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.
Parents, teens, prevention specialists, vaping policy advocates, and anyone concerned about youth substance co-use.
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot 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.
How to read the evidence
Small qualitative study providing rich behavioral insights but not generalizable to broader populations.
When this study was published
Published in 2026, using 2023 focus group data reflecting current youth vaping behaviors.
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.
Questions still open
- 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?
Common questions
Why do teens use nicotine and cannabis at the same time?
Does combining nicotine and cannabis make effects stronger?
Read the original research
A qualitative study of same session co-use of nicotine and cannabis among adolescents and young adults.
PloS one, 21(1), e0340050
Citation
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
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