Co-administration of cannabis and tobacco is a common practice, but there is little experimental evidence aimed at understanding the reasons for this prevalence. Some preliminary evidence suggests that tobacco may actually counteract the cognitive-impairing effects of cannabis, and may also increase the subjective ('liking') effects of cannabis, but results are inconclusive. Further, there are no studies into the effects of tobacco on other cannabis-related harms such as driving, or on the ability of tobacco to alter the blood levels of THC, the chemical responsible for the psychoactive properties of cannabis. The purpose of the present study will be to evaluate the effects of tobacco, cannabis or combinations of tobacco and cannabis on driving, cognition, subjective effects and blood THC. Driving will be assessed using a state-of-the-art driving simulator that allows for the safe and objective measurement of the effects of intoxicating substances on driving. Participants will be regular users of cannabis and will be invited to the lab for four counterbalanced test sessions. In these test sessions they will drive the simulator and undergo cognitive tests before and after smoking: 1) cannabis; 2) tobacco; 3) cannabis + tobacco; or 4) placebo. Outcomes will be measured at several time points after smoking the product. Participants will also give blood for determination of levels of THC, and will complete subjective effects questionnaires both before and after smoking the cigarette. This study will be one of the first experimental laboratory studies of the reasons behind co-administration of tobacco and cannabis.
• Adults aged 19 years to 45 years (to control for the effects of age on cognition)
Smoke or vape cannabis at least once a month but no more than 4 times a week (to avoid enrolling people with cannabis use disorder who may experience withdrawal when asked to abstain from cannabis)
Experience with smoked cannabis in the past year
Report use of at least 100 cigarettes in their lifetime to ensure familiarity with the tobacco used in the present study
• Use of psychoactive medications or drugs
Current alcohol or other substance use disorder, including cannabis (as assessed with the SCID)
Current or past nicotine dependence (to avoid precipitating a relapse)
Withdrawal symptoms as assessed with the Marijuana Withdrawal Checklist [57, 58]
Crossover
Cannabis
DrugDried flower cannabis cigarette with 22% THC
Tobacco
DrugDried flower cigarette with active nicotine
Cannabis tobacco
DrugDried flower cigarette with active nicotine and cannabis
Placebo
DrugDried flower cigarette with both placebo tobacco and cannabis
Standard deviation of lateral position
car 'weaving'
Standard deviation of lateral position
car 'weaving'
Standard deviation of lateral position
car 'weaving'
Speed
Speed (in km) of the car
Speed
Speed (in km) of the car
Speed
Speed (in km) of the car
Reaction time
Time to hit the brake after introduction of an obstacle
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