Discussion
In this cross-sectional study of marijuana, CBD, e-cigarette, and cigarette use in teenagers and adults with CF, we found that a substantial proportion of pwCF engaged in experimentation with at least one of these substances over their lifetime. Surprisingly, approximately one-quarter (xx%) of subjects surveyed reported currently using either marijuana, CBD, e-cigarettes, or cigarettes, with marijuana and e-cigarettes being the most commonly used substance.
We found notable differences in the prevalence of marijuana, e-cigarette, and cigarette usage in pwCF compared to prior studies. Our study reports the prevalence of CBD usage in pwCF for the first time, showing a prevalence of 22% (n=49). In a cross-sectional study of teenagers and young adults with CF, Hamberger and colleagues found that 27.4% (n=51) of subjects used marijuana, 15.2% (n=51) used e-cigarettes and 25.7% (n=87) used cigarettes in their lifetime. However, their study did not investigate current usage7. In our study, we found a much higher prevalence of lifetime use of marijuana (43.4%), e-cigarettes (30.1%), and cigarettes (27.9%). We also found a higher prevalence of current users than other studies with 29.4% (n=66) of subjects reporting marijuana use in the last year. In contrast, a cross-sectional study of six CF centers found a lower prevalence, with 16.5% reporting marijuana use in their lifetime and 15.4% in the last year6. This study by Stephen and colleagues6 focused on usage and attitudes towards medical marijuana in pwCF, while our study focused on all use of marijuana in pwCF. The higher prevalence of marijuana usage likely reflected the changing legalization of marijuana in the United States in recent years. The higher prevalence of usage of the other substances in our study also reflected broader trends in substance use in the United States; our data is consistent with national data from the general U.S. population, showing that 43% of Americans used marijuana, 19% vaped nicotine, 22% vaped marijuana, and 19% used cigarettes in the last year2.