Mixing tobacco with cannabis is linked to nicotine dependence in young adults
Nearly half of young adult cannabis users mix tobacco with cannabis, and mixing more frequently was associated with greater nicotine dependence even after accounting for other nicotine sources.
Quick Facts
What This Study Found
Of 313 past-year cannabis users (mean age 30.6), 48% reported mixing tobacco with cannabis. Weekly or daily mixing was associated with endorsing 0.5 more ICD-10 nicotine dependence criteria, and less-than-weekly mixing with 0.3 more criteria, after controlling for cigarettes smoked, other tobacco products, and secondhand smoke exposure.
Key Numbers
788 participants total, 313 past-year cannabis users, 150 (48%) reported mixing. Weekly/daily mixers: 0.5 additional ND criteria. Less than weekly mixers: 0.3 additional criteria.
How They Did This
Longitudinal cohort study of 788 young adults (2017-2020) using self-report questionnaires. Multivariable logistic regression identified characteristics of mixers. Nicotine dependence was measured using ICD-10 criteria.
Why This Research Matters
Mixing tobacco with cannabis creates an often-overlooked source of nicotine exposure that could make quitting tobacco harder for young adults who use both substances.
The Bigger Picture
Tobacco control efforts may be undermined if cannabis-tobacco mixing is not recognized as an independent pathway to nicotine dependence, especially in regions where mixing is culturally common.
What This Study Doesn't Tell Us
Self-reported measures. Longitudinal design but nicotine dependence analysis was cross-sectional within the cannabis-using subsample. Canadian context where mixing may be more common than in the U.S.
Questions This Raises
- ?Would reducing tobacco-cannabis mixing rates improve tobacco cessation outcomes?
- ?Are cannabis users who mix aware of the nicotine dependence risk?
Trust & Context
- Key Stat:
- 48% of cannabis users mixed tobacco with cannabis
- Evidence Grade:
- Longitudinal cohort with appropriate controls for other nicotine sources, though the mixing-dependence analysis was cross-sectional.
- Study Age:
- Published in 2022 with data from 2017-2020.
- Original Title:
- Who mixes tobacco with cannabis and does mixing relate to nicotine dependence?
- Published In:
- Addictive behaviors, 128, 107254 (2022)
- Authors:
- Dugas, Erika N(2), Wellman, Robert J(3), Sylvestre, Marie-Pierre(4), Bélanger, Richard E, O'Loughlin, Jennifer
- Database ID:
- RTHC-03821
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked Questions
Who is most likely to mix tobacco with cannabis?
Younger age, lower education and income, past-year cigarette use, other tobacco and illicit drug use, poor coping skills, and gambling were all associated with mixing.
Does mixing make nicotine dependence worse?
Yes. Even after accounting for cigarettes smoked, other tobacco products, and secondhand smoke, mixing tobacco with cannabis was independently associated with more nicotine dependence symptoms.
Read More on RethinkTHC
- cannabis-dependence-physical-psychological-addiction-science
- cannabis-perception-vs-evidence-gap
- cannabis-use-disorder-test
- cross-addiction-quit-weed-start-drinking
- is-weed-addictive
- is-weed-addictive-science
- quitting-weed-and-alcohol
- rehab-for-weed-addiction-necessary
- signs-of-cannabis-use-disorder
- weed-vape-pen-addiction
- blunts-vs-joints-vs-spliffs-difference
Cite This Study
https://rethinkthc.com/research/RTHC-03821APA
Dugas, Erika N; Wellman, Robert J; Sylvestre, Marie-Pierre; Bélanger, Richard E; O'Loughlin, Jennifer. (2022). Who mixes tobacco with cannabis and does mixing relate to nicotine dependence?. Addictive behaviors, 128, 107254. https://doi.org/10.1016/j.addbeh.2022.107254
MLA
Dugas, Erika N, et al. "Who mixes tobacco with cannabis and does mixing relate to nicotine dependence?." Addictive behaviors, 2022. https://doi.org/10.1016/j.addbeh.2022.107254
RethinkTHC
RethinkTHC Research Database. "Who mixes tobacco with cannabis and does mixing relate to ni..." RTHC-03821. Retrieved from https://rethinkthc.com/research/dugas-2022-who-mixes-tobacco-with
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.