Nicotine Use Disorder (Tobacco Use Disorder) and Cannabis
Nicotine use disorder, called tobacco use disorder in the DSM-5, is a pattern of using cigarettes, vapes or other nicotine products that you find hard to control and that causes real distress or harm. There is no reliable evidence in people that medical cannabis helps you quit nicotine, so any plan that includes it belongs in a conversation with a physician.
Built on peer-reviewed research published from 1988 to 2026: surveys and cohort studies in people, one trial and animal and laboratory work
Why quitting nicotine feels so hard, and why it’s not about willpower
If you have tried to stop and found yourself reaching for a cigarette or a vape a day later, you are in very large company. Nicotine reaches the brain within seconds of a puff and releases dopamine, the chemical the brain uses to mark something as worth repeating. After months or years, the brain adjusts to that steady supply. Take it away and the body protests: the first days without nicotine are uncomfortable for almost everyone, and that discomfort is what pulls people back.
There is also the habit around the nicotine. The cigarette with coffee, the vape in the car, the break at work, the moment after an argument. Each of these becomes a cue, and cues keep firing long after the physical withdrawal has eased. That is why a relapse after three good weeks is common, and why it says nothing about your character.
The products themselves have become harder to put down. Disposable vapes now carry higher nicotine concentrations and nicotine salts, which researchers link to more dependence, stronger withdrawal and a greater loss of control [3]. The numbers among young people show where that leads.
What this shows is not that people lack willpower. It shows that nicotine dependence is a medical condition with a name, a set of criteria a clinician can check and treatments that work better than going it alone. The rest of this page walks through each of them.
What does withdrawal feel like?
Pick one; each is a normal part of stopping, not a weakness.
Craving: a strong urge that comes in waves, often triggered by a place, a drink or a mood. A single wave usually passes within minutes if you ride it out. Nicotine replacement and quit medicines take the edge off cravings, and planning what you will do instead at your usual trigger times helps more than waiting for the urge to vanish.
Irritability: a short fuse, frustration or anger over small things, usually worst in the first week. It helps to warn the people around you, to keep the first days free of big decisions and to remember that this is chemistry settling, not who you are.
Anxiety: restlessness and a sense of unease are common early on, even in people who used nicotine to calm down. Many find that, after the first weeks, their baseline anxiety is lower than when they smoked. If you live with an anxiety disorder, tell the clinician helping you quit: the plan may need adjusting.
Sleep: trouble falling asleep, waking at night or vivid dreams can appear in the first weeks. Some quit medicines affect dreams too, which is worth mentioning to the prescriber. Keeping regular sleep and wake times and cutting late caffeine, which your body now clears faster, usually helps.
Focus: a foggy head and trouble concentrating are typical for the first two weeks or so. Short tasks, lists and a slower pace at work for a few days are reasonable. If the fog lingers well beyond a month, it deserves a check-up.
Appetite: nicotine dulls hunger, so food may taste better and snacking may increase after you stop. Some weight gain is common and far less harmful than continuing to use nicotine. Regular meals and something to keep your hands busy help.
What is tobacco use disorder?
Tobacco use disorder is the name the American Psychiatric Association’s diagnostic manual, the DSM-5-TR, gives to a problematic pattern of tobacco or nicotine use that leads to clinically significant impairment or distress: in plain words, use that has become hard to control and is causing problems you notice or others notice [4]. A clinician diagnoses it when at least two of eleven criteria have been present within the same 12-month period.
The disorder is not limited to cigarettes. It covers any product that delivers nicotine: cigarettes, e-cigarettes and disposable vapes, cigars and cigarillos, pipes and hookah, chewing tobacco and snuff, and the newer oral nicotine pouches. What defines it is not the product but the pattern: the craving, the loss of control and the use that continues despite harm.
Tobacco use disorder is usually described as a chronic, relapsing condition. Most people who quit for good have tried several times before, and the risk of going back stays raised for months after the last cigarette [5]. That is the reason guidelines treat it like other long-term conditions: with follow-up, repeated attempts and treatment that can be adjusted, rather than a single act of willpower [6].
Quick answers
Is nicotine use a substance use disorder?
Yes. The DSM-5-TR lists tobacco use disorder among the substance-related and addictive disorders, alongside alcohol use disorder and cannabis use disorder, and it uses the same kind of criteria for all of them [4]. Nicotine is the substance that drives the dependence, which is why clinicians often say “nicotine use disorder” for vapes and pouches that contain no tobacco leaf.
Is tobacco use disorder a chronic condition?
It is generally treated as one. Relapse is common, cravings can return years later in a stressful moment, and the DSM-5-TR has separate labels for early and sustained remission because recovery is a process over time [4]. Treating it as chronic is not pessimism: it means that a relapse is a reason to restart treatment, not proof that treatment does not work for you.
Why might someone use nicotine?
People start and keep using nicotine for many reasons: to cope with stress, to feel alert, to fit in with friends or family who use it, out of routine, or simply because stopping feels worse than continuing. In a study of 133 adolescents and young adults aged 16 to 22, having friends or family who used nicotine was linked to about four times higher odds of nicotine use at follow-up (odds ratio 4.40, 95% CI 1.77-10.93) [7]. Menthol is another factor: its cooling taste masks the harshness of smoke, which makes starting easier and quitting harder [8].
What diseases are caused by nicotine and tobacco?
Most of the damage comes from smoke, not from nicotine itself: lung cancer and many other cancers, heart disease, stroke, chronic obstructive pulmonary disease and complications in pregnancy [5]. Nicotine is the reason people keep inhaling that smoke. On its own it raises heart rate and blood pressure, is harmful to the developing brain of teenagers and to a fetus, and is what makes every tobacco and vape product addictive.
Nicotine use disorder vs tobacco use disorder: is there a difference?
Not in substance. “Tobacco use disorder” is the official DSM-5-TR term [4]. “Nicotine dependence” is the wording in ICD-10-CM, the code set used on medical records and insurance claims in the US [9]. “Nicotine use disorder” is what many clinicians and patients say, because it fits vapes and nicotine pouches better than a word that points to tobacco leaf. All three describe the same condition; which one you see depends on where you see it.
Where did you see the term?
Pick one to highlight the matching row; the rest of the table stays for comparison.
| Term | Where you’ll see it | What it covers |
|---|---|---|
| Tobacco use disorder | DSM-5-TR, psychiatric and addiction assessments, research [4] | The disorder itself, graded mild, moderate or severe by the number of criteria met |
| Nicotine dependence (F17.2-) | ICD-10-CM codes on medical records, claims and prescriptions [9] | The same condition, coded by product (cigarettes, chewing tobacco, other) and by state (current, in remission, with withdrawal) |
| Nicotine use disorder | Clinic conversations, patient materials, everyday speech | The same condition, named after the substance; fits vapes and pouches that contain no tobacco leaf |
| Tobacco use (Z72.0) | ICD-10-CM, often in a routine visit note [9] | Current use that does not meet the criteria for a disorder, or that has not been assessed |
A practical tip: if a form or a portal asks for your diagnosis, copy the wording on your records exactly. Programs and insurers match words and codes, not meanings.
What are the DSM-5 criteria for tobacco use disorder?
The DSM-5-TR lists eleven criteria. A clinician diagnoses tobacco use disorder when at least two of them have occurred within a 12-month period, and grades its severity by how many are present [4]. They fall into four groups: losing control over use, use getting in the way of life, use in risky situations, and the body’s adaptation (tolerance and withdrawal).
Each criterion below is shown in the manual’s clinical wording and in everyday words. Switch between them, or narrow the list to one group.
- 1
Tobacco is often taken in larger amounts or over a longer period than was intended.
You smoke or vape more, or for longer, than you meant to.
- 2
A persistent desire or unsuccessful efforts to cut down or control tobacco use.
You keep wanting to cut down, or you have tried and could not.
- 3
A great deal of time is spent obtaining or using tobacco.
Buying, using and planning around nicotine takes up a lot of your day.
- 4
Craving, or a strong desire or urge to use tobacco.
You get strong urges that are hard to think past.
- 5
Recurrent use resulting in a failure to fulfill major obligations at work, school or home.
Using gets in the way of your job, studies or duties at home.
- 6
Continued use despite persistent social or interpersonal problems caused or worsened by tobacco.
You keep using even though it causes arguments or strain with people close to you.
- 7
Important social, occupational or recreational activities are given up or reduced because of use.
You skip places, sports or plans where you can’t smoke or vape.
- 8
Recurrent use in situations in which it is physically hazardous, such as smoking in bed.
You use where it is unsafe: in bed, near oxygen, while refueling.
- 9
Use continues despite knowing of a physical or psychological problem likely caused or worsened by tobacco.
You keep using although you know it is harming your health.
- 10
Tolerance: a need for markedly more tobacco for the same effect, or less effect from the same amount.
You need more nicotine than before to feel the same.
- 11
Withdrawal, or tobacco or nicotine taken to relieve or avoid withdrawal symptoms.
You feel unwell without it, or you use to stop feeling that way.
Nicotine use disorder symptoms you might notice first
Few people think in criteria. What they notice is the first cigarette or vape of the day coming earlier, a check that the pack or pod is full before leaving the house, irritability on a long flight, or a promise to cut down that keeps sliding to next week. Withdrawal, as the DSM-5-TR describes it, includes irritability, anxiety, trouble concentrating, increased appetite, restlessness, low mood and trouble sleeping, usually starting within a day of stopping [4].
Mild, moderate or severe: how is severity defined?
Severity is a count. Two or three criteria mean mild tobacco use disorder, four or five mean moderate, and six or more mean severe [4]. A single criterion is not a disorder. The count is about how many areas of life nicotine has reached, not about how many cigarettes you smoke: a person on half a pack a day can meet more criteria than someone on a full pack.
How many criteria make each level?
How to read it: each square is one more criterion met, from 1 to 11. The label above a group names the severity, and the darker the squares, the more severe the level. Based on the DSM-5-TR [4].
- Not a disorder1
- Mild23
- Moderate45
- Severe67891011
Show as a table
| Criteria met | Level |
|---|---|
| 0 or 1 | Not a disorder |
| 2 or 3 | Mild |
| 4 or 5 | Moderate |
| 6 to 11 | Severe |
| Severity | Criteria met in 12 months | DSM-5-TR code |
|---|---|---|
| Mild | 2 or 3 | Z72.0 [4] |
| Moderate | 4 or 5 | F17.200; in remission F17.201 [4] |
| Severe | 6 or more | F17.200; in remission F17.201 [4] |
Remission and specifiers
Two more labels describe where someone is in recovery, and two describe the circumstances. All four come from the DSM-5-TR [4].
In early remission
The full criteria were met before, and for at least 3 months but less than 12 months none of them has been met, with one exception: craving may still be present. Craving is allowed because it often outlasts everything else.
In sustained remission
The same, for 12 months or longer. At this point the risk of relapse is lower, though not gone; many people still notice a pull in old trigger situations.
On maintenance therapy
The person is in remission while taking a long-term quit medicine such as nicotine replacement, varenicline or bupropion. Being on a medicine does not cancel the remission: it is a recognized way of staying there.
In a controlled environment
Remission that happens where access to tobacco is restricted, for example during a hospital stay. It is noted because the real test comes when access returns.
What is the ICD-10 code for nicotine use disorder?
In ICD-10-CM, the code set used on US medical records and claims, nicotine use disorder is coded as nicotine dependence under F17.2 [9]. The fifth character names the product: 0 for unspecified, 1 for cigarettes, 2 for chewing tobacco and 9 for other tobacco products, which is where e-cigarettes and vapes are coded. The sixth character names the state: 0 uncomplicated, 1 in remission, 3 with withdrawal, 8 with other nicotine-induced disorders and 9 with unspecified ones. So F17.210 reads “nicotine dependence, cigarettes, uncomplicated”.
Tobacco use that does not meet the criteria for a disorder has its own code, Z72.0, and the DSM-5-TR uses Z72.0 for mild tobacco use disorder as well [4][9]. A past dependence that has ended is often recorded as Z87.891, personal history of nicotine dependence. In pregnancy, smoking is coded with O99.33- and the F17 code is added alongside it [9].
Which code matches a diagnosis?
Choose what the clinician recorded. This shows how a diagnosis is coded; it does not tell you whether you have one.
Criteria counted
The count comes from the clinician’s interview against the 11 criteria above.
Status
Remission means no criteria met except craving, for 3-12 months (early) or 12 months or more (sustained).
Main product
The product the clinician wrote down; vapes are coded as “other tobacco product”.
Choose all three to see the code.
| Product | Uncomplicated | In remission | With withdrawal | With other nicotine-induced disorders | With unspecified nicotine-induced disorders |
|---|---|---|---|---|---|
| Cigarettes | F17.210 | F17.211 | F17.213 | F17.218 | F17.219 |
| Chewing tobacco | F17.220 | F17.221 | F17.223 | F17.228 | F17.229 |
| Other tobacco product (vapes, cigars, pipes) | F17.290 | F17.291 | F17.293 | F17.298 | F17.299 |
| Unspecified | F17.200 | F17.201 | F17.203 | F17.208 | F17.209 |
| Use without a disorder, or mild tobacco use disorder | Z72.0 Tobacco use | ||||
Codes are chosen by the clinician who makes the diagnosis, and payers can add their own rules. If a code on your records looks wrong to you, ask the office that wrote it; this table is for reading a code, not for choosing one.
How is nicotine use disorder diagnosed?
There is no blood test that diagnoses nicotine use disorder. The diagnosis comes from a conversation: a clinician (a primary care doctor, a psychiatrist, an addiction specialist or a nurse practitioner) asks about your use and checks it against the DSM-5-TR criteria [4]. Guidelines ask clinicians to raise tobacco use with every adult at routine visits, so the question often comes up even if you did not plan to bring it up [6].
- The clinical interview. What you use, how much and how often, when the first use of the day happens, past attempts to quit and what happened, and which of the eleven criteria apply over the past 12 months.
- A questionnaire on dependence. Many clinicians use the Fagerström Test for Nicotine Dependence. It asks, for example, how soon after waking you smoke your first cigarette, whether it is hard not to smoke where it is forbidden, which cigarette you would hate most to give up, how many you smoke a day, whether you smoke more in the morning and whether you smoke when ill in bed. The answers help the clinician judge how strong the physical dependence is and how to dose a quit medicine; they are read by the clinician, not scored on a page like this one.
- Other substances and mental health. Alcohol and cannabis often go together with nicotine and act as triggers for using more of it [10], and anxiety and depression are common alongside nicotine use [2]. A good assessment asks about all of them, because they change the plan.
- Tests, when useful. A clinician may measure cotinine, the substance the body makes when it breaks down nicotine, in urine, saliva or blood, usually to confirm abstinence in a program or before surgery, not to diagnose the disorder [11]. Exhaled carbon monoxide shows recent smoking. Lung and heart checks look at the effects of smoke.
What our online evaluation is
A one-on-one appointment with a physician licensed in your state, who reviews your diagnoses, medicines and history to decide whether you qualify for your state’s medical cannabis program.
It ends with a recommendation for the state program, if the physician approves one.
What it is not
Not an assessment for nicotine dependence, not a quit program and not a replacement for your regular doctor. If you want help quitting, the treatments in the next sections and your primary care clinician are the place to start.
Diagnoses already in your records are what the evaluation works from.
Could a medical card make sense for you while you deal with nicotine?
Twelve short questions about your nicotine use, your health and the medicines you take. Your answers stay on this page and show what to bring to a physician.
12 questions · about a minute · your answers stay in this browser
Tobacco use disorder treatment and guidelines
Quitting works best with help. The US Preventive Services Task Force recommends that clinicians ask every adult about tobacco use, advise those who use it to stop, and offer both behavioral support and FDA-approved medicines; combining the two works better than either alone [6]. For pregnant people it recommends behavioral support, and finds the evidence for medicines in pregnancy insufficient [6]. The American Thoracic Society’s 2020 guideline goes further on medicines: it favors varenicline over the nicotine patch, suggests adding the patch to varenicline for some people, and supports starting varenicline even before you feel ready to set a quit date [12].
Choose a group to narrow the list.
Counseling and CBT
Individual, group or phone counseling, often built on cognitive behavioral therapy (CBT): spotting your triggers, planning what to do instead and handling a slip. Even short sessions raise quit rates, and more sessions help more [6].
a referral, or counseling alongside a medicine.
Nicotine replacement
Patch, gum and lozenge (sold over the counter), inhaler and nasal spray (by prescription) give steady nicotine without smoke, then taper down [13]. Using a patch with a fast-acting form for cravings works better than one form alone.
the right strength for how much you use now.
Varenicline
A prescription tablet that partly activates the brain’s nicotine receptors, easing withdrawal and making a cigarette less rewarding. The ATS guideline names it the first choice for adults with tobacco dependence [12][13].
nausea, vivid dreams and how long to stay on it.
Bupropion
A prescription antidepressant, in its sustained-release form, approved to help people stop smoking [13]. It is started a week or two before the quit date and can be combined with nicotine replacement.
seizure history and other medicines you take.
Quitline and text programs
Free coaching by phone in every state at 1-800-QUIT-NOW (1-800-784-8669), text programs and apps from Smokefree.gov [14], and a text program for quitting vapes, This is Quitting [15].
pairing a quitline with a medicine.
Medical cannabis is not part of any of these guidelines, and no study in the research behind this page tested it as a quit aid in people. If you hope to use cannabis while quitting, for sleep, anxiety or pain, the quit plan and the cannabis question are best discussed together, with the same clinician, so that one does not undo the other.
Nicotine use and mental health
Nicotine and mental health are closely tied, and the link runs in more than one direction. Many people use nicotine to calm down or to cope, and withdrawal itself brings anxiety, low mood and broken sleep, which can feel like proof that nicotine was helping. People living with anxiety, depression and other mental health conditions use nicotine more often and find it harder to stop.
Surveys show the pattern but not its cause. In a survey of 5,065 US adults in 2021-2022, people with symptoms of anxiety or depression were more likely to vape every day [2]. That is an association: it does not show that nicotine causes anxiety or that anxiety causes vaping, only that the two travel together.
Quitting does not usually make mental health worse in the long run. If you take medicine for a mental health condition, tell the clinician helping you quit: smoking speeds up how fast the body clears some psychiatric medicines, and their doses may need checking once you stop.
Quick answers
Which mental health issues can nicotine treat?
None, as an approved treatment. Nicotine is not approved by the FDA for any mental health condition. Researchers have studied it experimentally for attention and thinking problems and in some neurological diseases, but that research has not produced a recommended treatment. The calm many people feel after a cigarette is largely relief of their own withdrawal.
Is there a medical use for nicotine?
One: helping people stop using tobacco. Nicotine replacement products (patch, gum, lozenge, inhaler and nasal spray) are FDA-approved for quitting [13]. They deliver nicotine without smoke and are meant to be tapered down. Nicotine does not cure any disease.
Does cannabis help with anxiety while quitting?
No study in the research behind this page tested that in people. In surveys, cannabis use goes along with more frequent vaping, not less [2], and THC can itself cause anxiety in some people. What is known about cannabis and anxiety disorders is covered on anxiety and medical cannabis.
Anxiety and medical cannabis · Depression and medical cannabis
Why cannabinoids are studied for nicotine, and what animal studies show
The interest comes from brain chemistry. The body has its own cannabinoid system, the endocannabinoid system, with receptors such as CB1 that THC acts on. That system overlaps with the reward circuits nicotine uses: nicotine raises dopamine in a brain region called the nucleus accumbens, and cannabinoid receptors help regulate the same signals. If the cannabinoid system can turn the nicotine reward up or down, researchers reason, it could be a target for treatment.
A newer target is GPR55, a receptor that some cannabinoids also bind. In rats and mice, GPR55 sat on glutamate nerve cells, and activating it with a lab compound called O-1602 reduced how much nicotine the animals took and how hard they worked to get it; blocking the receptor undid the effect [16]. The proposed mechanism: GPR55 briefly raises glutamate in the nucleus accumbens, which counteracts the dopamine boost from nicotine [16].
Another animal study points the other way. Mice missing FABP5, a protein that carries the body’s own cannabinoids inside cells, showed a stronger preference for a place linked to a low dose of nicotine (0.1 mg/kg; p = 0.036), while a higher dose showed no difference [17]. The authors read this as a possible “gateway” mechanism, in which changes in the cannabinoid system make nicotine more rewarding rather than less.
In rats
What was tested: THC given by the researchers at 3 or 30 mg/kg to 96 male and female rats trained to give themselves nicotine, including 14 days of THC before training [1].
What changed: daily THC after each session lowered nicotine self-administration; the high dose also slowed the animals down [1]. A GPR55 activator lowered nicotine taking and seeking [16].
What it means: a lead for laboratory research, in animals only.
In people
What was tested: no trial in the research behind this page gave cannabis or a cannabinoid to people to help them quit nicotine.
What was observed: in surveys, people who use cannabis vape more often, and cannabis and alcohol act as triggers for nicotine use [2][10].
What it means: there is no evidence that cannabis helps people quit.
Animal results do not transfer to people: rats in these studies received exact doses by injection on a fixed schedule, and doses per kilogram in a rat do not translate into a human dose.
How the rat study was done
Rats learned to press a lever for an intravenous dose of nicotine. The researchers then injected THC, at 3 mg/kg or at 30 mg/kg, either for 14 days before training or every day after the session, and counted how often the animals pressed for nicotine [1]. Daily THC after the sessions lowered nicotine intake. The authors note two limits: the schedule they used cannot fully separate a drop in motivation from simple sluggishness, since 30 mg/kg of THC can suppress movement, and more of the female rats on the high dose dropped out [1].
What studies in people show: cannabis, alcohol and vaping
In people, the picture is different from the lab. In the 2021-2022 survey of 5,065 US adults, both cannabis use and alcohol use were linked to more frequent e-cigarette use [2]. Among US students, cannabis use also changed how vaping trends moved between 2020 and 2024 [3]. And when researchers interviewed 14 young adults who used both cigarettes and e-cigarettes, participants described alcohol and cannabis as triggers that set off more tobacco and nicotine use [10].
The shared rituals explain part of it: the same hand-to-mouth habit, the same breaks and the same company. For someone trying to quit, that means cannabis can be a cue rather than a cure, especially when it is smoked.
What goes along with heavier nicotine use?
How to read it: each row compares two groups. The dot is the estimate, the line is the likely range (the confidence interval each study reported), the gray line marks no difference.
Youth vaping: change each year, 2020 → 2024
- Any vaping in the past 30 days, US students [3] 0.88× a year, less often (0.86-0.89)
- Daily vaping among students who vape [3] 1.14× a year, more often (1.11-1.18)
- Failed quit attempts among daily vapers [3] 1.08× a year, more often (1.02-1.15)
Who uses more
- Anxiety or depression symptoms → daily vaping, adults [2] 1.7× more often (1.1-2.5)
- Friends or family who use → any nicotine use later, ages 16-22 [7] 4.4× more often (1.8-10.9)
- Friends or family who use → monthly nicotine use later, ages 16-22 [7] 4.1× more often (1.6-10.2)
- Vaping to quit, not for enjoyment → more cigarettes a month, dual users [18] 1.2× more (1.1-1.3)
- Vaping to quit, not for enjoyment → first cigarette within 30 minutes of waking [18] 1.5× more often (1.1-2.0)
Show as a table
| Comparison | Measure | Estimate (95% CI) | Source |
|---|---|---|---|
| Any vaping in past 30 days, yearly trend 2020-2024 | Risk ratio | 0.88 (0.86-0.89) | [3] |
| Daily vaping among past-30-day vapers, yearly trend | Risk ratio | 1.14 (1.11-1.18) | [3] |
| Unsuccessful quit attempt among daily vapers, yearly trend | Risk ratio | 1.08 (1.02-1.15) | [3] |
| Daily e-cigarette use with anxiety or depression symptoms | Odds ratio | 1.69 (1.12-2.54) | [2] |
| Any nicotine product use at follow-up, peer or family use | Odds ratio | 4.40 (1.77-10.93) | [7] |
| Monthly or more nicotine product use at follow-up, peer or family use | Odds ratio | 4.06 (1.62-10.19) | [7] |
| Monthly cigarette consumption, vaping to quit vs for enjoyment | Ratio, type not stated | 1.17 (1.08-1.26) | [18] |
| First cigarette within 30 minutes, vaping to quit vs for enjoyment | Ratio, type not stated | 1.46 (1.05-2.02) | [18] |
None of these studies tested cannabis as a treatment. The surveys of youth and dual users are background: they show how nicotine use behaves in real life, which is why they matter for anyone deciding whether cannabis belongs in a quit plan.
What the research shows, from strongest to weakest
Not all studies count the same. A randomized trial in people answers “does it work?” far better than a survey or a rat experiment. For cannabis and nicotine, the strongest level is almost empty, and that shapes every answer on this page.
| Level | What exists for cannabis and nicotine | What it can and cannot tell you |
|---|---|---|
| Trials in people | One trial-based study, in Alaska Native people who smoke, on how fast the body breaks down nicotine; it did not test cannabis [19]. | Nothing yet about whether cannabis helps people quit. |
| Observational studies | A cohort of 133 adolescents and young adults linking alcohol, cannabis and peer use to later nicotine use [7]; national trends in youth vaping [3]. | Shows links, not causes; most participants are young. |
| Surveys and interviews | Adults whose cannabis and alcohol use went with more vaping [2]; young adults naming cannabis as a trigger [10]; menthol and vaping-motivation surveys as background. | Describes what people do and say; relies on self-report. |
| Animal and lab work | THC in rats [1]; GPR55 in rats and mice [16]; FABP5 in mice [17]. | Explains why scientists are interested; says nothing yet about patients. |
Browse the studies yourself
Every study cited on this page, in plain words. Studies that are not about cannabis are marked as background.
How fast the body breaks down nicotine
In Alaska Native adults who smoke, the nicotine metabolite ratio, a marker of how quickly nicotine is cleared, was examined against tobacco use and personal characteristics; results were neutral [19].
Daily vaping and failed quit attempts in US youth
Daily vaping among students who vaped rose from 15.4% in 2020 to 28.8% in 2024, and failed quit attempts among daily vapers from 28.2% to 53% [3].
Alcohol, cannabis and peers as risk factors
In 16- to 22-year-olds who vape, peer or family nicotine use predicted later use (odds ratio 4.40, 95% CI 1.77-10.93); alcohol and cannabis use were studied as risk factors too [7].
The automatic pull toward cigarettes
People who smoked showed an automatic approach tendency toward smoking cues, but not toward food cues, in a reaction-time task [20].
How people who smoke menthol see a menthol ban
Views were mixed; earlier data cited in the study put menthol use at 81% of Black and 34% of White people who smoke [8].
Quitting cigarettes and vapes at the same time
Most had tried to quit in the past year (86% e-cigarettes and 83% cigarettes) and described alcohol and cannabis as triggers for more use [10].
What predicts vaping in middle school
Lifetime e-cigarette use was 9.4% and dual use 3.8%; peers, home, school and easy access were among the strongest predictors [21].
Cannabis, alcohol, mental health and frequent vaping
Cannabis and alcohol use went with more frequent e-cigarette use, and anxiety or depression symptoms with daily use (odds ratio 1.69, 95% CI 1.12-2.54) [2].
Why people who smoke also vape
Those who vaped to quit smoked more cigarettes a month and more often lit up within 30 minutes of waking than those who vaped for enjoyment [18].
GPR55 and nicotine taking and seeking
Activating GPR55 with O-1602 reduced nicotine self-administration and seeking; a GPR55 blocker reversed it [16].
THC and nicotine self-administration
THC at 3 or 30 mg/kg after each session lowered nicotine intake; the high dose also suppressed movement, so results were mixed [1].
FABP5 and the reward of nicotine
Mice lacking FABP5 preferred a low-dose nicotine setting more strongly than normal mice, a possible “gateway” mechanism [17].
No studies of this type are cited on this page.
What kinds of studies is this evidence built on?
How to read it: each row is one kind of study, and the bar shows how many published studies on nicotine use disorder and cannabinoids are of that kind. Stronger designs are at the top. Gray bars are commentary, animal and lab work, which cannot answer whether something helps patients.
Show as a table
| Design | Studies |
|---|---|
| Randomized trials | 1 |
| Cohort studies | 2 |
| Cross-sectional studies | 2 |
| Surveys and interviews | 6 |
| Case reports | 1 |
| Narrative reviews | 8 |
| Animal and lab studies | 7 |
| Who was studied | Studies |
|---|---|
| People in clinical trials | 1 |
| People observed, not treated | 18 |
| Whole populations | 6 |
| Animals | 2 |
| Cells and molecules | 3 |
| Not classified | 4 |
Who wrote and reviewed this page
This page is written and checked by the Dr. Weedy medical team of physicians licensed in the states where we work. Every number from a study carries a reference to the paper, and official sources, the DSM-5-TR, the ICD-10-CM code set, federal guidelines and laws, are listed with links under References at the end of the page. Studies that are not about cannabis are marked as background wherever they appear, and the page is reviewed again when new research or code sets come out.
Does the form of cannabis matter for nicotine?
Yes, more than for most conditions. Cannabis is smoked, vaped, eaten, held under the tongue or put on the skin, and for someone trying to quit nicotine the form decides whether cannabis keeps the smoking ritual alive, or even adds tobacco to it. Some risks belong to one form, some to every form, and some to shared devices. This section explains the differences; it does not recommend a form.
How is it used, or how would it be?
Choose the closest; most people combine more than one.
Specific to smoking
Joints, pipes and bongs burn plant material, and the smoke travels the same airways as cigarette smoke. The motions, lighting up, inhaling, the break outside, are the very cues a quit plan tries to break, so smoked cannabis can keep the urge for a cigarette switched on.
Specific to blunts and spliffs
A blunt is cannabis rolled in a cigar wrapper or tobacco leaf, and a spliff mixes cannabis with loose tobacco. Both deliver nicotine directly, so using them is smoking tobacco, not an alternative to it. For a person with nicotine use disorder, a blunt or spliff keeps the dependence going while seeming to replace it.
Specific to vaping and dabbing
Dry-herb vaporizers, oil pens and cartridges avoid burning, but hot aerosol still travels the same airways, and the device looks and feels like a nicotine vape. Concentrates used for dabbing, such as wax or shatter, are very strong, which makes the dose hard to control.
Shared devices
A joint, pipe or vape passed between people also passes on colds and other infections. Sharing is also how cannabis sessions turn into tobacco or nicotine sessions: one shared vape or one rolled spliff is enough.
Specific to edibles and capsules
Gummies, chocolates, drinks, capsules and swallowed oils avoid smoke and the inhaling ritual. They act slowly, often an hour or more, and last for hours, and the liver processes them before they reach the blood. The classic mistake is a second piece “because the first did nothing.”
Specific to tinctures and sprays
Drops or oils held under the tongue and mouth sprays avoid the lungs and are measured by the drop or spray. Part of the dose is still swallowed and goes through the liver.
Specific to topicals and patches
Creams and balms act mainly where they are applied and do not reach the brain in a meaningful way. Transdermal patches are different: they deliver cannabinoids into the bloodstream, so their effects on the brain and on other medicines count like any other form.
Specific to prescription cannabinoids
Dronabinol (Marinol, Syndros), nabilone (Cesamet) and cannabidiol (Epidiolex) are FDA-approved medicines filled at a pharmacy, not dispensary products bought with a medical card. None of them is approved for nicotine use disorder or for quitting.
True of every form
- THC can cause drowsiness, dizziness, anxiety or paranoia, whatever the form.
- Whatever reaches the blood is processed by the liver and can change levels of other medicines, including some used while quitting.
- THC adds to the effect of sedatives, sleeping pills and alcohol.
- Cannabis use disorder can develop with any form.
- No driving after use.
Choosing a form is a conversation for the appointment.
All forms as a table
| Form | What it avoids | What remains |
|---|---|---|
| Smoking | Delay in onset | Smoke in the airways, the smoking ritual, shared devices, all effects of THC |
| Blunts and spliffs | Nothing, compared with smoking | Tobacco and nicotine added directly, smoke, the smoking ritual, all effects of THC |
| Vaping and dabbing | Burning plant material | Hot aerosol in the airways, a device like a nicotine vape, very strong concentrates, all effects of THC |
| Edibles and capsules | Smoke, aerosol, the inhaling ritual, shared devices | Slow, long effect, risk of a repeat dose, liver processing, interactions |
| Tinctures and sprays | Smoke, aerosol, the inhaling ritual, shared devices | Effects on the brain, partly swallowed dose, interactions |
| Topicals | Most effects on the brain | Skin reactions; no effect on nicotine use |
| Transdermal patches | Smoke, aerosol and swallowing | Effects on the brain, interactions |
| Prescription cannabinoids | Unknown product content | Drowsiness, dizziness, interactions; not approved for nicotine use disorder |
THC vs CBD: why the difference matters
“Cannabis” covers very different substances. THC is the compound that changes how you feel and the one tested in the rat study above. CBD does not cause a high, and it is often marketed for stress and cravings, but the research behind this page contains no study of CBD and nicotine at all. A result for one does not carry over to the other: what THC did in rats says nothing about a CBD-only oil, and the absence of a high says nothing about whether CBD helps you quit.
| Substance | What was studied | Design | What came out |
|---|---|---|---|
| Dispensary products (available with a medical card where your state allows) | |||
| THC | Nicotine self-administration in 96 rats, at 3 and 30 mg/kg [1]; in people, only as part of “cannabis use” in surveys [2]. | Animal study; surveys | Less nicotine taken by rats; in people, cannabis use goes with more frequent vaping. |
| CBD | Nothing in the research behind this page. | – | No data on CBD and nicotine use disorder. |
| THC + CBD products | Nothing in the research behind this page. | – | No data. |
| Prescription medicines (FDA-approved, by prescription, not through a card) | |||
| Dronabinol (Marinol, Syndros) | Not studied for nicotine in the research behind this page. | – | Approved for chemotherapy nausea and AIDS-related weight loss, not for quitting. |
| Nabilone (Cesamet) | Not studied for nicotine in the research behind this page. | – | Approved for chemotherapy nausea, not for quitting. |
| Cannabidiol (Epidiolex) | Not studied for nicotine in the research behind this page. | – | Approved for certain seizure disorders, not for quitting. |
| Lab compounds, not available to patients | |||
| O-1602 (GPR55 activator) | Nicotine taking and seeking in rats and mice [16]. | Animal study | Less nicotine taking and seeking; blocked by a GPR55 blocker. |
| URB597, URB694 (FAAH blockers) | Raise the body’s own cannabinoid anandamide; listed among the compounds tested in animal research on nicotine. | Animal studies | No results in people. |
What science doesn’t know yet
The gaps are most of the story here. The researchers who wrote these studies name the same limits again and again.
- No study shows that cannabis helps people quit nicotine. Not one work in the research behind this page tested it as a quit aid in people.
- One trial, and it is not about cannabis. The only trial-based study looked at how fast the body clears nicotine [19].
- The positive results are in animals. THC and GPR55 findings come from rats and mice; the high THC dose also slowed the animals down, which muddies the result [1], and the GPR55 compound acts on another receptor too [16].
- The human data are surveys and self-report. They rely on memory and on what people choose to say, and some were collected in shortened or remote form during the COVID-19 pandemic [3].
- Small and narrow samples. One cohort had 133 participants, lost more than 30% to follow-up and was mostly White [7]; an interview study covered 14 young adults in California [10].
- Doses, forms and long-term outcomes are unknown. Nobody has studied which product, how much or for how long, or what happens to nicotine use over years.
- Mechanisms are unsettled. How changes in the body’s cannabinoids affect the way nicotine is processed remains unknown [17].
If you bring this to a physician, three questions are worth asking: what would we expect cannabis to help with, given that quitting is not proven; how would we notice if it makes my nicotine use worse; and which quit treatment should I start or keep alongside it?
Safety and drug interactions to discuss with a doctor
The research behind this page did not record side effects of cannabis in people who use nicotine, so the points below come from what is generally known about THC and from the specific risks of combining the two. In animals, the high THC dose of 30 mg/kg suppressed movement [1] – a reminder that dose matters.
Drowsiness
THC can cause sleepiness and slower reactions, which add up with alcohol, sleeping pills and other sedating medicines.
Anxiety and paranoia
THC can raise anxiety and cause paranoia, especially at higher doses, the same feelings that nicotine withdrawal brings in the first weeks.
Double load on the lungs
Smoking cannabis and tobacco together, or in one blunt or spliff, adds smoke to smoke. Coughing and breathlessness are reasons for a lung check, not for a different strain.
Driving
THC slows reaction time and judgment. Anyone who has used it should not drive, and it is illegal in every state to drive impaired.
Cannabis use disorder
Regular use can lead to a dependence of its own. A personal or family history of substance use raises that risk.
Pregnancy
Both nicotine and THC reach the fetus. Pregnancy is a reason to stop both, with help that is safe in pregnancy [6].
Interactions
Open each one. This is what the studies recorded, not a complete list.
Alcohol and cannabis as triggers clinical data
Cannabis use and youth vaping trends clinical data
Among US students, cannabis use changed how both any vaping and daily vaping moved from 2020 to 2024 [3]. For teenagers, using one substance is a reason to ask about the other.
THC changes how nicotine is taken mechanism only
In rats, THC changed the pattern of nicotine intake [1]. That shows the two substances act on overlapping systems; it does not tell you what happens in a person.
GPR55 and its blocker mechanism only
A GPR55 blocker, CID 16020046, canceled the effect of the GPR55 activator on nicotine taking in animals [16]. This is laboratory pharmacology, not a patient interaction.
Quit-smoking medicines mechanism only
No study in the research behind this page tested cannabis together with varenicline, bupropion or nicotine replacement. Both THC and these medicines can affect sleep, mood and dreams, so changes are hard to sort out without the prescriber knowing about both. Do not stop a quit medicine to try cannabis.
Bring the complete list, prescriptions, quit medicines, over-the-counter sleep aids, supplements and anything taken “only sometimes,” to the appointment. That list, more than the diagnosis, decides whether cannabis is reasonable to consider.
Who should not use cannabis for this
For some people the answer is “not now” or “not at all,” whatever the reason for asking. There is no evidence of safety for them, and for several of these groups there is clear evidence of harm.
- A history of psychosis – hallucinations or delusions, or a close family history of schizophrenia; THC can trigger or worsen them. See cannabis and psychosis.
- Pregnancy or breastfeeding – THC and nicotine both reach the baby.
- Teenagers and young adults under 21 – the developing brain is more sensitive to both nicotine and THC, and most state programs set strict rules for minors.
- A current dependence on another substance, including alcohol or cannabis itself, unless it is part of a supervised treatment plan.
- Heart or lung disease while still smoking – adding cannabis smoke to tobacco smoke adds to the strain on both.
Talk to a licensed physician about whether any of these apply
Is nicotine use disorder a qualifying condition for a medical marijuana card?
Almost never on its own. State medical cannabis programs keep their own lists of qualifying conditions, and nicotine or tobacco use disorder is not named as a separate condition on the standard lists. That fits the evidence: no study shows that cannabis helps people quit nicotine.
Two situations change the answer. A few states let a physician recommend cannabis for any condition they judge appropriate – Oklahoma and Virginia do not limit physicians to a fixed list, and California allows other chronic or persistent symptoms. And many people who use nicotine also live with a condition that is listed, such as anxiety, PTSD, chronic pain or insomnia. In both cases, the physician decides at the evaluation, from your records.
A condition you also have is listed
Chronic pain, PTSD, anxiety or insomnia may be on your state’s list. What counts is a diagnosis in your records, not a symptom alone.
Your state lets physicians decide
The physician weighs your history, medicines and goals. Nicotine use disorder is part of that picture, and quitting remains its own plan.
Neither applies
A card may not be available for you yet. Some states accept petitions to add conditions; the quit treatments above work without one.
What else has a doctor diagnosed?
State lists name diagnoses, not symptoms: pick what is in your records.
Anxiety: several states list anxiety disorders or accept them under broader wording, and anxiety often travels with nicotine use. Read anxiety and medical cannabis.
PTSD: one of the most widely listed mental health conditions across state programs. Read PTSD and medical cannabis.
Insomnia: a diagnosed sleep disorder is listed in some programs, and broken sleep is common in the first weeks of quitting. Read insomnia and medical cannabis.
Chronic pain: the most widely listed condition across state programs. Read chronic pain and medical cannabis.
Depression: fewer states list it, and THC can affect mood in both directions. Read depression and medical cannabis.
None of these: then the decision rests on your state’s wording and the physician’s judgment. Start with your state’s medical marijuana laws.
Medical marijuana laws by state: legal status, possession limits, taxes, cultivation
Four things differ from state to state, and each one changes what a card gives you. Legal status: some states allow medical use only, others both medical and adult-use. Possession limits: how much a patient may buy and carry, often higher than for adult-use buyers. Taxes: some states tax patients less than recreational buyers, others the same. Cultivation: some programs let patients grow a limited number of plants at home, many do not. The current figures for each state, and whether its list names any condition related to nicotine, are kept on the laws and regulations pages.
Medical card vs recreational purchase: what you save
In states with adult-use sales, adults can buy without a card. A card still changes several things, though the details are set state by state.
| Aspect | With a medical card | Recreational |
|---|---|---|
| Taxes | Often lower; some states waive part of the cannabis tax for patients | Full state and local cannabis taxes |
| Purchase and possession limits | Often higher; depends on your state | Set for adult-use buyers |
| Products | Medical dispensaries and, in some states, medical-only products | Adult-use product range |
| Age | Patient age rules set by each program | Adult-use age limit set by the state |
| Physician involvement | A licensed physician reviews your conditions and medicines, including quit medicines | None |
| Document | State card or recommendation, recorded in a confidential registry | Government ID only |
Will a card save you money?
It can, but only where your state taxes patients less than recreational buyers, and the amount depends on your state’s tax rates and how much you buy. Weigh that against the evaluation fee and any state registration fee. The breakdown is in medical vs. recreational cannabis taxes, and the wider differences in medical and recreational cannabis compared.
About medical marijuana in your state
Qualifying is the first of two steps. In most states a physician’s recommendation is followed by registration with the state health department, which issues the card and enters you in a confidential patient registry; in a few, the recommendation itself is what a dispensary asks for. Purchases happen at licensed dispensaries, some of which deliver, and products there are lab-tested and labeled with their THC and CBD content, which also tells you whether a product contains tobacco, as a blunt does.
Many state laws also let a patient name a registered caregiver who may buy and handle products on the patient’s behalf; who qualifies and how to register is set by each state. Cards from one state are not automatically valid in another; see which states accept out-of-state cards. Possession limits, home growing and taxes are listed state by state on the laws and regulations pages.
Legal protections: firearms, work, privacy and driving
A state card protects you under state law. Federal law still lists cannabis as a controlled substance, and that gap matters most in four places. Choose one.
Firearms: federal law bars anyone who is an “unlawful user” of a controlled substance from shipping, receiving or possessing a firearm [22]. The federal Form 4473, filled in when buying a gun from a licensed dealer, asks this question directly, and a state card does not change the federal answer. If you own or plan to buy firearms, weigh this before applying.
Work: employment protections for card holders differ by state. Some states bar discrimination against registered patients; many still let employers enforce drug-free policies and act on a positive test, and federal jobs and safety-sensitive roles follow federal rules. Read your state’s rules on the laws and regulations pages.
Privacy: your medical records and your evaluation are protected health information under the HIPAA Privacy Rule [23]. State patient registries are confidential; dispensaries and law enforcement can usually check only whether a card is valid, not your diagnosis.
Driving: a card never makes it legal to drive impaired, and every state prohibits it. Keep products sealed and out of reach in the car, and do not carry cannabis across state lines: that is federal territory, and another state may not honor your card.
Which situation sounds like you?
People reach this page from very different places. Pick the one closest to yours; each ends with one clear next step.
I’m quitting, and I also live with anxiety, poor sleep or pain
Those conditions are on many state lists, and they make quitting harder. A physician can look at both together: whether a card makes sense for the listed condition, and how it fits with your quit plan and medicines.
See if I qualifyI hoped cannabis would help me quit
An honest answer: no study shows it does, and in people cannabis goes along with more nicotine use, not less. The treatments with real evidence are counseling, nicotine replacement, varenicline and bupropion, and the quitline is free.
What the studies foundI already have a card
Tell the physician at your next evaluation that you are quitting nicotine and which quit medicines you take, and avoid blunts and spliffs, which add tobacco. Your documents are in your account and documents.
Start your online evaluationOnly need the diagnosis or the code? Go straight to the DSM-5 criteria or the ICD-10 code finder.
What this means if you are considering it
A good evaluation is a conversation about the condition that qualifies you, the medicines you already take (quit medicines included) and what would count as “better.” It goes faster and safer when the facts are on the table.
What to bring to the appointment
Tap each item as you get it ready.
Questions worth asking
- Could cannabis make my nicotine cravings or use worse, and how would we notice?
- THC, CBD or both, and why that choice for my listed condition?
- Which forms keep me away from smoke and from tobacco?
- Does anything I take interact, including my quit medicine?
- What should make me stop right away?
An evaluation makes sense if
- You have a listed condition, such as anxiety, PTSD, insomnia or chronic pain, in your records.
- You have a quit plan, or are willing to start one.
- Your full medicine list can be reviewed.
- You understand cannabis is not a quit aid.
It is not the right step if
- The only goal is to stop smoking or vaping.
- You are pregnant or breastfeeding.
- There is a history of psychosis.
- You are under 21 or depend on another substance.
Talk to a licensed physician about your options
The evaluation is with a physician licensed in your state, one-on-one and online, so there is nowhere to travel and no waiting room. It reviews whether you qualify for your state’s program; it does not promise a recommendation or help with quitting, and the decision is the physician’s.
This page summarizes published research for education. It does not replace a physician’s advice. Cannabis has not been shown to help people quit nicotine, and blunts and spliffs add tobacco directly.
How to get your medical card online
Everything happens online, so there is nowhere to travel. Four steps take you from the first form to a card in your hand.
Fill in the intake form
Your state, your diagnoses and your current medicines, including quit medicines. Have records of a listed condition ready to upload.
See a physician licensed in your state
A one-on-one appointment online. You agree on the time with the physician; keep an hour free rather than a minute.
Receive your signed recommendation
If the physician approves, the signed recommendation arrives in your account.
Register with your state
Where required, you submit the recommendation to the state program, which reviews it and issues the card.
What you end up with
Across 250 reviews from patients in the states where we are licensed. We do not sort them by score and do not hide the low ones.
- 150,000+patients evaluated – everyone who has been through an appointment with us, in every state where we are licensed
- Since 2017doing only this: online evaluations for medical cannabis programs, and nothing else on the side
A recommendation from a physician licensed where you live, and, once your state registers it, a card that lets you buy at licensed dispensaries. Your documents stay in your account and documents, and how the medical card works explains the evaluation in detail. The physicians who see patients are listed on our physicians page.
Programs for veterans and for people with low income are available in some states.
Nicotine use disorder: frequently asked questions
Can cannabis help me quit nicotine?
There is no evidence that it does in people. THC lowered nicotine intake in rats [1], but in surveys of people cannabis use goes along with more frequent vaping [2], and young adults describe it as a trigger for more nicotine use [10]. The treatments with evidence are counseling, nicotine replacement, varenicline and bupropion.
Is tobacco use disorder a chronic condition?
It is generally treated as a chronic, relapsing condition. Many people need several attempts before quitting for good, and the DSM-5-TR has separate labels for early and sustained remission [4]. A relapse is a reason to restart treatment, not a sign that it cannot work.
Is nicotine use a substance use disorder?
Yes. Tobacco use disorder is one of the substance use disorders in the DSM-5-TR, diagnosed with the same type of criteria as alcohol or cannabis use disorder [4].
What is the medical use of nicotine?
Its only approved medical use is helping people stop tobacco, as nicotine replacement: patch, gum, lozenge, inhaler or nasal spray [13]. Nicotine is not approved to treat any mental health condition, and it does not cure diseases.
Is a blunt or spliff the same as smoking tobacco?
In terms of nicotine, yes. A blunt is wrapped in a cigar wrapper or tobacco leaf, and a spliff mixes tobacco into the cannabis, so both deliver nicotine and tobacco smoke. For someone with nicotine use disorder, they keep the dependence going.
How long does nicotine stay in your bloodstream?
Nicotine itself leaves the blood within hours. The body turns it into cotinine, which lasts much longer, usually several days, and longer in people who use a lot, which is why tests look for cotinine rather than nicotine [11]. Cravings and withdrawal follow their own timeline and peak in the first days after stopping.
What about delta-8 THC or CBD products sold without a card?
Hemp-derived products sold in shops and online are often less tightly regulated than dispensary products, and labels may not match what is inside. Delta-8 THC acts much like regular THC, and many of these products are sold as vapes, which keeps the vaping habit alive. None has been studied for quitting nicotine.
Can I use my card in another state?
Sometimes. Reciprocity (one state honoring another state’s card) exists in some states and not others, and rules for visitors vary. Check which states accept out-of-state cards and traveling with cannabis before a trip.
What if my card is lost?
Most states let you request a replacement from the program that issued it. The steps are in what to do if your card is lost and the medical card FAQ.
How do I renew my medical card?
Cards expire on a schedule your state sets, and renewal means a repeat evaluation with updated medicines and a new recommendation. Tell the physician what has changed since last time: a new diagnosis, a quit date, a new quit medicine. See how the medical card works, or choose your state from the list at the top of this page.
How much does it cost, and what if I’m not approved?
The evaluation fee for your state is shown before you pay; a state registration fee, where one exists, is paid to the state separately. Whether a recommendation is issued is the physician’s medical decision. Details for both are on how the medical card works and in the medical card FAQ.
Is an online evaluation legitimate?
Yes, where state law allows telemedicine for medical cannabis evaluations. The appointment is with a physician licensed in your state, one-on-one, and the recommendation is the same document an in-person visit would produce.
More research on cannabis and nicotine addiction
This page cites a selection of studies. Our research library holds every study we track on cannabis and nicotine addiction, from laboratory work to clinical trials, and lets you filter them by cannabinoid, study type and year.
- studies
- 39
- in people
- 25
- clinical trials
- 1
References
25 sources
- 1. Experimenter administered Δ9-THC decreases nicotine self-administration in a rat model. DOI: 10.1016/j.pbb.2023.173632 PMID: 37690617
- 2. The Influence of COVID-19 Pandemic on the Frequent Use of E-Cigarettes and Its Association with Substance Use and Mental Health Symptoms. DOI: 10.3390/bs12110453 PMID: 36421749
- 3. Trends in Daily Nicotine Vaping and Unsuccessful Quit Attempts in Youths. DOI: 10.1001/jamanetworkopen.2025.41061 PMID: 41182763
- 4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). 2022.
- 5. Centers for Disease Control and Prevention. Smoking and Tobacco Use. 2025.
- 6. US Preventive Services Task Force. Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions. 2021.
- 7. Substance Use and Social Influence as Risk Factors for Nicotine and Tobacco Product Use in Adolescents and Young Adults who use Electronic Nicotine Delivery Systems. DOI: 10.3389/fradm.2025.1486782 PMID: 40458183
- 8. Perceptions of a Menthol Cigarette Ban: Focus Group Study With US Adults who Smoke Menthol Cigarettes. DOI: 10.1177/08901171251388871 PMID: 41104740
- 9. National Center for Health Statistics, CDC. ICD-10-CM, FY 2026 code set. 2025.
- 10. Desires and Needs for Quitting Both e-Cigarettes and Cigarettes Among Young Adults: Formative Qualitative Study Informing the Development of a Smartphone Intervention for Dual Tobacco Cessation. DOI: 10.2196/63156 PMID: 39437386
- 11. Centers for Disease Control and Prevention. Cotinine Factsheet, National Biomonitoring Program. 2024.
- 12. American Thoracic Society. Initiating Pharmacologic Treatment in Tobacco-Dependent Adults: An Official ATS Clinical Practice Guideline. 2020.
- 13. US Food and Drug Administration. Want to Quit Smoking? FDA-Approved and FDA-Cleared Cessation Products Can Help. 2024.
- 14. National Cancer Institute. Smokefree.gov. 2025.
- 15. Truth Initiative. This is Quitting. 2025.
- 16. GPR55 is expressed in glutamate neurons and functionally modulates nicotine taking and seeking in rats and mice. DOI: 10.21203/rs.3.rs-3222344/v1 PMID: 37886574
- 17. Fatty Acid-Binding Protein 5 Gene Deletion Enhances Nicotine-Conditioned Place Preference: Illuminating the Putative Gateway Mechanisms. DOI: 10.3390/futurepharmacol3010007 PMID: 36864947
- 18. Why do smokers use e-cigarettes? A study on reasons among dual users. DOI: 10.1016/j.pmedr.2022.101924 PMID: 35911573
- 19. Correlates of the nicotine metabolite ratio in Alaska Native people who smoke cigarettes. DOI: 10.1037/pha0000461 PMID: 33856821
- 20. “A cigarette a day keeps the goodies away”: smokers show automatic approach tendencies for smoking–but not for food-related stimuli. DOI: 10.1371/journal.pone.0116464 PMID: 25692468
- 21. An ecological examination of early adolescent e-cigarette use: A machine learning approach to understanding a health epidemic. DOI: 10.1371/journal.pone.0287878 PMID: 38354165
- 22. US Code. 18 U.S.C. § 922(g)(3), unlawful acts. 2025.
- 23. US Department of Health and Human Services. The HIPAA Privacy Rule. 2025.
- 24. 988 Suicide and Crisis Lifeline. 988 Lifeline. 2025.
- 25. Substance Abuse and Mental Health Services Administration. SAMHSA’s National Helpline. 2025.