Evidence map›Paper›PMID 42831941›Full record

ReviewPsychopharmacology2026

Co-use of cannabis and tobacco in the same occasion: Acute effects. A systematic review.

Jingqi Xu, Adrien Nette, Christina Zakala, Sampson Zhao, Justin Matheson, Christine M Wickens, Sarah Bonato, Patricia Di Ciano

Abstract readReview
PubMed Publisher
In one paragraph

Review in Psychopharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jingqi XuInstitute for Mental Health and Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
Adrien NetteInstitute for Mental Health and Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
Christina ZakalaInstitute for Mental Health and Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
Sampson ZhaoInstitute for Mental Health and Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
Justin MathesonInstitute for Mental Health and Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
Christine M WickensInstitute for Mental Health and Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
Sarah BonatoCentre for Addiction and Mental Health, Toronto, Canada.
Patricia Di CianoInstitute for Mental Health and Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada. patricia.diciano@camh.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleCannabis and tobacco are widely used substances with addiction potential, which have opposing effects on cognition and subjective experience and are often co-used in a single occasion.

objectivesThe purpose of this systematic review was to synthesize evidence of the acute effects of same-occasion co-use of cannabis and tobacco.

methodsDatabases Embase, Medline, CINAHL, PsycINFO, and Web of Science were searched from inception to May 2025. Inclusion criteria were broad. Included studies were peer-reviewed papers, theses, grey literature and abstracts. Designs included randomized controlled trials, laboratory studies, epidemiological studies, qualitative studies, case reports, before-and-after studies, cohort, case-control, cross-sectional, longitudinal, secondary data analysis and naturalistic studies. Papers were screened and selected by two authors and studies were evaluated for quality with the SIGN methodology.

resultsIn total, 18 studies were included in the present synthesis, and some contained information on multiple outcomes. Five studies examined effects of same-occasion co-use of cannabis and tobacco on cognition; 12 studies evaluated same-occasion co-use on subjective experience; and seven studies evaluated effects on physiological measures. With respect to cognition, three studies found that cannabis and tobacco each attenuated the effects of the other, but the findings were not always consistent. For subjective experience, eight studies reported that the effects of same-occasion co-use of cannabis and tobacco did not differ from the effects of either drug on its own. Two studies of subjective experience found that tobacco dulled the effects of cannabis and two found that tobacco increased the stimulant properties of cannabis.

conclusionsIn sum, the evidence for additive effects of cannabis and tobacco is mixed, with some studies reporting that cannabis and tobacco attenuate the effects of the other on cognition. There are inconclusive findings with respect to the combined effects of cannabis and tobacco on subjective effects and physiological outcomes. However, studies are limited and more large-scale studies that investigate the full range of diverse effects of cannabis and tobacco are needed.

Indexed as

BluntsChasingCo-administrationMullingSequential co-useSpliffs

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.