Cannabis is associated with tobacco use and has been described as a "gateway" drug. But, whether adolescents who use cannabis only differ from those who use both cannabis and tobacco is unclear. To explore these possible differences, researchers assessed social and academic performance among a nationally representative sample of 5263 Swiss adolescents who either used cannabis only, cannabis and tobacco, or neither.

Subjects who used cannabis only, compared with subjects who used both cannabis and tobacco, were:

• More likely to practice sports, be on an academic track, and get good grades
• Less likely in the past month to use cannabis ≥10 times and get drunk

Subjects who used cannabis only, compared with subjects who never used cannabis or tobacco, were:

• More likely to practice sports, be on an academic track, and report good peer relationships as well as be truant, get drunk in the last month, and use other illegal drugs in last month
• Less likely to report a good relationship with their parents

Comments by Michael Levy, Ph.D.
The "take-home message" from this study is that youth who smoke both cannabis and tobacco may be at greater risk than youth who smoke cannabis only. Further, youth who smoke cannabis only may have success in school and good relationships with their peers, but their psychosocial problems should not be ignored or minimized. Youth who smoke cannabis, particularly those who also smoke cigarettes, could be important targets for preventive interventions.