Tobacco and cannabis co-use and interrelatedness among adults

Abstract

Cannabis and tobacco co-use is prevalent, but consensus regarding the reasons for co-use among adults and the degree of interrelatedness between these substances is lacking. Reasons for co-use have been explored with younger users, but little data exists for more experienced users with entrenched patterns of co-use. The goal of this study was to examine characteristics and patterns of cannabis-tobacco co-use among adults in the Southeastern United States (US), where there is a legal landscape of generally restrictive cannabis legislation coupled with more permissive tobacco control compared to other US regions. Participants (N=432) were regular cannabis users recruited through Amazon Mechanical Turk. Measures included demographics, patterns of cannabis and tobacco use, and reasons for co-use. Within this sample, 42% were current users of tobacco (n=182). Cannabis-tobacco co-users were older and had more years of cannabis use than cannabisonly users. Among the co-using sub-sample, there was little consistency in the reasons for co-use, suggesting individual differences in the use of both substances. High levels of cannabis-tobacco interrelatedness (i.e., temporally concurrent use) were associated with smoking more cigarettes (tobacco) per day and greater nicotine dependence scores when compared to users with low levels of interrelatedness. Though these results are limited by a small sample size and generalizability issues, there were individual differences in cannabis-tobacco relatedness, which may be of importance when considering treatment strategies for cannabis, tobacco, or both. With additional research, personalized strategies adapted to cannabis-tobacco relatedness profiles among co-users may be warranted as a treatment strategy.

Smoking cessation in head and neck cancer patients: Factors influencing successes and failures

“…Marijuana usage was also found to be intrinsically linked with tobacco use and cessation. While no prior studies have investigated the interaction of marijuana and tobacco in HNC patients, multiple studies in the general population have demonstrated that co‐use of marijuana and tobacco is associated with higher nicotine dependence 22,23 which can make cessation challenging. There is a clear requirement for future studies to investigate whether addressing marijuana cessation will improve rates of tobacco abstinence among newly diagnosed HNC patients.…”

Marijuana Use and Adherence to Smoking Cessation Treatment Among Callers to Tobacco Quitlines

“…From 18% to 39% of adults who used tobacco in the past month in the United States also used marijuana, and 69% to 78% of marijuana users used tobacco in the past month (4,5). Recent longitudinal research showed that marijuana users were more likely to start smoking cigarettes, continue to smoke cigarettes over time (as opposed to quitting), and relapse back to cigarette smoking once they had quit (6). Daily use of marijuana is associated with a 3.6-fold increase in nicotine dependence (7,8).…”

A cross sectional survey of internet use among a highly socially disadvantaged population of tobacco smokers

“…Social disadvantage is related to increased rates of concurrent use of tobacco and cannabis [5–7]. Concurrent daily tobacco and cannabis use has been found to be high (40–78%) as cannabis users often mix their cannabis with tobacco for smoking [8]. Concurrent use has been linked to an increased risk of and higher levels of nicotine dependence, poorer health outcomes and greater difficulty when quitting [8–11].…”