Assessing cannabis and tobacco co‐use: the pros and cons of additional data collection

Abstract

Co-use of cannabis and tobacco is common, but often under-reported and studied less than exclusive use of either substance. The changing regulatory environments regarding cannabis, tobacco and vaporized nicotine products (VNPs) are likely to affect co-use. While there are barriers to including additional measures in surveys, the pros outweigh the cons and are important for our understanding of population health and wellbeing. Research and health-care is traditionally siloed. This is perhaps why, at least in part, the enquiry into the co-use, and in particular the co-administration, of tobacco and cannabis has not been ‘front of mind’ of many researchers, clinicians and policymakers. It would be incorrect to say that this issue has gone unnoticed. There are numerous reports describing the associations between tobacco and cannabis, but the impacts of co-use on health and wellbeing have not been fully explored and remain relatively unknown. In our view, there is much to be gained by more accurate description of tobacco, nicotine and cannabis use with the use of standard measures. Reaching a consensus on standard measures may be challenging, but lessons can be taken from similar work conducted with VNPs [19]. As researchers and clinicians, we appreciate the extra burden of expanding measures, but in today's rapidly evolving environment we believe that the benefits of including these outweigh the negatives and support the argument for change. H.M. has received honoraria for speaking at smoking cessation meetings and attending advisory board meetings that have been organized by Pfizer. V.B. and R.C. have no interests to declare.