Brain and Body

Mixing Cannabis and Tobacco Linked to an Increased Risk of Dependence

July 6, 2016 | Kelly Tatera

Cigarettes in an ashtray. Tobacco.
Photo credit: .jocelyn./flickr (CC BY 2.0)

Based on an analysis of over 33,000 cannabis users.

According to the World Health Organization (WHO), over 1 billion people around the world smoke tobacco and over 147 million people consume cannabis, making the two substances some of the most popular drugs on the planet.

Researchers from London and Australia explain that some smokers will mix cannabis with tobacco since it can be a way to save money, and tobacco can also increase the efficiency of cannabis inhalation.

However, according to their latest research, which has been published in the journal Frontiers in Psychology, mixing cannabis and tobacco may increase the risk of dependence.

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"Cannabis dependence and tobacco dependence manifest in similar ways, so it is often difficult to separate these out in people who use both drugs," lead author Chandni Hindocha, a doctoral student at the Clinical Psychopharmacology Unit of University College London, said in a press release. "Cannabis is less addictive than tobacco, but we show here that mixing tobacco with cannabis lowers the motivation to quit using these drugs."

Together with researchers from the University of Queensland, King’s College London, and the South London and Maudsley NHS Trust, the team analyzed responses from 33,687 cannabis users who took part in the 2014 Global Drug Survey. The new study is the first to look at the different methods of cannabis consumption — or routes of administration — around the world, and gauge the effects on cannabis and tobacco dependency.

The researchers found that routes of administration vary widely between countries. For instance, mixing tobacco and cannabis in blunts, joints, or pipes is much more popular in Europe than elsewhere. These tobacco routes are the least popular in the Americas — only 16 percent of Canadian, 4.4 percent of US, and 7.4 percent of Brazilian cannabis users used tobacco routes of administration. In contrast, the US and Canada had the highest number of smokers using a strictly non-tobacco route: cannabis vaporizers.

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The analysis also showed that a preference for the tobacco route of administration negatively impacted smokers’ motivation to quit or seek professional help to do so. Compared to smokers who used tobacco routes, those who favored non-tobacco routes had a 61.5 percent higher chance of wanting professional help to smoke less cannabis and an 80.6 percent higher odds of wanting help to use less tobacco.

According to the researchers, these results suggest that people who regularly mix tobacco and cannabis are at a higher risk of psychological dependence than those who don’t. However, it’s important to note that these results show a link between mixed use and higher dependence — the findings don’t prove that mixing cannabis and tobacco causes more of a dependence.

"Our results highlight the importance of routes of administration when considering the health effects of cannabis and show that the co-administration of tobacco and cannabis is associated with decreased motivation to cease tobacco use, and to seek help for ceasing the use of tobacco and cannabis," Michael T. Lynskey, Professor of Addictions at King's College London, said in the release.

"Given a changing legislative environment surrounding access to cannabis in many jurisdictions, increased research focus should be given to reducing the use of routes of administration that involve the co-administration of tobacco."

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