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

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.

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.

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.

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.