The Influence of Cannabis and Nicotine Co-Use on Neuromaturation – A Systematic Review of Adolescent and Young Adult Studies
M. H. Mejia, N. Wade, Rachel E. Baca, V. Diaz, Joanna Jacobus
Biological Psychiatry September 29, 2020 DOI: 10.1016/j.biopsych.2020.09.021 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Longitudinal Peer reviewed |
|---|---|
| Population | Adolescents and young adults aged 13-35, and non-adult preclinical subjects |
| Topics | Cannabis |
| Key findings | The review found that cannabis and nicotine have independent effects on cognition, and that nicotine may mask cognitive deficits associated with cannabis use. Preliminary evidence suggests hippocampal volume differences in co-users, but no differences in nucleus accumbens activity during reward processing were found. No structural neuroimaging studies examined combined effects in adolescent-only populations. |
Abstract
Accumulating evidence suggests that the use of cannabis and nicotine and tobacco-related products (NTPs) during the adolescent years has harmful effects on the developing brain. Yet, few studies have focused on the developing brain as it relates to the co-administration of cannabis and NTPs, despite the high prevalence rates of co-use in adolescence. The review aimed to synthesize the existing literature on the neurocognitive, structural, and functional outcomes associated with cannabis and NTP co-use. A systematic search of peer-reviewed articles resulted in a pool of 1,107 articles. Inclusion criteria were: 1) data-based, 2) age range of 13-35 or, for preclinical studies, non-adult subjects, 3) cannabis and NTP group jointly considered, and 4) neurocognitive, structural neuroimaging, or functional neuroimaging as an outcome measure. A total of 12 studies met inclusion criteria. Consistent with the literature, cannabis and nicotine were found to have independent effects on cognition. The available research on the co-use of cannabis and NTPs demonstrates a potential nicotine-related masking effect on cognitive deficits associated with cannabis use, yet there is little research on co-use and associations with neuroimaging indices. Of the neuroimaging studies, there is preliminary evidence for hippocampal volume differences in co-users and a lack of evidence for co-use differences related to nucleus accumbens activity during reward processing. Notably, no structural neuroimaging studies were found to examine the combined effects of nicotine and cannabis in adolescent-only populations. Further research, including longitudinal studies, is warranted to investigate the influence of cannabis and NTP co-use on maturation.
Comparable studies
Other systematic reviews and meta-analyses on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Effects of cannabis use on outcomes of psychotic disorders: systematic review People with psychotic disorders, as examined in 13 longitudinal studies | 2008 | Systematic review | |
| The Impact of Cannabis Use on Cognitive Functioning in Patients With Schizophrenia: A Meta-analysis of Existing Findings and New Data in a First-Episode Sample Patients with established schizophrenia (meta-analysis: 572) and patients with... | 2010 | Meta-analysis and cross-sectional observational study | n = 700 |
| Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review | 2020 | Systematic review | |
| Neuroimaging in cannabis use: a systematic review of the literature Cannabis users and controls in neuroimaging studies | 2009 | Systematic review | |
| Human Laboratory Studies on Cannabinoids and Psychosis. Healthy human subjects and individuals with schizophrenia | 2016 | Systematic review |
Citations in the library
Cited by 3
- Cannabis and Tobacco Co-Use Is Associated With Impaired Neurocognitive Performance in Individuals at Clinical High Risk for Psychosis. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging April 1, 2026
- Longitudinal Neurocognitive Trajectories in a Large Cohort of Youth Who Use Cannabis: Combining Self-Report and Toxicology. bioRxiv : the preprint server for biology March 6, 2026
- Chronic cannabis use affects cerebellum dependent visuomotor adaptation. Journal of Psychiatric Research October 6, 2022
Cites 17
- Acute memory and psychotomimetic effects of cannabis and tobacco both ‘joint’ and individually: a placebo-controlled trial Psychological Medicine May 30, 2017
- Grey Matter Volume Differences Associated with Extremely Low Levels of Cannabis Use in Adolescence Journal of Neuroscience January 14, 2019
- Regular cannabis use is associated with altered activation of central executive and default mode networks even after prolonged abstinence in adolescent users: Results from a complementary meta-analysis Neuroscience & Biobehavioral Reviews 2019
- Association of Cannabis With Cognitive Functioning in Adolescents and Young Adults: A Systematic Review and Meta-analysis JAMA Psychiatry June 1, 2018
- Longitudinal Changes in Cognition in Young Adult Cannabis Users Journal of Clinical and Experimental Neuropsychology October 23, 2017
and 12 more in the library