Higher rates has been reported in Benin,south-south Nigeria and Ile-Ife south west Nigeria.These studies were not only separated be several years but were also conducted in different regions of Nigeria and may suggest not only a possible decline in the use of the substance but socio-cultural influences. All these studies reported male dominance which is similar to the index study.The use of tobacco and marijuana among individuals with hypertension and diabetes merits some comments. About 5% of people with hypertension and5.8% of those with diabetes still smoked. The proportion was even 20.8% and28.8% for those who used snuff. Furthermore, 6% of stroke patients also used snuff. The explanations for these findings maybe difficult considering the limitations of the index study, however the use of these substances should be discouraged and patients help to quit because of their considerable poor health implications.
Correlates of cigarette, snuff and marijuana smoking are shown in Table 3.The common use of alcohol and tobacco and/or cannabis has been previously reported and should be used in formulating public health educational programs against substance abuse. The correlation between diabetes and snuff use may be related to age of the patients . It is also possible that people with stroke may consider snuff less harmful or even helpful. However,cannabis grow system the reason for this finding is difficult to decipher from the index study. The type of alcohol beverage correlated differently with different substances. The ubiquitous nature of beer and gins which appear in different and fanciful packaging, widespread advertisements and proliferations of beer parlours may explain some of these findings. Local brew which are mostly consumed by older individuals may explain the correlation between it and snuff use.The predictors of tobacco use are similar to most previous studies and should form both target groups and items for public health education. Health problems associated tobacco and marijuana should be included in the health-related topics of current educational curriculum with the aim of reducing the use of these substances.There are limitations to the index study. The prevalence of these substances was self-reported and may not be accurate especially among women. Secondly,the number of cigarettes and or the amount of snuff were not reported.
This would have given a more comprehensive understanding of the nature of the problem in the community. Finally, the age of exposure or onset of substance use could have given an insight at what level to start educational interventions.Despite these limitations this study which to best of our knowledge is the only community-based study of its type in south east Nigeria will provide baseline data for further studies in the region and educational material for public health workers and policy makers.Marijuana has been the most common illicit substance used in the United States for several decades . It is especially common among young adults, with approxi mately 16% of young adults having used marijuana within the past month. In addition, as many as 9.4% of college freshman may have a marijuana use disorder , and about 35% of users meet at least one criterion for marijuana dependence . Marijuana use has several important negative implications. In terms of morbidity and mortality, marijuana use plays a major role in motor vehicle crashes , has ad-verse effects on the respiratory and cardiovascular systems ,increases susceptibility to cancer , and impairs short- and long-term memory functioning.Not only are there health consequences, but marijuana use has important psychosocial effects.
Marijuana use is associated with impaired poor school performance, low educational aspirations and expectations, low educational attainment,reduced workplace productivity, and the postponement of marriage and employment.Certain intra-individual characteristics are related to marijuana use . For example, one longitudinal study over a 23 year span from early adolescence to adulthood found that chronic marijuana use was associated with poor selfcontrol , more externalizing behavior , and greater sensation seeking . Higher levels of depressive symptoms have also been found to prospectively predict different trajectories of marijuana use through adolescence . In addition, stress has been a factor associated with using marijuana.Moreover, marijuana use has been correlated with other problem behaviors, such as rebelliousness , delinquency , and risky sexual behavior . It is also associated with an increased risk of use of other substances, including cigarette smoking and alcohol use .