Initial reactions to tobacco and cannabis smoking: a twin study

Background and Aims Initial subjective reactions to cannabis and tobacco, broadly classified as positive or negative, have previously been explored for their associations with onset and maintenance of subsequent abuse/dependence. We examine (i) the factorial architecture of self-reported initial reactions to cannabis and tobacco; (ii) whether these factors associate with concurrently reported age at onset of DSM-IV diagnosis of nicotine dependence and cannabis abuse/dependence; and (iii) estimate heritable variation in and covariation between the factors. Design Factorial and exploratory structural equation modeling was conducted to examine the factor structure of initial reactions. Cox proportional hazards modeling was employed to examine their association with time to onset of diagnosis of DSM-IV nicotine dependence and cannabis abuse/dependence. Classical twin modeling, using univariate and multivariate models, was used to parse variance in each factor (and the covariance between factors) to their additive genetic, shared environmental and non-shared environmental sources. Setting and Participants General population sample of Caucasian female twins aged 18-32 years, with a life-time history of tobacco [n = 2393] and cannabis [n = 1445] use. Measurement Self-report of initial subjective reactions to tobacco (cigarettes) and cannabis the first time they were used and time to onset of life-time history of DSM-IV diagnosis of abuse (cannabis) and dependence (cannabis or nicotine). Findings Factors representing putatively positive and negative reactions to cannabis and tobacco emerged. Initial reactions to tobacco were associated with onset of DSM-IV diagnosis of nicotine dependence and cannabis abuse/dependence while initial reactions to cannabis were associated with onset of DSM-IV diagnosis of cannabis abuse/dependence alone. Genetic factors played a moderate role in each factor (heritability of 27-35%, P < 0.05), with the remaining variance attributed to individual-specific environment. Covariation across the factors indexing positive and negative initial reactions was attributable to genetic sources (0.18-0.58, P < 0.05) and to overlapping individual-specific environmental factors (-0.16 to 0.36, P < 0.05). Conclusions Initial subjective reactions to tobacco are associated with onset of DSM-IV diagnosis of nicotine dependence and cannabis abuse/dependence while initial subjective reactions to cannabis are only associated with onset of diagnosis of DSM-IV cannabis abuse/dependence. Genetic and environmental factors underpin the overlap across the factors representing initial reactions, both positive and negative.