Is marijuana use becoming a gateway to nicotine dependence?
Previous studies have documented a reliable pattern for initiating substance use, with many adolescents beginning with nicotine and/or alcohol and progressing to illicit drugs. Nicotine is a particularly potent gateway drug for marijuana. However, recent research suggests that a ‘reverse gateway’ effect may occur for some cigarette smokers, with marijuana use preceding tobacco. In this issue, Amos et al. report on a qualitative study examining the relationships between tobacco and marijuana use among adolescents and young adults in Scotland. A fundamental theme in this report is the link between cannabis use and cigarette smoking, and how this association reinforced nicotine use in general. Combined use of tobacco and marijuana is a cross-cultural phenomenon. In the United States concurrent use of cigarettes and marijuana is common, as is the use of blunts, marijuana rolled in cigar papers. Studies highlight the universality of this problem in adolescents and introduce another layer of
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