Table 2.

Associations of tobacco and cannabis use from age 18 to 38 with age 38 physical health measures.

							Statistical Tests^b

		% or Mean As a Function of Use, Adjusted for Sex^a					Model 1^c: Bivariate			Model 2^c: + Control for Pack-Years (or Joint-Years)

Age 38 Health	Predictor	Never Used	<5 y/No Dx	5 to <10 y/1 Dx	10 to <15 y/2 Dx	15⁺y/3⁺ Dx	β	95% CI	p	β	95% CI	p
A. Periodontal Health

Mean Attachment Loss Across Sites (mm)	Pack-years	1.37	1.44	1.63	1.79	2.32	0.50	0.45, 0.56	<.001	0.45	0.38, 0.51	<.001
	Joint-Years	1.41	1.57	2.08	2.21	2.51	0.33	0.26, 0.39	<.001	0.12	0.05, 0.18	<.001
	Cannabis Dependence	1.41	1.57	1.75	2.06	2.58	0.33	0.27, 0.39	<.001	0.09	0.02, 0.16	.011
B. Lung Function
FEV₁/FVC^±	Pack-years	80.98	79.74	79.78	79.67	77.58	−0.19	−0.26, −0.13	<.001	−0.15	−0.22, −0.08	<.001
	Joint-Years	80.72	80.15	77.95	78.09	76.43	−0.17	−0.23, −0.11	<.001	−0.10	−0.17, −0.02	.010
	Cannabis Dependence	80.72	80.17	78.93	78.47	76.47	−0.15	−0.22, −0.08	<.001	−0.06	−0.14, 0.01	.106
C. Systemic Inflammation
C-Reactive Protein Level (mg/L)	Pack-years	2.32	1.70	3.20	2.05	3.17	0.12	0.05, 0.18	<.001	0.12	0.04, 0.19	.002
	Joint-Years	2.48	2.33	2.09	4.01	2.28	0.06	−0.01, 0.13	.073	0.00	−0.07, 0.08	.95
	Cannabis Dependence	2.48	2.36	2.24	3.24	2.64	0.04	−0.02, 0.11	.21	−0.03	−0.11, 0.05	.46
D. Metabolic Health
% with Metabolic Syndrome	Pack-years	14.32	13.12	15.86	15.16	23.16	1.18^d	1.04, 1.35	.012	1.24^d	1.06, 1.45	.006
	Joint-Years	18.91	14.23	15.38	21.79	13.53	1.01^d	0.88, 1.16	.94	0.90^d	0.76, 1.07	.23
	Cannabis Dependence	18.88	13.27	19.49	26.54	10.99	0.99^d	0.85, 1.15	.88	0.86^d	0.73, 1.02	.092

Waist (cm)	Pack-years	86.70	85.47	87.84	86.69	85.64	−0.02	−0.08,0.04	.55	0.02	−0.05, 0.09	.56
	Joint-Years	88.15	86.00	84.57	84.97	82.93	−0.07	−0.13, −0.01	.029	−0.08	−0.15, −0.01	.026
	Cannabis Dependence	88.12	85.53	87.56	85.81	83.77	−0.07	−0.13, −0.01	.038	−0.08	−0.15, −0.01	.033

High Density Lipoprotein (HDL) Level^± (mmol/L)	Pack-years	1.46	1.48	1.43	1.45	1.38	−0.06	−0.13, −0.01	.036	−0.10	−0.17, −0.03	.004
	Joint-Years	1.40	1.45	1.58	1.56	1.35	0.03	−0.03, 0.09	.39	0.08	0.01, 0.15	.029
	Cannabis	1.40	1.47	1.43	1.39	1.48	0.03	−0.03, 0.09	.36	0.09	0.01, 0.16	.019

Triglyceride Level (mmol/L)	Pack-years	1.99	1.99	2.08	2.27	2.22	0.07	0.01, 0.13	.021	0.11	0.04, 0.17	.002
	Joint-Years	2.12	2.07	1.88	1.98	1.84	−0.03	−0.09, 0.03	.38	−0.08	−0.15, −0.01	.019
	Cannabis Dependence	2.12	2.02	2.02	2.56	1.77	−0.02	−0.08, 0.04	.51	−0.08	−0.15, −0.01	.027

Systolic Blood Pressure (mm Hg)	Pack-years	120.92	119.26	118.04	122.01	119.51	−0.02	−0.09, 0.04	.44	−0.01	−0.08, 0.06	.71
	Joint-Years	121.33	119.68	120.69	121.93	117.20	−0.02	−0.08, 0.04	.53	−0.01	−0.08, 0.06	.69
	Cannabis Dependence	121.34	119.73	120.54	120.62	117.50	−0.05	−0.12, 0.01	.101	−0.06	−0.13, 0.02	.127

Diastolic Blood Pressure (mm Hg)	Pack-years	78.64	77.19	77.27	78.13	78.20	0.00	−0.06, 0.06	.98	0.01	−0.06, 0.08	.68
	Joint-Years	79.42	77.55	77.70	79.13	76.40	−0.01	−0.08, 0.05	.69	−0.02	−0.09, 0.05	.57
	Cannabis Dependence	79.42	77.44	79.37	77.86	75.80	−0.06	−0.13, 0.00	.056	−0.09	−0.16, −0.01	.019

HbA1c	Pack-years	5.40	5.33	5.36	5.37	5.53	0.11	0.05, 0.18	<.001	0.15	0.08, 0.23	<.001
	Joint-Years	5.48	5.37	5.39	5.43	5.36	0.00	−0.07, 0.06	.94	−0.08	−0.15, −0.01	.037
	Cannabis Dependence	5.48	5.36	5.40	5.45	5.38	−0.03	−0.10, 0.03	.34	−0.13	−0.20, −0.05	.001
E. Obesity
Body Mass Index (BMI)	Pack-Years	27.50	26.80	27.89	27.30	26.32	−0.06	−0.12, 0.00	.066	−0.02	−0.10, 0.05	.51
	Joint-Years	28.22	26.92	26.26	26.38	25.59	−0.09	−0.15, −0.02	.011	−0.07	−0.15, 0.00	.050
	Cannabis Dependence	28.21	26.82	27.10	26.59	25.75	−0.11	−0.17, −0.04	.002	−0.10	−0.18, −0.03	.009
F. Self-Reported Health
Mean Health Rating^±	Pack-years	3.97	3.96	3.72	3.70	3.43	−0.27	−0.33, −0.21	<.001	−0.26	−0.32, −0.19	<.001
	Joint-Years	3.86	3.88	3.53	3.46	3.47	−0.15	−0.22, −0.09	<.001	−0.03	−0.10, 0.04	.42
	Cannabis Dependence	3.86	3.91	3.55	3.55	3.27	−0.16	−0.23, −0.10	<.001	−0.03	−0.11, 0.04	.40

Note:

For presentation of percentages and means, participants were grouped according to pack-years and joint-years between ages 18–38 as follows: never used, used <5 years, used from 5 to <10 years, used from 10 to <15 years, and used for 15+ years. Participants were grouped according to persistence of cannabis dependence as follows: never used=never used cannabis, no dx=used cannabis at least once between ages 18–38 but never diagnosed, 1 dx= diagnosed once between ages 18–38, 2 dx=diagnosed twice, 3+ dx=diagnosed 3+ times.

Statistical analyses tested associations of cumulative pack-years (a continuous variable), cumulative joint-years (a continuous variable), and cannabis dependence (a 5-level ordinal variable) with continuous outcomes (except for metabolic syndrome, which is a categorical outcome). Continuous variables were standardized for statistical tests. Therefore, beta coefficients can be interpreted as the increase in risk of the outcome, given a 1 SD increase in pack-years or joint-years. Betas with a positive sign indicate poorer health except where noted.

^±

Betas with a negative sign indicate poorer health. Statistically significant associations are shown in bold.

Model 1 controls for sex. Model 2 adds controls for joint-years in analyses of pack-years, and adds controls for pack-years in analyses of joint-years and cannabis dependence. Analyses of lung function additionally control for height. d. Estimates are relative risks. For analyses of tobacco pack-years, Ns range from 892–945 for Model 1 and 886–938 for Model 2. For analyses of cannabis joint-years and cannabis dependence, Ns range from 888–940 for Model 1 and 886–938 for Model 2. The reasons for different Ns across analyses is that there was some variation in missingness for specific health measurements. Among the 947 study members included in this report, n=47 refused the dental exam, n=28 did not complete the lung function assessment, n=35 refused phlebotomy, 9 were pregnant, 6 HbA1c samples were lost in the laboratory due to the 2011 Christchurch earthquake, and there were a handful of miscellaneous assay failures.