Associations between cigarette smoking and cannabis dependence: a longitudinal study of young cannabis users in the United Kingdom

Chandni Hindocha, Natacha D C Shaban, Tom P Freeman, Ravi K Das, Grace Gale, Grainne Schafer, Caroline J Falconer, Celia J A Morgan, H Valerie Curran

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AIMS: To determine the degree to which cigarette smoking predicts levels of cannabis dependence above and beyond cannabis use itself, concurrently and in an exploratory four-year follow-up, and to investigate whether cigarette smoking mediates the relationship between cannabis use and cannabis dependence.

METHODS: The study was cross sectional with an exploratory follow-up in the participants' own homes or via telephone interviews in the United Kingdom. Participants were 298 cannabis and tobacco users aged between 16 and 23; follow-up consisted of 65 cannabis and tobacco users. The primary outcome variable was cannabis dependence as measured by the Severity of Dependence Scale (SDS). Cannabis and tobacco smoking were assessed through a self-reported drug history.

RESULTS: Regression analyses at baseline showed cigarette smoking (frequency of cigarette smoking: B=0.029, 95% CI=0.01, 0.05; years of cigarette smoking: B=0.159, 95% CI=0.05, 0.27) accounted for 29% of the variance in cannabis dependence when controlling for frequency of cannabis use. At follow-up, only baseline cannabis dependence predicted follow-up cannabis dependence (B=0.274, 95% CI=0.05, 0.53). At baseline, cigarette smoking mediated the relationship between frequency of cannabis use and dependence (B=0.0168, 95% CI=0.008, 0.288) even when controlling for possible confounding variables (B=0.0153, 95% CI=0.007, 0.027).

CONCLUSIONS: Cigarette smoking is related to concurrent cannabis dependence independently of cannabis use frequency. Cigarette smoking also mediates the relationship between cannabis use and cannabis dependence suggesting tobacco is a partial driver of cannabis dependence in young people who use cannabis and tobacco.

Original languageEnglish
Pages (from-to)165-171
Number of pages7
JournalDrug and Alcohol Dependence
Early online date13 Jan 2015
Publication statusPublished - 1 Mar 2015



  • Adolescent
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Marijuana Abuse/diagnosis
  • Smoking/epidemiology
  • United Kingdom/epidemiology
  • Young Adult

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