Acute memory and psychotomimetic effects of cannabis and tobacco both 'joint' and individually: a placebo-controlled trial

C Hindocha, T P Freeman, J X Xia, N D C Shaban, H V Curran

Research output: Contribution to journalArticlepeer-review

71 Citations (SciVal)


BACKGROUND: Cannabis and tobacco have contrasting cognitive effects. Smoking cannabis with tobacco is prevalent in many countries and although this may well influence cognitive and mental health outcomes, the possibility has rarely been investigated in human experimental psychopharmacological research.

METHOD: The individual and interactive effects of cannabis and tobacco were evaluated in 24 non-dependent cannabis and tobacco smokers in a randomized, placebo-controlled, double-blind, 2 (cannabis, placebo) × 2 (tobacco, placebo) crossover design. Verbal memory (prose recall), working memory (WM) performance including maintenance, manipulation and attention (N-back), psychotomimetic, subjective and cardiovascular measures were recorded on each of four sessions.

RESULTS: Cannabis alone impaired verbal memory. A priori contrasts indicated that tobacco offset the effects of cannabis on delayed recall. However, this was not supported by linear mixed model analysis. Cannabis load-dependently impaired WM. By contrast, tobacco improved WM across all load levels. The acute psychotomimetic effects and ratings of 'stoned' and 'dizzy' induced by cannabis were not altered by tobacco. Cannabis and tobacco had independent effects on increasing heart rate and interacting effects on increasing diastolic blood pressure.

CONCLUSIONS: Relative to placebo, acute cannabis impaired verbal memory and WM. Tobacco enhanced performance on WM, independently of cannabis. Moreover, we found some preliminary evidence that tobacco may offset the effects of cannabis on delayed, but not immediate, verbal recall. In contrast, the psychotomimetic and subjective effects of cannabis were unaffected by tobacco co-administration. By reducing the cognitive impairment from cannabis, tobacco co-administration may perpetuate use despite adverse health consequences.

Original languageEnglish
Pages (from-to)2708-2719
Number of pages12
JournalPsychological Medicine
Issue number15
Early online date31 May 2017
Publication statusPublished - 1 Nov 2017


  • Adult
  • Attention/drug effects
  • Blood Pressure/drug effects
  • Cannabinoids/administration & dosage
  • Cigarette Smoking/adverse effects
  • Cognitive Dysfunction/chemically induced
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Heart Rate/drug effects
  • Humans
  • Male
  • Marijuana Smoking/adverse effects
  • Memory, Short-Term/drug effects
  • Mental Recall/drug effects
  • Nicotine/administration & dosage
  • Young Adult


Dive into the research topics of 'Acute memory and psychotomimetic effects of cannabis and tobacco both 'joint' and individually: a placebo-controlled trial'. Together they form a unique fingerprint.

Cite this