The influence of acute cannabis smoking on cigarette and e-cigarette puff topography and subjective effects in people who use cannabis, cigarettes, and e-cigarettes.
C Austin Zamarripa, Tory R Spindle, Dustin C Lee, Cecilia L Bergeria, Lakshmi Kumar, Kushani Shah, Elise M Weerts, Julie A. Marusich, Erica N Peters, Ryan Vandrey
Experimental and Clinical Psychopharmacology October 22, 2026 DOI: 10.1037/pha0000882 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Double-blind placebo-controlled laboratory study Peer reviewed |
|---|---|
| Sample size | 20 |
| Population | Adults who used cannabis, combustible cigarettes, and e-cigarettes; 6 used cannabis infrequently (≤2 times per week) and 14 used it frequently (>2 times per week) |
| Interventions | THC-dominant cannabis Combustible cigarettes JUUL e-cigarette |
| Dose | 10 mg THC for infrequent cannabis users; 25 mg THC for frequent users; placebo 0 mg THC; JUUL 3% or 5% nicotine |
| Duration | Seven double-blind outpatient sessions with 5-hour ad libitum access to cigarettes or e-cigarettes after cannabis |
| Topics | Cannabis |
| Key points | Cannabis increased subjective drug effects and heart rate compared with placebo, but did not alter time to first nicotine use or puff topography of cigarettes or e-cigarettes, and neither nicotine product enhanced or extended acute cannabis effects. The authors report that cannabis exposure did not increase nicotine use behavior in this laboratory model of "chasing." |
Abstract
Co-use of smoked/vaped tobacco and cannabis is increasing with expanding legalization, yet controlled clinical studies examining mechanisms underlying co-use remain limited. This study evaluated whether acute smoked cannabis influences subsequent use ("chasing") of combustible cigarettes and e-cigarettes among people who use cannabis, cigarettes, and e-cigarettes. Twenty adults who used cannabis, cigarettes, and e-cigarettes completed seven double-blind outpatient sessions; six used cannabis infrequently (i.e., ≤2 times per week), and 14 used cannabis frequently (i.e., >2 times per week). Participants smoked THC-dominant cannabis (10 mg for infrequent; 25 mg for frequent use) or placebo (0 mg THC) and then had 5-hr ad libitum access to their preferred cigarette brand or a JUUL e-cigarette (3% or 5% nicotine). A THC-dominant cannabis-only condition served as a control. Primary outcomes included cannabis and nicotine use behavior (puff topography, time-to-first use) and acute subjective, cognitive, and physiological effects. Cannabis administration increased subjective drug effects (e.g., drug liking, pleasant effects) and heart rate compared with placebo, as expected. However, the time course and magnitude of subjective and physiological effects following ad libitum e-cigarette or cigarette use did not differ between the cannabis and placebo conditions. Likewise, cannabis did not alter ad libitum cigarette or e-cigarette puff topography relative to placebo. Cannabis exposure did not increase nicotine use behavior, and neither cigarette nor e-cigarette use enhanced or extended acute cannabis effects in this laboratory model of chasing. Modeling naturalistic cannabis-tobacco co-use in controlled settings remains challenging. Further research examining simultaneous use and alternative sequencing patterns is needed to clarify mechanisms underlying co-use behaviors. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Comparable studies
Other randomized controlled trials on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment Healthy participants | 2012 | Randomized controlled trial | n = 48 |
| Distinct Effects of Δ9-Tetrahydrocannabinol and Cannabidiol on Neural Activation During Emotional Processing Healthy, English-native, right-handed men who had used cannabis 15 times or less in... | 2009 | Double-blind, randomized, placebo-controlled crossover trial | n = 15 |
| Acute Effects of a Single, Oral dose of d9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) Administration in Healthy Volunteers Healthy male subjects | 2012 | Randomized controlled trial | n = 16 |
| Modulation of Mediotemporal and Ventrostriatal Function in Humans by Δ9-Tetrahydrocannabinol Healthy, native English-speaking, right-handed men of white race/ethnicity who had used... | 2009 | Randomized controlled trial | n = 15 |
| Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition Healthy volunteers with a history of light cannabis use | 2019 | Randomized, double-blind, within-subjects crossover | n = 14 |