title: A cross-sectional analysis of the association between marijuana and cigarette smoking with metabolic syndrome among adults in the United States.
abstract: OBJECTIVE
  To assess the relationship between marijuana use, cigarette smoking and metabolic syndrome among adults in the United States who reported they use marijuana or cigarettes in comparison to non-marijuana and non-cigarette users.
  
  
  METHODS
  We conducted multiple logistic regression analyses using data from the 2011-2012 United States National Health and Nutrition Examination Survey to estimate relationships between cardio-metabolic risk factors and increasing years of smoking cigarette or marijuana use. Statistical adjustments were made for both demographic and endogenous factors related to recreational substance use.
  
  
  RESULTS
  Each year increase in marijuana use was significantly associated with increased odds of metabolic syndrome (OR=1.05; 95% CI: 1.01, 1.09), and hypertension (OR=1.04; 95% CI: 1.01, 1.07) adjusting for both demographic and endogenous factors related to recreational substance use. Each year increase in cigarette smoking was significantly associated with increased odds of hypertension (OR=1.03; 95% CI: 1.00, 1.06) and hyperglycemia (OR=1.03; 95% CI: 1.01, 1.05) after adjusting for confounders.
  
  
  CONCLUSIONS
  The results of this investigation suggest that increased years of marijuana or cigarette use are important factors in metabolic health; and consequently calls for the need to consider the potential negative effects of marijuana or cigarette for metabolic syndrome and its associated cardio-metabolic risk components.
authors.affiliation: Georgia State University, School of Public Health, Division of Epidemiology and Biostatistics, 140 Decatur Street, Suite 848, Atlanta, GA 30303, USA. Electronic address: byankey1@student.gsu.edu.
authors.forename: Barbara N A
authors.initials: BN
authors.lastname: Yankey
authors.affiliation: Georgia State University, School of Public Health, Division of Health Promotion and Behavior, 140 Decatur Street, Suite 848, Atlanta, GA 30303, USA.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Strasser
authors.affiliation: Georgia State University, School of Public Health, Division of Epidemiology and Biostatistics, 140 Decatur Street, Suite 848, Atlanta, GA 30303, USA.
authors.forename: Ike S
authors.initials: IS
authors.lastname: Okosun
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*; D024821:Metabolic Syndrome / Q000209:etiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014481:United States
keywords: Cannabis; Cigarette; Marijuana; Metabolic syndrome; Smoking; Tobacco