ArticleAddiction (Abingdon, England)2021
Unknown population-level harms of cannabis and tobacco co-use: if you don't measure it, you can't manage it.
Article in Addiction (Abingdon, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Health education interventions to reduce cannabis and tobacco smoking-related harms among people who use cannabis: a systematic review.Health education research · 2026Pooled it
- Associations of cannabis use, tobacco use, and incident anxiety, mood, and psychotic disorders: a systematic review and meta-analysis.Psychological medicine · 2024Pooled it
- Recent cannabis exposure and acute nicotine effects: insights from randomized, double-blind, placebo-controlled intravenous nicotine studies.The international journal of neuropsychopharmacology · 2026Trial
- Cannabis use among adults who smoke tobacco: Relations with switching from combusted cigarettes to e-cigarettes or very low nicotine cigarettes.Drug and alcohol dependence · 2025Trial
- Change in Cigarette, Other Tobacco Product, and Cannabis Use Among Individuals Who Used or Did Not Use Cannabis During a Smoking Cessation Trial.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Trial
- Perceived Effectiveness of Cigar Warnings in Discouraging Blunt Use.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Trial
- Effects of Marijuana Use on Smokers Switching to E-Cigarettes in a Randomized Clinical Trial.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Trial
- Harm perceptions of smoking versus vaping cannabis and correlates: national surveys of youth and young adults in England, Canada, and the United States.Addictive behaviors · 2026Article
- Determining the impact of cannabis use on tobacco cessation: Results from a prospective non-randomized tobacco treatment trial.Addiction (Abingdon, England) · 2026Article
- The Association Between Sociodemographic Factors and co-Use of Cigars or Cigarillos with Cannabis.Substance use & misuse · 2026Article
- Enhancing data compatibility in an evolving landscape: Medical cannabis and polysubstance use protocols in the PhenX Toolkit.Drug and alcohol dependence · 2026Article
- A qualitative study of same session co-use of nicotine and cannabis among adolescents and young adults.PloS one · 2026Article
- Reactivity to electronic nicotine delivery system (ENDS) cues in adults who smoke cigarettes and vape cannabis.Addictive behaviors · 2026Article
- Waterpipe and Co-Use of Inhaled Nicotine and Tobacco Products: Findings from a Population-Based Cross-Sectional Household Survey in Germany.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Lifetime Cannabis, Non-Cigarette Tobacco, and Illicit Drug Use and Cardiovascular Disease Among Young and Middle-Aged U.S. Adults.American journal of lifestyle medicine · 2025Article
- Adult-use cannabis legalization in the united states: a scoping review of outcome monitoring recommendations.BMC public health · 2025Article
- Prevalence and factors associated with tobacco and cannabis co-use in France: Results from a national representative survey.Drug and alcohol dependence reports · 2025Article
- Concurrent availability of cannabinoid and tobacco products in licensed tobacco retailers in three U.S. cities.The International journal on drug policy · 2025Article
- Initial Subjective Response to Nicotine Vaping Predicts Subsequent E-Cigarette Use in Early Adolescence: An ABCD Investigation.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Effects of Inhaled Tobacco and Cannabis Co-Use on Respiratory Health and Tobacco Cessation: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundNationally representative data of cannabis-tobacco co-use have shown that these substances are closely entwined and have significant adverse health consequences, although population-level harms of co-use are largely unknown. Current epidemiological research does not assess co-use in a manner that has yielded the necessary data to draw conclusions regarding health effects. This has given rise to a hidden population of co-users who go under-served. Therefore, this paper has two aims: (1) to review new challenges in the collection of co-use data due to rapidly changing regulations of cannabis and nicotine products and (2) to provide recommendations for the terminology and assessment of co-use. ARGUMENT: We argue that: (1) the prevalence of co-use is not being assessed accurately at a population level and (2) changes in legalization have created novel challenges, but without proper monitoring the impact on co-use will go undetected. We propose a three-level tiered set of recommendations for co-use assessments, which includes assessments of cannabis, tobacco and co-use metrics ranging from least burdensome (self-report of co-administered products) to most burdensome (assays, event-level data).
conclusionsWe propose that clinical studies begin to incorporate cannabis-tobacco co-use assessments to justify better their inclusion in clinical trials and national surveillance surveys. Integration of co-use assessments will aid in understanding the true impact on co-use of the changing cannabis and tobacco/nicotine regulatory environments. Co-use is prevalent and problematic, and the ability to make conclusions about its health outcomes is hindered by lack of nuance in data collection. If you do not measure it, you cannot manage it.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.