthly concurrent use exhibited more differences by mode, and more similarities by substance. Specific sequential use practices showed mode-specific associations; with greater frequency of cigarette smoking and nicotine vaping. Co-administration was associated with more frequent tobacco and cannabis smoking. Those who regularly vape nicotine and cannabis tend to engage in some form of smoking. Different subsets of nicotine and cannabis co-use behaviors showed different associations with patterns of use and modes of drug delivery. Findings underscore the diversity of nicotine and cannabis use behaviors among co-users, and the importance of considering associations by both substance and mode of use. [ABSTRACT FROM AUTHOR]

Background: The legal status of cannabis is rapidly evolving, outpacing systematic research and educational efforts. Aims: We investigated knowledge of cannabinoid content and dosages among frequent cannabis users. A brief survey was administered in April 2019 (N = 472) at a cannabis advocacy event in a state with legal medical and recreational adult cannabis use. Most participants (67%) used cannabis every day, 85% used cannabis for health or medical purposes. Knowledge of cannabis was mostly from participants' own experiences (78%), with some receiving information from a medical cannabis caregiver or dispensary (23%) or their primary care provider (18%). The majority reported not knowing the effective dosages of THC (53% of participants) or CBD (68% of participants), other participants gave average estimates of 91 mg and 177 mg, respectively. Participants' average estimates for high-THC (52%) and high-CBD (53%) as well as low-THC (28%), and low-CBD (30%) strains of cannabis were considerably higher than currently accepted definitions. Men, European Americans, and participants who had medical cannabis cards were more accurate in cannabinoid concentration estimates. Frequent cannabis users reported low knowledge of and substantially overestimated cannabinoid content. The importance of education and research on cannabinoid dosages grows with increasing cannabis accessibility. [ABSTRACT FROM AUTHOR]

Purpose: To compare cannabis enthusiasts' knowledge about cannabis risks and effectiveness in treating medical conditions with existing empirical evidence.Design: A brief survey assessed cannabis use, information sources, and knowledge about risks and effectiveness.Setting: A cannabis advocacy event in April 2019 in a state with legal medical and recreational cannabis.Participants: Demographically diverse adults (N = 472) who frequently used cannabis; 85% used cannabis for health or medical purposes.Measures: Participants reported the sources of their cannabis information, health conditions they thought cannabis was effective in treating (n = 10), and health risks increased by cannabis (n = 6). Conditions and risks were based on ratings of evidence (ie, from substantial to insufficient) for therapeutic effects and risks identified in a review by The National Academies of Sciences, Engineering, and Medicine (NASEM, 2017).Analyses: Chi-square tests examined the correspondence between participants' knowledge and NASEM conclusions.Results: Most participants' (95% confidence interval [CI]: 74%-81%) knowledge of cannabis was from their own experiences; 18% (95% CI: 14%-21%) received information from primary care providers. On average, participants' beliefs matched NASEM conclusions for half of effectiveness (95% CI: 50%-53%) and risk items (95% CI: 55%-57%). Many (95% CI: 38%-42%) thought that cannabis use did not increase any risk. Contrary to NASEM conclusions, many thought cannabis was effective in treating cancer (76%), depressive symptoms (72%), and epilepsy (68%). Those who received cannabis information from their primary care providers had better knowledge of medical effectiveness. Medicinal cannabis use frequency inversely predicted knowledge of medical effectiveness and increased risks of adverse events.Conclusion: There were considerable discrepancies between cannabis users' knowledge and available evidence, highlighting the need for more research and education (by physicians, caregivers, and dispensaries) on effectiveness and health risks, especially for users with specific health issues such as pregnant women and people with depression. [ABSTRACT FROM AUTHOR]