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Cannabis use and educational level-which is the chicken and which is the egg?

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HAL Id: hal-01723492

https://hal.sorbonne-universite.fr/hal-01723492

Submitted on 5 Mar 2018

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and which is the egg?

Maria Melchior, Marine Azevedo Da Silva

To cite this version:

Maria Melchior, Marine Azevedo Da Silva. Cannabis use and educational level-which is the chicken and which is the egg?. Addiction, Wiley, 2018, 113 (3), pp.462 - 463. �10.1111/add.14099�. �hal-01723492�

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Component Description

Title Cannabis use and educational level – which is the chicken and which is the egg?

Author(s) Maria Melchior, Marine Azevedo da Silva Author

affiliation(s)

Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France

Statement of competing interest

No financial or other relevant links to companies with an interest in the topic of this article.

Key words Cannabis, educational level, social inequalities, epidemiology Concise

statement

The relationship between high school attainment and cannabis use could reflect changes in educational level over time, as well as higher rates of desistance from cananabis use among people from the most advantaged socioeconomic groups.

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Commentary Chan et al. (1) report that the decline in cannabis use observed since 2001 in Australia has primarily occurred in higher

socioeconomic groups. Among people from less advantaged groups, cannabis use levels have remained stable. The net result is the widening of social inequalities.

An important point raised by Chan et al. (1) relates to the

concurrent use of cannabis and tobacco (2), mainly in Europe and in Australia. In adolescence tobacco sometimes serves as a

gateway substance to cannabis. But, conversely, cannabis may also function as a reverse gateway for the onset or maintenance of a tobacco habit (3). This is in part because these substances have common routes of administration and are often used

simultaneously in the form of ‘joints’ or ‘blunts’ (4). As reported by Chan et al., social inequalities with regard to tobacco consumption and cessation in industrialized countries start in adolescence and widen over time. These may also contribute to increasing

inequalities in cannabis use (5, 6).

Findings by Chan et al. resonate with time-trends with regard to other risk factors of non-communicable diseases (e.g. blood pressure, cholesterol, glycaemia and diabetes, body-mass index) (7). As these health risks become better known, people with higher education and income are the first to change their eating habits or start exercising regularly. People with lower education, unstable income or irregular employment are slower to do so (7) for complex reasons that have to do with the impact of

socioeconomic position on the ability to make long-term plans (6) or act to change one’s life circumstances (8).

Like other investigators in this area (9), Chan et al. report that cannabis use is most strongly associated with individuals’

educational level. The authors suggest that this may in part be due to changes in educational attainment in the population but they were not able to fully explore these issues. Between 2001 and 2010, the percentage of young people in Australia who completed high school increased from 70 to 78% (10). This may mean that today young Australians who do not complete high school have a high probability of having characteristics that put them at risk of cannabis abuse (e.g. lower cognitive attainment, behavioural difficulties) than in previous generations (11-14). Moreover, young people who use cannabis reduce their chances of completing high school and pursuing higher education (15). This may in part be due to the neurocognitive effects of early cannabis consumption – particularly when it is regular – on memory, concentration, and motivation to engage in school-related activities (16). Although the causal mechanisms are unclear, substance use difficulties in adolescence undoubtedly have complex long-term consequences. References 1. CHAN G.,LEUNG J.K.,QUINN C.,WEIER M.,HALL W.

Socioeconomic differentials in cannabis trends in Australia, Addiction 2017: In Press.

2. MEIER E.,HATSUKAMI D.K. A review of the additive health risk of cannabis and tobacco co-use, Drug and Alcohol Dependence 2016: 166: 6-12.

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3. BADIANI A.,BODEN J.M.,DE PIRRO S.,FERGUSSON D.M., HORWOOD L.J.,HAROLD G.T. Tobacco smoking and cannabis use in a longitudinal birth cohort: evidence of reciprocal causal relationships, Drug and Alcohol Dependence 2015: 150: 69-76.

4. HINDOCHA C.,FREEMAN T.P.,FERRIS J.A.,LYNSKEY M.T., WINSTOCK A.R. No smoke without tobacco: A global

overview of cannabis and tobacco routes of administration and their association with intention to quit, Frontiers in Psychiatry 2016: 7: 104.

5. LEGLEYE S.,KHLAT M.,BECK F.,PERETTI-WATEL P. Widening

inequalities in smoking initiation and cessation patterns: a cohort and gender analysis in France, Drug and Alcohol Dependence 2011: 117: 233-241.

6. PERETTI-WATEL P.,CONSTANCE J.,SEROR V.,BECK F. Cigarettes and social differentiation in France: is tobacco use increasingly concentrated among the poor?, Addiction 2009: 104: 1718-1728.

7. DI CESARE M.,KHANG Y.H.,ASARIA P.,BLAKELY T.,COWAN M.J., FARZADFAR F. et al. Inequalities in non-communicable diseases and effective responses, Lancet 2013: 381: 585-597.

8. MARMOT M. The Health Gap: The challenge of an unequal world: the argument, International Journal of

Epidemiology 2017: 46: 1312-1318.

9. LEGLEYE S.,KHLAT M.,MAYET A.,BECK F.,FALISSARD B.,CHAU N.

et al. From cannabis initiation to daily use: educational inequalities in consumption behaviours over three generations in France, Addiction 2016: 111: 1856-1866. 10. STATISTICS A.B. O. Australian social trends March 2011: Year

12 attainment.; 2011.

11. CASTELLANOS-RYAN N.,PINGAULT J.B.,PARENT S.,VITARO F.,

TREMBLAY R.E.,SEGUIN J.R. Adolescent cannabis use,

change in neurocognitive function, and high-school graduation: A longitudinal study from early adolescence to young adulthood, Developmental Psychopathology 2017: 29: 1253-1266.

12. GALERA C.,BOUVARD M.P.,MELCHIOR M.,CHASTANG J.F.,

LAGARDE E.,MICHEL G. et al. Disruptive symptoms in

childhood and adolescence and early initiation of tobacco and cannabis use: the Gazel Youth study, European Psychiatry 2010: 25: 402-408.

13. TIMBERLAKE D.S.,HABERSTICK B.C.,HOPFER C.J.,BRICKER J., SAKAI J.T.,LESSEM J.M. et al. Progression from marijuana use to daily smoking and nicotine dependence in a national sample of U.S. adolescents, Drug and Alcohol Dependence 2007: 88: 272-281.

14. GALÉRA C.,MELCHIOR M.,CHASTANG J.F.,BOUVARD M.P., FOMBONNE E. Childhood and adolescent hyperactivity-inattention symptoms and academic achievement 8 years later: the GAZEL Youth study, Psychological Medicine 2009: 39: 1895-1906.

15. MELCHIOR M.,BOLZE C.,FOMBONNE E.,SURKAN P.J.,PRYOR L.,

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educational attainment: is the association causal? Data from the French TEMPO study, International Journal of Epidemiology 2017:In Press.

16. TREZZA V.,CUOMO V.,VANDERSCHUREN L.J. Cannabis and the

developing brain: insights from behavior, European Journal of Pharmacology 2008: 585: 441-452.

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