What question did this study set out to answer?

To quantify patterns and doses of alcohol, cannabis, and nicotine co-use compared to single-substance use in adolescents.

August 1, 2026Journal of Adolescent HealthOpen Access

Co-use of Some Substances Associated With Higher Doses in Adolescents: Findings From the Adolescent Brain Cognitive Development Study

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Authors

CRColbey Ricklefs KKKristen E. Kim ATAri Thompson

Discussion

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Overview

Cohort study reveals higher consumed doses of nicotine and alcohol during same-day co-use in adolescents, highlighting compounded risks during critical brain development.

Key Points

To quantify patterns and doses of alcohol, cannabis, and nicotine co-use compared to single-substance use in adolescents.
Analyzed data across six waves of the Adolescent Brain Cognitive Development (ABCD) study.
Measured daily consumption quantity, single use, and same-day co-use across standard units using a web-based timeline followback interview.
Evaluated differences in average dose per substance class between single use and co-use across years 4 to 6 using linear mixed-effects modeling.
In year 6, average nicotine dose was significantly higher during co-use with alcohol (difference: 4.32; 95% CI: 2.55–6.09; p < .001) or cannabis (difference: 4.41; 95% CI: 2.76–6.05; p < .001) relative to nicotine use alone, reflecting patterns also observed in years 4 and 5.
In year 6, average alcohol dose increased significantly when co-used with cannabis (difference: 1.87; 95% CI: 0.37–3.36; p = .004) or nicotine (difference: 1.64; 95% CI: 0.06–3.22; p = .03) compared to single alcohol use.
Cannabis doses did not show statistically significant differences when used singularly versus co-used alongside alcohol or nicotine across the analyzed study years.

Cite This Study

Ricklefs et al. (2026) studied this question.

synapsesocial.com/papers/6a779028d8eb58afc2bdf5b6 https://doi.org/10.1016/j.jadohealth.2026.06.007

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August 1, 2026Journal of Adolescent HealthOpen Access

Co-use of Some Substances Associated With Higher Doses in Adolescents: Findings From the Adolescent Brain Cognitive Development Study

View Full Paper

Ask AI

Bookmark

Authors

CRColbey Ricklefs KKKristen E. Kim ATAri Thompson

Discussion

Member takes

Overview

Cohort study reveals higher consumed doses of nicotine and alcohol during same-day co-use in adolescents, highlighting compounded risks during critical brain development.

Key Points

To quantify patterns and doses of alcohol, cannabis, and nicotine co-use compared to single-substance use in adolescents.
Analyzed data across six waves of the Adolescent Brain Cognitive Development (ABCD) study.
Measured daily consumption quantity, single use, and same-day co-use across standard units using a web-based timeline followback interview.
Evaluated differences in average dose per substance class between single use and co-use across years 4 to 6 using linear mixed-effects modeling.
In year 6, average nicotine dose was significantly higher during co-use with alcohol (difference: 4.32; 95% CI: 2.55–6.09; p < .001) or cannabis (difference: 4.41; 95% CI: 2.76–6.05; p < .001) relative to nicotine use alone, reflecting patterns also observed in years 4 and 5.
In year 6, average alcohol dose increased significantly when co-used with cannabis (difference: 1.87; 95% CI: 0.37–3.36; p = .004) or nicotine (difference: 1.64; 95% CI: 0.06–3.22; p = .03) compared to single alcohol use.
Cannabis doses did not show statistically significant differences when used singularly versus co-used alongside alcohol or nicotine across the analyzed study years.

Cite This Study

Ricklefs et al. (2026) studied this question.

synapsesocial.com/papers/6a779028d8eb58afc2bdf5b6 https://doi.org/10.1016/j.jadohealth.2026.06.007

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