Teens Mix Nicotine and Cannabis in the Same Session to Boost the High
Focus groups with 29 teens and young adults revealed that same-session nicotine and cannabis use is deliberate — primarily to enhance the cannabis high, mask taste, or reduce throat irritation.
Quick Facts
What This Study Found
Young people reported intentionally using nicotine and cannabis in the same session primarily to enhance the positive psychoactive effects of cannabis (improve/enhance the high). Secondary reasons included reducing negative cannabis effects (throat irritation, taste masking with flavored nicotine vapes). Some reported nicotine use was so frequent it unintentionally overlapped with cannabis. Others avoided same-session use because combined effects were too strong.
Key Numbers
29 participants in 6 focus groups. Ages 15-20. All reported past-month nicotine and cannabis vaping. Most common reason: enhance cannabis high. Secondary: reduce throat irritation, mask taste with flavored nicotine. Some reported unintentional overlap due to frequent nicotine use.
How They Did This
Qualitative study with six focus groups of Connecticut adolescents and young adults (15-20 years old, N=29, mean group size 5) who reported past-month nicotine and cannabis vaping. Conducted spring 2023. Two-stage deductive and inductive thematic analysis.
Why This Research Matters
Understanding why teens combine nicotine and cannabis in the same session is crucial for prevention. If nicotine is used to enhance the cannabis experience, then addressing one substance requires addressing both — they're functionally linked in young users' behavior.
The Bigger Picture
This reveals that nicotine and cannabis aren't just independently used — they're deliberately combined as a system. Flavored nicotine vapes serve a functional role in the cannabis experience, which has implications for flavored vape regulations and dual-substance prevention efforts.
What This Study Doesn't Tell Us
Small qualitative sample (29 participants). Single region (Connecticut). Focus group dynamics may influence responses. Participants who co-use may differ from those who don't. No objective measures of use patterns.
Questions This Raises
- ?Would banning flavored nicotine vapes reduce cannabis co-use?
- ?Does same-session use increase addiction risk for both substances?
- ?How prevalent is deliberate co-use nationally?
Trust & Context
- Key Stat:
- Evidence Grade:
- Small qualitative study providing rich behavioral insights but not generalizable to broader populations.
- Study Age:
- Published in 2026, using 2023 focus group data reflecting current youth vaping behaviors.
- Original Title:
- A qualitative study of same session co-use of nicotine and cannabis among adolescents and young adults.
- Published In:
- PloS one, 21(1), e0340050 (2026)
- Authors:
- Davis, Danielle R(2), Cavallo, Dana A, Bold, Krysten W(4), Morean, Meghan E, Kong, Grace, Li, Wei, Ponte, Vanessa, Franco, Nicholas, Lichenstein, Sarah, Krishnan-Sarin, Suchitra
- Database ID:
- RTHC-08203
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Why do teens use nicotine and cannabis at the same time?
Primarily to enhance the cannabis high. Teens also reported using flavored nicotine vapes to mask cannabis taste or reduce throat irritation from smoking. Some used nicotine so frequently it just happened to overlap with cannabis sessions.
Does combining nicotine and cannabis make effects stronger?
Teens reported that it does — same-session use was described as enhancing positive cannabis effects. Some teens actually avoided combining them because the combined effect was too intense.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-08203APA
Davis, Danielle R; Cavallo, Dana A; Bold, Krysten W; Morean, Meghan E; Kong, Grace; Li, Wei; Ponte, Vanessa; Franco, Nicholas; Lichenstein, Sarah; Krishnan-Sarin, Suchitra. (2026). A qualitative study of same session co-use of nicotine and cannabis among adolescents and young adults.. PloS one, 21(1), e0340050. https://doi.org/10.1371/journal.pone.0340050
MLA
Davis, Danielle R, et al. "A qualitative study of same session co-use of nicotine and cannabis among adolescents and young adults.." PloS one, 2026. https://doi.org/10.1371/journal.pone.0340050
RethinkTHC
RethinkTHC Research Database. "A qualitative study of same session co-use of nicotine and c..." RTHC-08203. Retrieved from https://rethinkthc.com/research/davis-2026-a-qualitative-study-of
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.