Associations of cannabis and cigarette use with depression and anxiety at age 18: findings from the Avon Longitudinal Study of Parents and Children.
Open accessAbstract
INTRODUCTION: Substance use is associated with common mental health disorders, but the causal effect of specific substances is uncertain. We investigate whether adolescent cannabis and cigarette use is associated with incident depression and anxiety, while attempting to account for confounding and reverse causation. METHODS: We used data from ALSPAC, a UK birth cohort study, to investigate associations between cannabis or cigarettes (measured at age 16) and depression or anxiety (measured at age 18), before and after adjustment for pre-birth, childhood and adolescent confounders. Our imputed sample size was 4561 participants. RESULTS: Both cannabis (unadjusted OR 1.50, 95% CI 1.26, 1.80) and cigarette use (OR 1.37, 95% CI 1.16, 1.61) increased the odds of developing depression. Adjustment for pre-birth and childhood confounders partly attenuated these relationships though strong evidence of association persisted for cannabis use. There was weak evidence of association for cannabis (fully adjusted OR 1.30, 95% CI 0.98, 1.72) and insufficient evidence for association for cigarette use (fully adjusted OR = 0.97, 95% CI 0.75, 1.24) after mutually adjusting for each other, or for alcohol or other substance use. Neither cannabis nor cigarette use were associated with anxiety after adjustment for pre-birth and childhood confounders. CONCLUSIONS: Whilst evidence of association between cannabis use and depression persisted after adjusting for pre-term and childhood confounders, our results highlight the difficulties in trying to estimate and interpret independent effects of cannabis and tobacco on psychopathology. Complementary methods are required to robustly examine effects of cannabis and tobacco on psychopathology.
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There is some evidence of specificity of outcome for cannabis and psychosis, though this is not seen in all studies.
“There is also some evidence of specificity of outcome (10,56) though this is not seen in all studies (57).”
From Association Between Cannabis and Psychosis: Epidemiologic Evidence (2016) · cites this paper as [57]
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- Authors
- Gage, S. H., Hickman, M., Heron, J., Munafò, M. R., Lewis, G., Macleod, J., & Zammit, S.
- Affiliations
- University of Bristol (GB)
- University College London (GB)
- Corresponding author
- Gage, Suzanne H.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-04-13
- Volume
- 10
- Issue
- 4
- Pages
- e0122896
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4395304
- OpenAlex
- W2090076330
- Cited by
- 90
- References
- 50
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 8 · 2023: 5 · 2022: 5 · 2021: 11 · 2020: 14 · 2019: 12 · 2018: 8 · 2017: 8 · 2016: 5 · 2015: 5
- FWCI
- 6.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- Bristol Research (University of Bristol) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Explore Bristol Research (submittedVersion, cc-by)
- Funders
- Wellcome Trust (076467, 084268, 74882, 084268/Z/07/Z)
- University of Bristol (74882, 076467)
- Medical Research Council (74882, G0701503, G0802736, G0800612, MR/K023195/1, 076467, G0800612 and G0802736, MR/L010305/1, MR/K023233/1)
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- cannabis use, cigarette smoking, adolescent substance use, depression, anxiety, adolescent mental health, reverse causality, confounding, Avon Longitudinal Study of Parents and Children, birth cohort
- MeSH terms
- Adolescent, Anxiety, Depression, Female, Humans, Longitudinal Studies, Male, Marijuana Smoking, Parents, Smoking, Cohort Studies
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