title: Medical Marijuana Legalization and Co-use in Adult Cigarette Smokers.
abstract: OBJECTIVE
  We examined effects of long-term medical marijuana legalization on cigarette co-use in a sample of adults.
  
  
  METHODS
  We conducted secondary analysis using data from the 2014 US Tobacco Attitudes and Beliefs Survey, which consisted of cigarette smokers, aged ≥ 45 years (N = 506). Participants were categorized by their state residence, where medical marijuana was (1) illegal, (2) legalized < 10 years, and (3) legalized ≥ 10 years. The Web-based survey assessed participants' marijuana use, beliefs and attitudes on marijuana, and nicotine dependence using Fagerstrom Tolerance for Nicotine Dependence (FTND) and Hooked on Nicotine Checklist (HONC) scores.
  
  
  RESULTS
  In cigarette smokers aged ≥ 45 years, long-term legalization of medical marijuana was associated with stable positive increases in marijuana use prevalence (ever in a lifetime) (p = .005) and frequency (number of days in past 30 days) (unadjusted p = .005; adjusted p = .08). Those who reported marijuana co-use had greater FTND and HONC scores after adjusting for covariates (p = .05).
  
  
  CONCLUSIONS
  These preliminary findings warrant further examination of the potential impact of long-term legalization of medical marijuana on greater cigarette and marijuana co-use in adults and higher nicotine dependence among co-users at the population level.
authors.affiliation: Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA. julie.wang@ucsf.edu.
authors.forename: Julie B
authors.initials: JB
authors.lastname: Wang
authors.affiliation: School of Nursing, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Janine K
authors.initials: JK
authors.lastname: Cataldo
mesh_terms: D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007603:Jurisprudence; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000523:psychology / Q000639:trends; D064086:Medical Marijuana; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology / Q000639:trends; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology; D014481:United States / Q000453:epidemiology
chemical_list: D064086:Medical Marijuana