Rest-activity rhythms in individuals who separately or concomitantly use cannabis and cigarettes

Background

Cannabis use and cigarette smoking, a primary source of nicotine exposure, are prevalent behaviors that frequently co-occur. The independent or interactive effects of cigarette-derived nicotine and cannabis on rest-activity rhythms (RAR) are not well understood.

Methods

Using data from the 2011–2012 and 2013–2014 cycles of the National Health and Nutrition Examination Survey (NHANES), we tested whether self-reported cigarette and/or cannabis use was associated with RAR—assessed from actigraphy data—in U.S. adults ages 18–59 years old.

Results

5129 participants with valid RAR, as well as cigarette and cannabis use information were included in the analysis. A vast majority of participants reported no use of cannabis or cigarettes (71 %), while 15.7 % consumed only cigarettes, 6.3 % consumed only cannabis, and 6.7 % endorsed dual consumption. Our multiple linear regression models, which were adjusted for (model 1) age, sex, race/ethnicity; (model 2) income, education; (model 3) BMI, alcohol use, and number of prescription medications showed that cigarette use, with or without cannabis co-use, was associated with a decrease in Interdaily Stability (IS) scores. Decreased relative amplitude (RA) scores were associated with respondents who used cigarettes, with or without cannabis use. All exposure categories, including co-use, were associated with decreased Intradaily Variability (IV) scores.

Conclusions

Cigarette and cannabis use have varying effects on RAR, with the effects of co-use largely reflecting the influence of cigarettes. Research involving greater specificity regarding substance use exposures is necessary to elucidate the dose related effects of cannabis and cigarette use on RAR.