Review of Nicotine and Cannabis Interactions: Reinforcement May Be Enhanced When Used Together

A comprehensive review found that combining nicotine and cannabis, increasingly common among young people, may enhance reinforcing and anxiety-reducing effects while having opposite effects on appetite and cognition, with adolescent co-use being a particular concern.

Viveros, Maria-Paz et al.·Neuroscience and biobehavioral reviews·2006·Moderate EvidenceReview
RTHC-00250ReviewModerate Evidence2006RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

This review examined the pharmacological interactions between nicotine and cannabis, two drugs increasingly used in combination, especially by adolescents and young adults.

Animal studies suggested that the reinforcing effects of both drugs may be enhanced by joint consumption. Anxiety-reducing effects may also be amplified when used together, which could be particularly appealing to adolescent girls.

However, the two drugs have contrasting effects in other domains: cannabis increases appetite while nicotine suppresses it; cannabis impairs cognition while nicotine may enhance certain cognitive functions. The review highlighted the adolescent period as requiring urgent further investigation, with sex differences emerging as an important variable.

Key Numbers

Two of the most widely used drugs of dependence. Increasingly combined, particularly among adolescents. Animal studies suggest enhanced reinforcement and anxiolytic effects from co-use. Opposite effects on appetite and cognition.

How They Did This

Comprehensive narrative review examining nicotine and cannabinoid system interactions. Covered addiction processes, gateway theories, adolescent effects, anxiety, food intake, and cognition. Drew on animal behavioral studies, human observational data, and pharmacological evidence.

Why This Research Matters

Cannabis and tobacco are frequently co-used, often mixed together in joints. Understanding their pharmacological interactions is critical because enhanced reinforcement from combining them could accelerate addiction to both substances, particularly during the vulnerable adolescent period.

The Bigger Picture

The "gateway" and "reverse gateway" theories of addiction are discussed: tobacco use may lead to cannabis, but cannabis use may also lead to tobacco. The shared pharmacological interactions between nicotinic and cannabinoid systems at the receptor level provide a biological basis for cross-substance vulnerability.

What This Study Doesn't Tell Us

Much evidence from animal studies that may not directly translate to human use patterns. The review identifies concerns about adolescent co-use but notes the area is "in urgent need of further investigation." Sex differences are emerging but not well characterized.

Questions This Raises

  • ?Does combining cannabis and nicotine increase addiction risk for both substances?
  • ?Do the opposite cognitive effects (cannabis impairing, nicotine enhancing) cancel each other out during co-use?

Trust & Context

Key Stat:
Co-use of nicotine and cannabis may enhance reinforcing effects, increasing addiction risk for both
Evidence Grade:
Comprehensive narrative review synthesizing animal and human evidence. Identifies important interaction effects but many findings are preliminary.
Study Age:
Published in 2006. Research on nicotine-cannabis co-use has expanded, particularly regarding vaping and the rise of nicotine-cannabis dual use among young people.
Original Title:
Nicotine and cannabinoids: parallels, contrasts and interactions.
Published In:
Neuroscience and biobehavioral reviews, 30(8), 1161-81 (2006)
Database ID:
RTHC-00250

Evidence Hierarchy

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

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

Does mixing cannabis with tobacco make both more addictive?

Animal studies reviewed here suggest that combining nicotine and cannabis may enhance the reinforcing (rewarding) effects of both drugs, potentially increasing addiction risk. This is particularly concerning for adolescents who frequently co-use these substances.

Why do people mix cannabis and tobacco?

The review suggests the combination may enhance anxiety-reducing effects, which could be appealing, especially to young users. Additionally, nicotine may counteract some of cannabis's cognitive-impairing effects. However, the enhanced reinforcement may accelerate dependence on both substances.

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Cite This Study

RTHC-00250·https://rethinkthc.com/research/RTHC-00250

APA

Viveros, Maria-Paz; Marco, Eva M; File, Sandra E. (2006). Nicotine and cannabinoids: parallels, contrasts and interactions.. Neuroscience and biobehavioral reviews, 30(8), 1161-81.

MLA

Viveros, Maria-Paz, et al. "Nicotine and cannabinoids: parallels, contrasts and interactions.." Neuroscience and biobehavioral reviews, 2006.

RethinkTHC

RethinkTHC Research Database. "Nicotine and cannabinoids: parallels, contrasts and interact..." RTHC-00250. Retrieved from https://rethinkthc.com/research/viveros-2006-nicotine-and-cannabinoids-parallels

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.