Many people use cannabis and tobacco to reduce stress. But recent findings show the combination could increase mental disorders like anxiety and depression. Read on to find out what a current review reveals about what cannabis and tobacco use may be doing to your mental health.
The Study of Cannabis and Tobacco Use
Nhung Nguyen, an assistant professor at the University of California in San Francisco led a review study of 53,843 adults who had participated in an online COVID-19 Citizens Health Study between 2020 and 2022. 4.9% of participants used tobacco only, 6.9% used cannabis only and 1.6% reported cannabis and tobacco use.
More than 25% of the participants in the group who reported cannabis and tobacco use experienced anxiety and depression. This data is compared to just 10% of non-users reporting emotional disorders.
The study on cannabis and tobacco use can be further broken down with the following statistics:
- 26.5% of the 1.6% who reported both cannabis and tobacco use experienced anxiety. 28.3% experienced depression.
- 10.6% of participants who reported no cannabis and tobacco use experienced anxiety, and 11.2% experienced depression.
- Study findings showed that a combination of cannabis and tobacco use increased the risk of anxiety and depression 1.8 times.
Nguyen’s study was published in the journal PLosOne on Sept. 13.
“Use of either tobacco or cannabis is related to poor mental health. Thus, co-use, or using both substances, might potentially have addictive effects on mental health,” said Nguyen who is also a behavioral scientist studying substance abuse.
“In our study, the likelihood of anxiety of co-use was higher than that for tobacco-only use but were not significantly different from cannabis-only use,” Nguyen went on to report.
Is Cannabis and Tobacco Use the Cause or the Result?
The study was unable to establish cannabis and tobacco use as the cause of anxiety and depression. It may be that people who deal with these emotional disorders are more likely to self-medicate with cannabis and tobacco.
Pharmacological effects may also play a role.
“The current evidence suggests that co-use is associated with exposure to more toxicants (like carbon monoxide) and increased likelihood of psychiatric and psychological problems (like bipolar and anxiety disorder, personality disorder), greater tobacco/cannabis use and dependence, and poorer cessation outcomes for tobacco and cannabis that those who use single substances,” Nguyen pointed out.
“(Therefore) the use of tobacco and cannabis may lead to a toxic effect and neurological changes that prompt or exacerbate anxiety and depressive symptoms, particularly during periods of withdrawal, when individuals stop using these substances,” she went on to say.
Cannabis and Tobacco Use and Interaction
Nguyen and her team also considered how cannabis and tobacco use combine to contribute to emotional issues. They were unable to determine a clear solution.
“There is mixed evidence on the interaction of pharmacological effects of nicotine and THC, indicating both synergistic and counteracting effects,” Nguyen said.
“The combination of tobacco and cannabis can increase the release of certain neurotransmitters like dopamine, resulting in more pronounced euphoric effects and increased feelings of pleasure (while you are smoking them). Conversely, the stimulant properties of nicotine may counteract the sedating effects of cannabinoids.”
Dopamine production is typically related to pleasure. However, overproduction can lead to anxiety, sleep problems, impulse control issues, and hallucinations.
“The impact of co-use of health in general, and on mental health, is not fully understood. More attention is needed toward this emerging public health issue because if we only address the use of a single substance in isolation, we miss opportunities to address multiple substance-use issues simultaneously. “
“Coordinating tobacco and cannabis cessation with mental health treatment may be beneficial for people with co-use of tobacco and cannabis. In addition, screening for use of tobacco and cannabis should be implemented in mental health treatment centers,” Nguyen said in summation.
Critics of the Study on Cannabis and Tobacco Use
Dr. Peter Grinspoon, a primary care physician and cannabis specialist at Massachusetts General Hospital and Harvard Medical School, feels that the study’s main fault is its failure to prove causation.
“The Achilles heel of this entire study is that the correlation is not causation,” he says. “It’s always made much more sense to me that people are just self-medicating and self-treating their anxiety and their depression. I treat a lot of people who treat their anxiety and depression with cannabis and it’s very successful.”
He also reflected on tobacco’s properties saying, “I generally think tobacco doesn’t make anything better. But we also don’t know if it makes your depression and anxiety worse.”
However, he also referred to studies that have linked cannabis to mental health issues like paranoia and schizophrenia.
A National Academies of Sciences, Engineering, and Medicine study shows that frequent use of marijuana can cause anxiety, paranoia, and disorientation. It has also been linked to suicide ideation, suicide attempts, suicide, social anxiety, and depression.
A 2016 study published in JAMA Psychiatry shows marijuana use has been linked to temporary psychosis and schizophrenia which is more likely to occur in people that start using marijuana at an early age.
Grinspoon also pointed out that the people in the study who reported poor mental health also faced economic challenges that may contribute to anxiety and depression. These people are also less likely to afford medications designed to treat mental illnesses.
“If you’re miserable by circumstances, who wouldn’t be tempted to smoke or use cannabis?” Grinspoon pointed out. “In a perfect world, we’d all do yoga and eat tofu and meditate. But a lot of people have these challenging lives and they’re using these substances just to get by.”