Is Smoking Cannabis With Tobacco Bad for You?

Cannabis and tobacco have been used recreationally for thousands of years. We don’t know exactly when we started mixing cannabis and tobacco but smoking joints has become one of the most common ways to use cannabis. Both have controversial reputations due to links with a lot of - sometimes fatal - health issues¹ and sometimes the information out there can be confusing.

Debunking some myths

You can get addicted to cannabis, and of course tobacco too. Cannabis has been shown to be less addictive than tobacco, but mixing them together could make it even harder to quit either drug^2,3. With cannabis you won’t typically become physically dependent like with nicotine in tobacco but you can become habitually addicted and go on to develop cannabis use disorder⁴.

Mixing cannabis with tobacco doesn’t increase the high from cannabis. Tobacco will do little more than add to the heart rate increase effect from cannabis⁵, which can be dangerous for people with fragile hearts and increases the likelihood of negative consequences for everyone⁶.

Why we mix cannabis and tobacco

Cannabis and tobacco are wide-reaching recreational drugs, they’re used throughout the world but in various different ways. Mixing cannabis and tobacco - a joint - seems to be a largely European habit, with 90% favouring joints over other methods⁷, whereas in North America vaping is the favourite (although this wasn’t always the case!).

The popularity of joints seems to stem from hash. Back in the 70s, hash was widespread in Europe, likely because it was much easier to smuggle than cannabis flowers (bud). However, hash can’t just be rolled up into a spliff (pure cannabis cigarettes), so people started rolling hash into cigarettes⁸.

In America bud was more easily accessible, probably due to a better-suited climate for growing higher THC cannabis. America never really took to mixing in tobacco because there never was a need. Most Americans smoke spliffs⁹ or use bongs, both of which work well with bud. That’s probably also why vaping took on so well there.

Potentially positive impacts

Surprisingly, some studies have shown tobacco to have a protective effect on the brain¹⁰, potentially reducing some of cannabis’s negative effects. Nicotine, the addictive chemical in tobacco, also helps sharpen the mind. This could partially explain why people continue to mix tobacco and cannabis despite knowing the consequences.

With medical cannabis legalisation fast-growing, it seems like cannabis’ protective effect¹¹ is finally being acknowledged. From Alzheimer’s disease to Parkinson’s disease, anxiety to pain, our understanding of how cannabis can be used medically is always improving, leading to considerable changes in accessibility to medical cannabis too.

Definitely negative consequences

It’s widely known that smoking is bad for your health. When you heat something to such high temperatures, you change it. When you do this with cannabis and tobacco, a huge number of harmful chemicals and carcinogens are released.

Smoking tobacco kills more than 8 million people a year¹². It can lead to many diseases that are life-limiting and eventually lead to death. They include heart disease, stroke, various types of cancer, and chronic obstructive pulmonary disorder. All of these conditions are preventable if you stop smoking in early adulthood and stopping smoking any time after that will reduce your risk^13,14.

Cannabis and tobacco have a complicated relationship1 that makes it difficult to separate their associated harms. Smoking is definitely one of them. Awareness of its lethal reputation lead to change, creating healthier alternatives to smoking.

Is vaping healthier?

Vaping has become incredibly popular in both cannabis and tobacco smokers as it bypasses some of the risks related to smoking. However, we can’t forget that these are addictive substances. Vaping doesn’t take away all of their potential harm¹⁵.

There has been a recent spate of life-changing illnesses and deaths related to vaping, prompting many countries to tighten up laws and even ban e-cigarettes altogether¹⁶. In America, the CDC related this epidemic to vitamin E acetate. It’s added to THC- or nicotine- containing e-cigarettes and vaping products, usually as a thickening agent.

Harm reduction for cannabis and tobacco

Legalisation of cannabis also aims to promote using cannabis without tobacco. There’s a huge range of alternatives now; capsules, tinctures, sprays and many more. They avoid health conditions caused by smoking whilst still providing you with the potential benefits. And given the recent vaping epidemic, it’s important to highlight that you should always purchase any cannabis-based products from reliable retailers. Look for brands that are well-known, have reviews and are open about their ingredients.

As with any drug, you can reduce the risks in a variety of ways, but there is no method that is 100% safe. One thing you can do is educate yourself and those around you. Head over to our website to see the variety of guides, including cannabis and tobacco, which provide you with an in-depth but concise look at certain drugs, with an emphasis on harm reduction.

References

¹ Jones, H. J., Gage, S. H., Heron, J., Hickman, M., Lewis, G., Munafò, M. R., & Zammit, S. (2018). Association of combined patterns of tobacco and cannabis use in adolescence with psychotic experiences. JAMA psychiatry, 75(3), 240-246.

² Hindocha, C., Shaban, N. D., Freeman, T. P., Das, R. K., Gale, G., Schafer, G., ... & Curran, H. V. (2015). Associations between cigarette smoking and cannabis dependence: a longitudinal study of young cannabis users in the United Kingdom. Drug and alcohol dependence, 148, 165-171.

³ Hindocha, C., Freeman, T. P., Ferris, J. A., Lynskey, M. T., & Winstock, A. R. (2016). No smoke without tobacco: a global overview of cannabis and tobacco routes of administration and their association with intention to quit. Frontiers in psychiatry, 7, 104.

⁴ Patel J, Marwaha R. (2021) Cannabis Use Disorder. In: StatPearls. StatPearls Publishing, Treasure Island (FL). PMID: 30844158.

⁵ UCL News (2017). Adding tobacco to cannabis doesn't affect the high, but impacts memory and heart. University College London. Accessed: 10 April 2022.

⁶ Ream, G. L., Benoit, E., Johnson, B. D., & Dunlap, E. (2008). Smoking tobacco along with marijuana increases symptoms of cannabis dependence. Drug and alcohol dependence, 95(3), 199-208.

⁷ Global Drug Survey (2019). GDS 2019. Global Drug Survey. Accessed: 10 April 2022.

⁸ Booth, M. (2005). Cannabis: a history. Macmillan.

⁹ Michael Knodt (2019). A Strange Blend: Why Are Europeans Mixing Cannabis and Tobacco?. Accessed: 10 April 2022.

¹⁰ Hindocha, C., Freeman, T. P., Xia, J. X., Shaban, N. D., & Curran, H. V. (2017). Acute memory and psychotomimetic effects of cannabis and tobacco both ‘joint’and individually: a placebo-controlled trial. Psychological Medicine, 47(15), 2708-2719.

¹¹ Kumar, R. N., Chambers, W. A., & Pertwee, R. G. (2001). Pharmacological actions and therapeutic uses of cannabis and cannabinoids. Anaesthesia, 56(11), 1059-1068.

¹² WHO (2021). Tobacco. WHO. Accessed: 10 April 2022.

¹³ West, R. (2017). Tobacco smoking: Health impact, prevalence, correlates and interventions. Psychology & health, 32(8), 1018-1036.

¹⁴ NHS (2018). What are the health risks of smoking?. NHS. Accessed: 10 April 2022.

¹⁵ Tashkin DP (2015). How beneficial is vaping cannabis to respiratory health compared to smoking? Addiction.

¹⁶ Snaith E. (2019). What are the dangers of vaping? The Independent. Accessed: 10 April 2022.