Cannabis Use Linked With Higher Rates of Smoking

April 4, 2018
woman smoking cigarette

Cannabis use is linked with increased initiation of cigarette use in nonsmokers—as well as increased likelihood of relapse in former smokers and increased persistence of cigarette use in current smokers, according to a study published online in The Journal of Clinical Psychiatry.

“Developing a better understanding of the relationship between marijuana use and cigarette use transitions is critical and timely as cigarette smoking remains the leading preventable cause of premature death and disease, and use of cannabis is on the rise in the United States,” said senior author Renee Goodwin, PhD, of the department of epidemiology at Columbia University in New York City.

Using data from the National Epidemiologic Survey on Alcohol and Related Conditions, researchers from Columbia’s Mailman School of Public Health and the City University of New York focused on 34,639 adults who responded to questions about cannabis use and smoking status from 2001-2002, then again from 2004-2005.

Higher Potency of Today's Cannabis May Pose Mental Health Risks

Renee Goodwin, PhD
     Renee Goodwin, PhD

Cannabis use was associated with higher odds of nonsmokers initiating smoking over the next 3 years, according to the study. Meanwhile, adults who smoked cigarettes and used cannabis were less likely to quit smoking cigarettes, compared with adults who did not use cannabis. Additionally, respondents who had previously smoked cigarettes but had stopped were more prone to relapse if they used cannabis.

The association of cannabis use with increased odds of cigarette smoking onset, relapse, and persistence occurred even in the absence of cannabis use disorder, researchers pointed out. Because cannabis use is more common than cannabis use disorder, they warned marijuana’s impact on cigarette use may be more significant than estimates based on cannabis use disorder alone have suggested.

Consequently, tobacco control efforts and clinical settings aimed at reducing cigarette smoking may want to pay additional heed to cannabis use, they concluded.

—Jolynn Tumolo


Weinberger AH, Platt J, Copeland J, Goodwin RD. Is cannabis use associated with increased risk of cigarette smoking initiation, persistence, and relapse? Longitudinal data from a representative sample of US adults. . 2018 March 6;[Epub ahead of print].

Marijuana may lead non-smokers to cigarettes [press release]. New York, New York: Columbia University Mailman School of Public Health; March 28, 2018.