{"doi":"10.1111/add.15885","title":"Commentary on Weinberger <i>et al</i>.: Tobacco and cannabis policies as drivers of nicotine and cannabis co‐use ‐ research and measurement implications to move the field forward","abstract":"Research examining policy impacts on nicotine and cannabis co-use is important due to its high prevalence and adverse health effects. Important next steps to ensure rigor in policy research include: employing comprehensive policy exposure measurements; fully capturing routes of administration; and expanding existing research infrastructure. Nicotine and cannabis co-use (i.e. current use of both substances, including simultaneous use) is an increasingly prevalent behavior with documented adverse health effects [1, 2]. Young people report the highest co-use rates: [3] more than one-quarter of people aged 18–24 years in the United States reported past-month co-use, with notable subgroup differences by race/ethnicity, sexual identity and other factors [4]. Moreover, co-use can involve several routes of nicotine and cannabis administration, sometimes unknowingly. For example, many people who use blunts (i.e. hollowed-out cigars filled with cannabis) do not identify that as tobacco consumption [5, 6], despite blunts containing nicotine and other tobacco toxicants [5, 7]. Given the detrimental impacts of co-use, researchers are beginning to study potential policy-related drivers. However, the divergent trends in tobacco control and cannabis policies world-wide pose various measurement challenges. Increasingly restrictive tobacco policies (e.g. taxation, age restrictions) generally aim to curb nicotine initiation and use, whereas cannabis policies—such as medical cannabis laws (MCL) and recreational cannabis laws (RCL)—generally aim to liberalize access for adults [8]. This research is internationally relevant: 18 US states and multiple countries (e.g. Canada, Uruguay, Georgia, South Africa) recently passed RCL. A study by Weinberger and colleagues [9] examined associations between MCL, RCL and cigarette–cannabis co-use using the 2004–17 National Survey on Drug Use and Health (NSDUH). While MCL was associated with an increase in co-use overall, the greatest effects were observed among people aged 50 years and older, married, non-Hispanic Black and with a college degree. Findings aligned with syndemic theory [10], which suggests mechanisms for differential policy impacts on co-use among subgroups (e.g. by gender, age, race/ethnicity). Weinberger et al.’s paper contributes to research assessing cannabis policy ‘spillover effects’ (e.g. on tobacco use) [11-14], which can occur even when MCL status knowledge is low [15]. Policy research also aims to explain differences in ‘spillover effects’ within subgroups (e.g. sexual minority individuals) [12, 13]. To facilitate the comprehensive study of policy impacts on nicotine and cannabis co-use, both within and across countries, we identify three important next steps. Due to a complex policy environment, existing tobacco- and cannabis-focused policy research sometimes relies upon binary exposures (e.g. MCL yes/no) and/or takes a ‘one policy one outcome’ approach. The former fails to capture nuanced within-policy variations (e.g. retailer licensing limits) across states/provinces, countries or time. The latter ignores the broader policy context, but policies do not exist in isolation. To address this, researchers have begun using indices and other composite measures of policy climate exposures [16, 17] (e.g. an index of tobacco policies that includes taxation, age regulations, cessation services, etc.). Expanded measurement approaches can help to identify potential policy levers in a real-world context of multiple concurrent policies, and offer insight into policy approaches’ additive or synergistic impacts. Vaping, edibles, ‘dabbing’ and other novel products and routes of nicotine and cannabis administration are increasingly popular, especially among young people. For example, while cigarette use has declined among young people, past-month nicotine vaping doubled among US high school students from 2017 to 2019 [18] and cannabis vaping increased threefold [19]. Focusing only upon singular produc","journal":"Addiction","year":2022,"id":299971,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9546,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":318604,"name":"Daniel P Giovenco","orcid":"0000-0001-6256-9612","position":1,"is_corresponding":false},{"id":340339,"name":"Pia M. Mauro","orcid":"0000-0003-2482-8841","position":2,"is_corresponding":false},{"id":340336,"name":"Morgan M. Philbin","orcid":"0000-0001-7608-7921","position":0,"is_corresponding":true}],"reference_count":19,"raw_metadata":null,"created_at":"2026-07-19T00:31:49.412501Z","pmid":"35362234","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}