Cannabis use among young adults is often framed as low-risk or socially acceptable, especially in states where marijuana is legal. But growing research tells a more concerning story: cannabis use significantly increases the likelihood of tobacco initiation and nicotine dependence, particularly in adolescents and young adult men. Once these substances overlap, quitting either becomes more difficult, and the risk of long-term addiction rises sharply.
For men struggling with cannabis and tobacco co-use, Bayview Recovery Center in San Diego, California, offers specialized treatment designed to address dual substance dependence. Understanding how cannabis and tobacco interact, and why young adults are especially vulnerable, can help families intervene earlier and support lasting recovery.
This relationship is bidirectional. Cannabis use increases the likelihood of tobacco use, and tobacco use increases the likelihood of cannabis use. Among young adults ages 18–24, current cannabis users consistently show higher rates of cigarette smoking, vaping, hookah use, and cigar use compared to non-users.
Once this pattern begins, it becomes harder to quit either substance. Tobacco dependence deepens, while cannabis use often escalates into habitual or problematic patterns. The combination reinforces addiction on both sides.
Cannabis Use Is Becoming More Common Among Young Adults
Cannabis use has increased significantly in recent years. National data show that 22.3% of Americans ages 12 and older, approximately 64.2 million people, used cannabis in the past year, according to the 2024 National Survey on Drug Use and Health. In California, where recreational marijuana is legal, approximately 37% of adults report current cannabis use.
As access expands and social attitudes soften, many young adults underestimate the risks, particularly when cannabis is combined with tobacco. For young men, this underestimation often leads to patterns of use that feel manageable at first but become increasingly difficult to control.
Trends in Cannabis Use Among Adolescents and Young Adults
As legalization has shifted perceptions of marijuana as low risk or harmless, rates of co-use have risen, particularly in legal states. Studies further show that adolescents ages 17–21 who use cannabis monthly are significantly more likely to begin daily cigarette smoking and develop nicotine dependence within six years.
Many young people started viewing cannabis as safer than it actually is. States with legalized cannabis show higher rates of dual weed and tobacco use among young adults. Research shows older adolescents (ages 17-21) with past-month cannabis use are more likely to start daily smoking. They may also develop nicotine dependence within six years.
Modern cannabis is far more potent than it was decades ago. Higher THC concentrations increase the risk of addiction and intensify changes in the brain’s reward system. Stronger cannabis also appears to increase vulnerability to nicotine dependence.
Young adults now consume cannabis through multiple methods, including:
- Smoking joints or blunts
- Vaping high-THC concentrates
- Edibles and infused products
Among dual users, smoking remains common, especially joints that mix cannabis and tobacco. These shared consumption methods make co-use easy and socially normalized.
Approximately 34% of adults ages 18-50 use both cannabis and tobacco. Among young adults ages 18-24, current cannabis use is linked to recent use of various tobacco products. This includes cigarettes, cigars, e-cigarettes, and hookah. Concurrent use nearly doubled the odds of more serious externalizing problems compared to single-substance use.
Most people who use both substances start in their late teens or early twenties. Lifetime cannabis use in 9th grade predicts high school cigarette smoking. Dual use rates vary significantly by region, with young men showing higher rates than young women.
How Common Is Dual Cannabis and Tobacco Use?
Among ages 18–24
- Current cannabis use is strongly linked to recent use of cigarettes, e-cigarettes, cigars, and hookah
- Dual users experience nearly double the odds of behavioral and emotional problems compared to single-substance users
- Most dual use begins in the late teens or early twenties
Young men consistently show higher rates of co-use than young women, particularly in social environments where substance use is normalized.
Escalating Risks of Tobacco Use in Young Adults
The developing brain, which continues maturing into the mid-20s, is particularly vulnerable to nicotine’s effects, increasing the likelihood of long-term dependence, impaired impulse control, and future substance use disorders. When combined with substances like cannabis, tobacco use becomes even more concerning, creating multiple pathways to addiction and making cessation more difficult for young adults.
Traditional cigarette smoking rates have declined, yet e-cigarette use has increased substantially. Many young adults think vaping is safer than smoking, but it’s not. Nicotine is addictive regardless of delivery method.
Cannabis use makes these risks worse. Among young adults aged 18-24, current cannabis use links to past 30-day use of cigarettes, e-cigarettes, and hookah, creating multiple pathways to nicotine addiction.
The brain keeps developing until the mid-20s, meaning substance use during this time causes lasting brain damage. Nicotine exposure during this developmental window impairs areas responsible for decision-making and impulse control.
Co-use of weed and tobacco intensifies health risks. In a 2024 national sample of 5,585 youths ages 14-17, using both substances nearly doubled the odds of behavioral issues like aggression and rule-breaking.
Cannabis use significantly increases tobacco initiation and nicotine dependence. Among non-smoking teens, weekly cannabis use made them over eight times more likely to start using tobacco later. Daily cannabis use in 21-year-old smokers more than tripled their odds of nicotine dependence by age 24.
Cannabis changes the brain’s reward system, making it more sensitive to nicotine. Cannabis use in adolescence predicted more extensive tobacco smoking patterns and higher transition rates to nicotine dependence. Co-users showed only 6% quit rates compared to 21% new user rates.
Cannabis as a Gateway to Tobacco Addiction
Key findings include:
- Weekly cannabis use among non-smoking teens increased tobacco initiation odds more than eightfold
- Daily cannabis use at age 21 more than tripled the likelihood of nicotine dependence by age 24
- Adolescents who used cannabis were more likely to develop heavier, more persistent smoking patterns
Cannabis alters the brain’s reward circuitry, making it more responsive to nicotine. Once nicotine is introduced, addiction pathways strengthen quickly.
Why Cannabis and Tobacco Reinforce Each Other
Both cannabis and nicotine affect dopamine, serotonin, and norepinephrine, neurotransmitters involved in reward, motivation, and mood. Regular cannabis use conditions the brain to expect chemical stimulation. Nicotine then activates similar pathways, reinforcing the cycle.
Dual use increases the activity of the FAAH enzyme, which breaks down anandamide, a compound involved in mood and stress regulation. Elevated FAAH levels reduce natural stress relief, increasing anxiety and depression, and driving continued substance use.
Dual use is often reinforced socially:
- Shared smoking rituals
- Peer normalization
- Stress coping
- Easy access to both substances
Mixing cannabis with tobacco (such as blunts or spliffs) further entrenches co-use behaviors.
Why Young People Are Especially Vulnerable
The prefrontal cortex, the part of the brain responsible for judgment and self-control, is not fully developed until around age 25. Substance use during this time can permanently alter brain development.
Who young adults spend time with matters. Substance use often occurs in social settings where cannabis and tobacco are both present, making co-use feel normal.
Many young adults begin with casual cannabis use and progress to nicotine dependence without realizing it. Early cannabis use predicts later tobacco addiction more reliably than the reverse.
Health Impacts of Dual Cannabis and Tobacco Use
Using both substances damages the lungs more than using either alone. Cannabis users often inhale more deeply and hold smoke longer, increasing exposure to harmful chemicals.
Dual use is associated with:
- Memory problems and attention deficits
- Increased anxiety and depression
- Higher risk of psychosis
Co-users show lower quit rates, more severe withdrawal symptoms, and stronger cravings than single-substance users.
Warning Signs of Cannabis and Tobacco Dependence
- Declining academic or work performance
- Increased absences
- Shifting peer groups
- Chronic cough or breathing issues
- Red eyes, fatigue, lingering smoke smell
- Irritability when substances aren’t available
- Anxiety or depressive symptoms
- Difficulty concentrating
Prevention and Education Strategies
Effective programs teach students how cannabis use predicts nicotine addiction, rather than treating substances in isolation.
Community initiatives that involve schools, healthcare providers, and families reduce experimentation and misinformation.
Open communication, clear boundaries, and early intervention significantly reduce risk.
How Treatment Centers Address Dual Substance Use
Bayview Recovery Center uses therapies such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) to help young adults manage triggers, emotions, and cravings related to both substances.
Men face unique social pressures and stressors. Gender-responsive programs address masculinity norms, work stress, and emotional expression.
LGBTQ+ individuals experience higher rates of cannabis and tobacco use. Culturally competent care addresses identity-related stressors safely.
Supporting Youth and Families Through Recovery
- Teaching coping skills
- Connecting families to support networks
- Encouraging informed decision-making
Recover From Polysubstance Abuse at Bayview Recovery Center
Bayview Recovery Center in San Diego, CA, specializes in treating dual cannabis and tobacco dependence with evidence-based, gender-responsive care. If you or someone you love is struggling, professional help is available. Contact Bayview Recovery Center today to start the path toward recovery.
