Tobacco and cannabis co-use : toxicity, dependence and cessation management.

Objectives: Tobacco and cannabis are the most used inhaled drugs worldwide. This review looked at the effects of their combined use, the dependence induced, and the ways of helping people to quit. Method: Medline was searched using the keywords « tobacco smoking » or « cannabis use » or « tobacco marijuana co-use » and « health effects » or « dependence » or ' « smoking cessation intervention » with « Title/Abstract » limits and search period from 1980 to 2023. A selection of articles in English or in French was analyzed. Results: Combustion smoke from tobacco and cannabis is more toxic than of tobacco or cannabis, induced dependence is more elevated, tobacco and cannabis cessation is more difficult than quitting tobacco or cannabis alone. Conclusion: The marketing of cannabis with a high active ingredient content, the availability of synthetic forms and the increasing legalization of recreational use, against a backdrop of a slow decline in the prevalence of smoking, is leading to the danger of an increase in the combined use of tobacco and cannabis ; this risk should be a concern for all health authorities and professionnals.