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Substance Use: Cannabis, Tobacco

Using cannabis and tobacco together

Using cannabis and tobacco together is common. People do this in different ways. One way is using one of them while you’re still feeling the effects of the other. This includes using one right after the other (called chasing), and mixing cannabis and tobacco together to use at the same time. Another way is using both cannabis and tobacco, but at different times.

Using cannabis and tobacco together can be very bad for your health.

What are the most common ways of using cannabis and tobacco?

Smoking and vaping are the most common ways people use cannabis and tobacco.

  • Smoking is breathing in (inhaling) smoke from dried cannabis and tobacco. People smoke cigarettes, rolled paper joints, blunts, pipes, bowls, water pipes, bongs and hookahs, or tobacco cigarettes dipped in cannabis oil.
  • Vaping is breathing in vapour from heating dried cannabis or tobacco or an extract. The high heat turns it into vapour without burning.

What are the risks of using cannabis and tobacco together?

Using cannabis and tobacco together seems to have health risks. While we don’t yet fully understand the long-term effects, we do know:

  • Smoking is the most harmful way of using cannabis and tobacco. Smoking directly damages your lungs and can cause breathing problems.
  • Vaping cannabis and tobacco has different risks and harms. Vaping directly affects your lungs and may damage them. Vaping has been linked to serious breathing problems. Some people end up in the hospital, and some people have even died. We still don’t know the long-term effects of vaping.
  • Smoking both cannabis and tobacco together is bad for your health because you’re exposed to harmful chemicals and compounds from both. For example, carbon monoxide and tar can cause cancer.
  • Using tobacco and cannabis together can cause nicotine (a chemical in tobacco) dependence. This is when you can’t stop using it. It also puts you at higher risk of dependence on cannabis. This is when you keep using cannabis even though it’s harming your health and causing you other problems (such as with work or your relationships).
  • For people younger than 25, using cannabis and nicotine can negatively affect how your brain develops. The earlier you begin using cannabis and tobacco, the higher your risk of dependence on cannabis and tobacco. It also puts you at risk for serious health problems.
  • Using cannabis with tobacco can put the people around you at risk. They can breathe in your smoke (second-hand smoke) or your smoke can stay on things like clothes, furniture, and walls. This can expose people to poisons such as cyanide and ammonia and put them at higher risk for lung problems and cancer.

Using cannabis and tobacco together can also put you at risk of the following:

  • making unsafe decisions, such as driving while impaired (drunk or high), or other risky behaviours, such as using alcohol and other drugs, and having unsafe sex
  • having depression, anxiety, and thinking problems, including problems with memory and learning
  • using more cannabis or tobacco compared to people who don’t use these 2 things together
  • developing more serious problems such as tobacco and cannabis use disorder
  • having social problems, including issues in personal and family relationships, and money problems
  • finding it harder to quit smoking because using cannabis and tobacco together can make nicotine withdrawal (uncomfortable symptoms when you stop using) stronger and make you less motivated to quit

How can I lower my risk?

All forms of cannabis and tobacco have health risks. The only way to completely avoid these risks is by choosing not to use. If you do choose to use cannabis or tobacco, here are some tips to lower your risk:

  • Don’t mix cannabis and tobacco together, and don’t mix them with alcohol or other drugs.
  • Don’t inhale deeply and don’t hold your breath so it’s not as hard on your lungs.
  • Choose other forms of cannabis, such as edibles. These are less harmful for your lungs, but remember that they still have health risks.
  • Don’t use cannabis or tobacco if you’re pregnant, think you might be, or are trying to get pregnant. We don’t know of any safe amount or way of using cannabis or tobacco while you’re pregnant or breastfeeding.
  • Don’t smoke or vape cannabis or tobacco in your home or around children. Second-hand smoke or vape is harmful, especially to children or women who are pregnant or breastfeeding.

What if I’m worried about my cannabis and tobacco use?

Talk to your doctor or pharmacist about ways to help you quit or use less cannabis and tobacco.

If you’re worried about your cannabis and tobacco use, you can also get support and information from Alberta Health Services:

  • For support to quit tobacco, call or text AlbertaQuits at 1-866-710-QUIT (7848).
  • If you’re concerned about your own or someone else’s use of cannabis, call the Addiction Helpline at 1-866-332-2322.
  • For more information about cannabis, visit

What if I need urgent medical help?

Cannabis poisoning can happen when you use too much cannabis. The symptoms include:

  • very fast heart rate
  • feeling very sick to your stomach or throwing up
  • feeling very anxious, confused, or paranoid
  • panic attacks
  • seizures

If you’re worried that you or someone else has used too much cannabis and might have cannabis poisoning, call:

Note: References to “tobacco” on this page do not include tobacco that is used for traditional and sacred reasons.

Current as of: June 11, 2020

Author: Tobacco Reduction Program, Alberta Health Services