Nicotine and Cannabis vaping in adolescents and adults: A prospective trial
Summary
Vaping is an emerging epidemic in the last decade and the percentage of adolescents and adults vaping is steadily increasing since 2011 as per National Institute on Drug Abuse (NIDA) (1). The majority of these data are obtained from the Monitoring the Future survey (MTF) of adolescents in schools. The prevalence of vaping in patients presenting to healthcare facilities is still lacking. Adolescents and adults use portable devices to aerosolize and inhale liquid substances. Nicotine and tetrahydrocannabinol (THC) are the main active ingredients in vaping vehicles. THC is a psychoactive component of marijuana with physiological and psychological effects on health (2). According to the American Lung Association, vaping of any kind likely causes the same effects as tobacco smoking that could potentially lead to lung injury (ALA 2020). Marijuana suppresses the immune system, leading to an increased risk of lower respiratory tract infections. Many teens report that they vape for the flavor, to experiment, for social reasons, or to feel good. Many are unaware of the long-term physical and mental health consequences.
Aims and objectives:
This study aims to identify adolescents and adults that present to Arkansas Children’s Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS) with cannabis and nicotine vaping.
Aim 1. Evaluate the prevalence of nicotine and cannabis vaping in adolescents and adults in healthcare settings.
We will conduct a retrospective chart review of patients with nicotine and /or cannabis use in both outpatient and inpatient settings at UAMS and ACH. This will help us identify the scope of the problem in health care settings.
Aim 2. Identify the risk of potential pulmonary and mental health issues in individuals vaping nicotine and/or cannabis.
We will develop a screening tool to identify and stratify potential risks of nicotine and/or cannabis vaping. This tool may also be used in outpatient clinics and inpatient settings for potential referrals for nicotine and cannabis use disorder treatments. This screening instrument will also help us recruit patients for our prospective trial.
Aim 3. Develop and evaluate the benefit of a novel adjunct educational tool along with standard evidence-based treatments in this cohort.
This pilot, randomized, controlled trial will assess the potential benefit of an audiovisual aid added to standard treatments for nicotine and cannabis use disorder. The purpose of the audiovisual aid is to educate patients and families on vaping-related health consequences, including potential mental health problems and other substance use disorders, in order to motivate families to engage in treatment for cannabis use disorder. The standard therapies for nicotine and cannabis use disorder, including cognitive-behavioral therapy, contingency management, and motivational enhancement therapy (3), will be offered to both groups.
The findings of this pilot will inform a large trial to examine the efficacy of the novel educational tool to help motivate nicotine and cannabis use disordered patients to engage in treatment for their disorder.
References:
- Miech R, Johnston L, O’Malley PM, Bachman JG, Patrick ME. Trends in Adolescent Vaping, 2017-2019. N Engl J Med. 2019 Oct 10;381(15):1490-1491. doi: 10.1056/NEJMc1910739. Epub 2019 Sep 18. PMID: 31532955; PMCID: PMC7310772.
- Spindle TR, Cone EJ, Schlienz NJ, et al. Acute effects of smoked and vaporized cannabis in healthy adults who infrequently use cannabis: a crossover trial. JAMA Netw Open. 2018;1(7):e184841-e184841.
- NIDA. 2020, April 8. Available Treatments for Marijuana Use Disorders. Retrieved from https://www.drugabuse.gov/publications/research-reports/marijuana/available-treatments-marijuana-use-disorders on 2021, February 28
Keywords:
- vaping
- marijuana
- Cannabis
- lung injury
- mental health
- addiction