Clinical correlates of co‐occurring cannabis and tobacco use: a systematic review

Abstract

Aims A growing literature has documented the substantial prevalence of and putative mechanisms underlying co-occurring (i.e., concurrent or simultaneous) cannabis and tobacco use. Greater understanding of the clinical correlates of co-occurring cannabis and tobacco use may suggest how intervention strategies may be refined to improve cessation outcomes and decrease the public health burden associated with cannabis and tobacco use. Methods A systematic review of the literature on clinical diagnoses, psychosocial problems, and outcomes associated with co-occurring cannabis and tobacco use. Twenty-eight studies compared clinical correlates in co-occurring cannabis and tobacco users vs. cannabis or tobacco only users. These included studies of treatment-seekers in clinical trials and non-treatment-seekers in cross-sectional or longitudinal epidemiological or non-population-based surveys. Results Sixteen studies examined clinical diagnoses, four studies examined psychosocial problems, and 11 studies examined cessation outcomes in co-occurring cannabis and tobacco users (several studies examined multiple clinical correlates). Relative to cannabis use only, co-occurring cannabis and tobacco use was associated with a greater likelihood of cannabis use disorders, more psychosocial problems, and poorer cannabis cessation outcomes. Relative to tobacco use only, co-occurring use did not appear to be consistently associated with a greater likelihood of tobacco use disorders, more psychosocial problems, nor poorer tobacco cessation outcomes. Conclusions Cannabis users who also smoke tobacco are more dependent on cannabis, have more psychosocial problems, and have poorer cessation outcomes than those who use cannabis but not tobacco. The converse does not appear to be the case.

Marijuana use among US tobacco users: Findings from wave 1 of the population assessment of tobacco health (PATH) study

“…Associations between concurrent use and dependence are well documented (Castane et al, 2005;Maldonado et al, 2006;Peters et al, 2012) and have plausible mechanisms via enhanced reinforcement, conditioned pairings to strengthen cues for concurrent use, and amelioration of cognitive deficits of marijuana use alone (Schuster et al, 2016). When examining the relative impact of levels of dependence, no observed relationship between product user group and concurrent use of marijuana was D.R.…”

An fMRI-Based Neural Signature of Decisions to Smoke Cannabis

“…Because two of these residential studies focused on comorbid cigarette and cannabis use, almost all participants in the present study smoked both cigarettes and cannabis. Although this may limit generalizability, laboratory (Haney et al, 2013a) and clinical (de Dios et al, 2009;Kohn et al, 2003;Peters et al, 2012) studies have shown that cigarette smoking represents a marker for particularly intransigent use of drugs, including cannabis. Thus, although potentially limiting generalizability to the ∼ 50% of heavy cannabis smokers who also smoke cigarettes (Moore and Budney, 2001;Stinson et al, 2006), this is a particularly clinically relevant group of cannabis smokers to study.…”

El consumo de tabaco como automedicación de depresión/ansiedad entre los jóvenes: resultados de un estudio con método mixto

“…Adicionalmente, el consumo de tabaco se asocia en varias de sus modalidades con el abuso de alcohol, el consumo de cánnabis, la existencia de fumadores en el hogar y de consumidores de cánnabis, mostrando un panorama de policonsumo e influencias de la red social confirmadas en la literatura (Guo et al, 2010), (Emory et al, 2010), (Turner, Mermelstein y Flay, 2004), (Alcalá, Azañas, Moreno y Gálvez, 2002), (Peters, Budney y Carroll, 2012). No obstante, los resultados no están exentos de paradojas.…”