Double Trouble: Disturbingly High Rates of Depression and Anxiety in People Who Use Both Tobacco and Cannabis

Smoking Mental Health Art

People using both tobacco and cannabis face higher anxiety and depression rates than solo or non-users, according to a PLOS ONE study. Integrating mental health support in cessation programs could be beneficial.

Among more than 50,000 COVID-19 Citizen Science Study participants, around a quarter of users of both tobacco and cannabis experienced anxiety or depression – almost twice the rate of non-users.

People who use both tobacco and cannabis are more likely to report anxiety and depression than those who use tobacco only or those who use neither substance. This is according to a new study published this week in the open-access journal PLOS ONE by Nhung Nguyen of the University of California, San Francisco, USA, and colleagues.

Data Analysis and Results

Tobacco and cannabis rank among the most commonly used substances worldwide, and their co-use has been on the rise amid the expanding legalization of cannabis. In the new study, the researchers analyzed data on the substance use and mental health of 53,843 US adults who participated in online surveys as part of the COVID-19 Citizens Health Study, which collected data from 2020 to 2022.

Overall, 4.9% of participants reported tobacco-only use, 6.9% reported cannabis-only use, and 1.6% reported co-use. Among people in the co-use group, 26.5% reported anxiety and 28.3% reported depression, while among people who used neither tobacco or cannabis, percentages of anxiety and depression were 10.6% and 11.2%. The likelihood of having these mental health disorders was about 1.8 times greater for co-users than non-users, the study found. Co-use and use of cannabis only were also associated with a higher likelihood of having anxiety compared to use of tobacco only.

Interpretation and Suggestions

While this study doesn’t claim a direct cause-and-effect relationship, its findings underline the association between the co-use of tobacco and cannabis and deteriorated mental health. Consequently, the authors recommend the incorporation of mental health resources into tobacco and cannabis cessation initiatives to potentially mitigate this connection.

The authors add: “Engaging in both tobacco and cannabis is linked to diminished mental well-being.”

Reference: “Associations between tobacco and cannabis use and anxiety and depression among adults in the United States: Findings from the COVID-19 citizen science study” by Nhung Nguyen, Noah D. Peyser, Jeffrey E. Olgin, Mark J. Pletcher, Alexis L. Beatty, Madelaine F. Modrow, Thomas W. Carton, Rasha Khatib, Djeneba Audrey Djibo, Pamela M. Ling and Gregory M. Marcus, 13 September 2023, PLOS ONE.
DOI: 10.1371/journal.pone.0289058

Funding: NN is supported by the California Tobacco-Related Disease Research Program (grants T31FT1564 and T32KT5071) and the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF Clinical and Translational Science Institute (grant UL1 TR001872-06). The Eureka Research Platform was supported by grant 5U2CEB021881 from NIH to GM, JO, and MP. The COVID-19 Citizen Science Study is supported by Patient-Centered Outcomes Research Institute contract COVID-2020C2-10761 to GM, JO, and MP; the Bill and Melinda Gates Foundation contract INV-017206 to GM, JO, and MP, and grants 75N91020C00039 from NIH/NCI and 3U2CEB021881-05S1 from NIH/NIBIB to GM, JO, and MP. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

3 Comments on "Double Trouble: Disturbingly High Rates of Depression and Anxiety in People Who Use Both Tobacco and Cannabis"

  1. I’m sure that this finding has nothing to do with what is all going on in the world.

  2. An amazingly high level of anxiety and depression is measured in people who take antidepressents and antianxiety pills compared to those who don’t.

    A better study would be comparing the effectiveness of different ways of dealing with anxiety and depression.

    Western medicine provides little in the way of actual relief from anxiety and depression at a cost similar to a toke and a smoke.

  3. Could it be that people with anxiety or depression consume cannibinoids combined with nicotine to cope with symptoms? It sounds as if the research indicates that people with symptoms will medicate.

Leave a comment

Email address is optional. If provided, your email will not be published or shared.