{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:23Z","timestamp":1792787723750,"version":"4.5.0"},"reference-count":48,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute on Drug Abuse","award":["U54DA058271"],"award-info":[{"award-number":["U54DA058271"]}],"id":[{"id":"https:\/\/ror.org\/00fq5cm18","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cannabis &amp; Cannabinoid Research"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A pharmacologic approach for smoking cessation is enzyme inhibition. Cytochrome P450 2A6 (CYP2A6)\u2013mediated nicotine metabolism is a key target, yet no safe or effective inhibitors are currently available. We examined associations between marijuana use and the nicotine metabolite ratio (NMR) in adults who smoke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a cross-sectional analysis of adults who currently smoke in the National Health and Nutrition Examination Survey (NHANES) 2013\u20132018. Marijuana use was assessed by two self-reported measures: marijuana use every month for 1 or more years and frequency of marijuana use. NMR was calculated as the ratio of serum\n                      <jats:italic toggle=\"yes\">trans<\/jats:italic>\n                      -3\u2032-hydroxycotinine (3-HCOT) to cotinine and categorized into quartiles based on weighted population cutoffs. Survey-weighted multinomial models adjusted for sociodemographic covariates were used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 2984 adults who currently smoke, marijuana use every month for 1 or more years was associated with lower NMR. Compared with those who didn't use marijuana, participants who used marijuana every month for 1 or more years had reduced odds of being in NMR quartile 4 (adjusted odds ratio [aOR] = 0.59, 95% confidence interval [CI] = 0.41\u20130.85); no significant association was observed for quartile 2 or 3. When the frequency of marijuana use (DUQ230) was modeled categorically, weekly users had reduced odds of quartile 4 classification relative to never users (aOR = 0.53, 95% CI = 0.31\u20130.91). Monthly and daily use frequency showed a similar direction of association with reduced odds of quartile 4 classification (aOR = 0.73, 95% CI = 0.37\u20131.44; and aOR = 0.54, 95% CI = 0.28\u20131.04, respectively), though these did not reach statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>People who smoke cigarettes and co-use marijuana had a lower NMR. Pharmacokinetic studies are needed to further determine whether cannabinoids affect nicotine metabolism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact:<\/jats:title>\n                    <jats:p>The nonpsychoactive forms of cannabinoids may be useful for the treatment of tobacco use disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/25785125261493188","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:59:53Z","timestamp":1791867593000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Cannabis (Marijuana) on Nicotine Metabolism in U.S. Adults Who Smoke Cigarettes: Findings from NHANES 2013\u20132018"],"prefix":"10.1177","author":[{"given":"Wanyu","family":"Hua","sequence":"first","affiliation":[{"name":"Division of Epidemiology, Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Lazarus","sequence":"additional","affiliation":[{"name":"Division of Molecular Biosciences, Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tolulope V.","family":"Adebile","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0867-423X","authenticated-orcid":false,"given":"Joshua E.","family":"Muscat","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntx083"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1238"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-011-2341-1"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addicn.2023.100103"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2023.109833"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.chemrestox.2c00259"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpet.2024.101661"},{"key":"e_1_3_2_9_1","unstructured":"8.CDC. Cannabis Health Effects. Cannabis and Public Health. CDC: Atlanta GA; 2024. Available from: https:\/\/www.cdc.gov\/cannabis\/health-effects\/index.html [Last accessed: 22January 2026]."},{"key":"e_1_3_2_10_1","unstructured":"9.Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2022 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality: Rockville MD; 2023. Available from: https:\/\/www.samhsa.gov\/data\/report\/2022-nsduh-annual-national-report"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.47626\/2237-6089-2022-0001"},{"key":"e_1_3_2_12_1","unstructured":"11.National Conference of State Legislatures. State Medical Cannabis Laws. National Conference of State Legislatures: Denver CO; 2024. 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Routes of marijuana use \u2014 Behavioral risk factor surveillance system, 22 U.S. States and Two Territories 2025;74(12).","journal-title":"States and Two Territories"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2024.108129"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2020.102754"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2024.102912"},{"key":"e_1_3_2_19_1","unstructured":"18.CDC. NHANES Questionnaires Datasets and Related Documentation. CDC: Hyattsville MD. 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Smoking cessation: A report of the surgeon general. Tobacco\u2014Surgeon General\u2019s Reports. U.S. Department of Health and Human Services: Washington DC; 2020. Available from: https:\/\/www.cdc.gov\/tobacco-surgeon-general-reports\/reports\/2020-smoking-cessation\/index.html [Last accessed: 24February 2026]."},{"key":"e_1_3_2_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntz085"},{"key":"e_1_3_2_46_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.47799"},{"key":"e_1_3_2_47_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2013.16"},{"key":"e_1_3_2_48_1","unstructured":"47.Drug Enforcement Administration. Schedules of Controlled Substances: Placement in Schedule V of Certain FDA-Approved Drugs Containing Cannabidiol; Corresponding Change to Permit Requirements. Drug Enforcement Administration: Washington DC; 2018. 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