Veterans who co-use tobacco and cannabis have worse mental health symptoms

Among Iraq and Afghanistan war veterans, those who used both tobacco and cannabis in the past 30 days reported significantly higher levels of stress, PTSD, depression, and anxiety compared to those using only one substance.

Fitzke, Reagan E et al.·Journal of psychoactive drugs·2022·Moderate EvidenceCross-Sectional
RTHC-03844Cross SectionalModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Past 30-day co-users of tobacco and cannabis endorsed significantly higher levels of stress, PTSD, depression, and anxiety compared to singular product users. Lifetime and past 30-day rates of both tobacco and cannabis use were high among OEF/OIF veterans.

Key Numbers

1,230 OEF/OIF veterans surveyed. Co-users had significantly higher stress, PTSD, depression, and anxiety scores than single-substance users.

How They Did This

Cross-sectional survey of 1,230 OEF/OIF veterans examining co-use patterns of tobacco products (cigarettes, vaping) and cannabis, with validated measures of mental health symptoms.

Why This Research Matters

Veterans have elevated rates of both tobacco and cannabis use. Understanding that co-use is associated with worse mental health symptoms could inform integrated treatment approaches.

The Bigger Picture

Whether co-use worsens mental health or people with worse mental health are more likely to use both substances cannot be determined from this study, but the association suggests co-users may need more comprehensive care.

What This Study Doesn't Tell Us

Cross-sectional design cannot determine causation. Self-reported substance use and mental health. Convenience sample of veterans may not represent all service members.

Questions This Raises

  • ?Does tobacco-cannabis co-use worsen mental health, or do veterans with worse symptoms seek both substances?
  • ?Would addressing co-use in treatment improve mental health outcomes?

Trust & Context

Key Stat:
Co-users had significantly higher PTSD and depression scores
Evidence Grade:
Moderate sample size with validated measures, but cross-sectional design and convenience sampling limit causal inference.
Study Age:
Published in 2022.
Original Title:
Co-use of Tobacco Products and Cannabis among Veterans: A Preliminary Investigation of Prevalence and Associations with Mental Health Outcomes.
Published In:
Journal of psychoactive drugs, 54(3), 250-257 (2022)
Database ID:
RTHC-03844

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Is using both tobacco and cannabis worse than using just one?

The study found co-users reported higher levels of stress, PTSD, depression, and anxiety, but cannot determine whether co-use causes worse mental health or vice versa.

How common was co-use among veterans?

Both lifetime and past 30-day rates of tobacco and cannabis use were high among the OEF/OIF veteran sample, with substantial overlap in co-use.

Read More on RethinkTHC

Cite This Study

RTHC-03844·https://rethinkthc.com/research/RTHC-03844

APA

Fitzke, Reagan E; Davis, Jordan P; Pedersen, Eric R. (2022). Co-use of Tobacco Products and Cannabis among Veterans: A Preliminary Investigation of Prevalence and Associations with Mental Health Outcomes.. Journal of psychoactive drugs, 54(3), 250-257. https://doi.org/10.1080/02791072.2021.1956026

MLA

Fitzke, Reagan E, et al. "Co-use of Tobacco Products and Cannabis among Veterans: A Preliminary Investigation of Prevalence and Associations with Mental Health Outcomes.." Journal of psychoactive drugs, 2022. https://doi.org/10.1080/02791072.2021.1956026

RethinkTHC

RethinkTHC Research Database. "Co-use of Tobacco Products and Cannabis among Veterans: A Pr..." RTHC-03844. Retrieved from https://rethinkthc.com/research/fitzke-2022-couse-of-tobacco-products

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.