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Health Education Research Advance Access published online on June 10, 2009
Health Education Research, doi:10.1093/her/cyp027
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© The Author 2009. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Cannabis and tobacco use: where are the boundaries? A qualitative study on cannabis consumption modes among adolescents

Christina Akre, Pierre-André Michaud, André Berchtold and Joan-Carles Suris*

Research Group on Adolescent Health, Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Bugnon 17, 1005 Lausanne, Switzerland

Correspondence to: * Correspondence to: J.-C. Suris. E-mail: joan-carles.suris{at}chuv.ch

The purpose of this article is to identify tobacco and cannabis co-consumptions and consumers’ perceptions of each substance. A qualitative research including 22 youths (14 males) aged 15–21 years in seven individual interviews and five focus groups. Discussions were recorded, transcribed verbatim and transferred to Atlas.ti software for narrative analysis. The main consumption mode is cannabis cigarettes which always mix cannabis and tobacco. Participants perceive cannabis much more positively than tobacco, which is considered unnatural, harmful and addictive. Future consumption forecasts thus more often exclude tobacco smoking than cannabis consumption. A substitution phenomenon often takes place between both substances. Given the co-consumption of tobacco and cannabis, in helping youths quit or decrease their consumptions, both substances should be taken into account in a global approach. Cannabis consumers should be made aware of their tobacco use while consuming cannabis and the risk of inducing nicotine addiction through cannabis use, despite the perceived disconnect between the two substances. Prevention programs should correct made-up ideas about cannabis consumption and convey a clear message about its harmful consequences. Our findings support the growing evidence which suggests that nicotine dependence and cigarette smoking may be induced by cannabis consumption.

Received on August 4, 2008; accepted on March 4, 2009


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