Does CBD interact with nicotine and other stimulants?

  • According to Smokefree.gov of the National Cancer Institute (NCI), some people use smoking as a way to manage stress or other unpleasant feelings(1). Unfortunately, nicotine, tar, and carbon monoxide (a toxic gas) are also released when tobacco is smoked(2).
  • Meanwhile, CBD might be useful for managing stress and emotions without the user having to experience a euphoric high. Research has shown that CBD possesses anti-anxiety and non-psychoactive properties(3).
  • A study found that CBD interactions with stimulants caused reduced appetite, weight decrease, and insomnia or sleep disturbance(4). However, specific data on nicotine and CBD interaction is not available.
  • In a 2013 study published in the Addictive Behaviors journal, it was noted that CBD might theoretically be a potential treatment for nicotine dependence(5).
  • Still, a consultation with a doctor experienced in cannabis use is advised before replacing nicotine with CBD or before trying to combat nicotine dependence with CBD.

Can CBD be taken with nicotine?

The effects of nicotine use in conjunction with other drugs, including over-the-counter or prescribed medications, can be unpredictable and cause reduced effectiveness of the drug or increased blood clots(6). However, no data is available on the specific interaction between nicotine and cannabidiol.

Nicotine is a stimulant drug that accelerates the messages travelling between the brain and body. It may be more addictive than heroin, says the Alcohol and Drug Foundation of Australia(7).

Products such as cigarettes, pipe tobacco, cigars, chewing tobacco and wet and dry snuff (ground tobacco leaves), and the dried leaves from the tobacco plant all contain nicotine(8). 

When tobacco is smoked, nicotine, tar, and carbon monoxide (a toxic gas) are released(9).

Electronic cigarettes (also known as e-cigarettes) may still have some nicotine content, although they do not contain dried tobacco leaves(10).

DrugBank’s BioInteractor utilizes data to provide information on drug-drug interactions(11). However, in the case of cannabidiol-nicotine interaction, no specific data is available.

Meanwhile, there have been studies that demonstrate how marijuana interacts with nicotine(12)

Although the studies are not specific to CBD, the data may offer insight into CBD-nicotine interaction given that cannabidiol may be derived from either a hemp plant or marijuana plant

In a 2015 study funded by the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH), scientists at the Center for BrainHealth at the University of Texas at Dallas have uncovered an association between smaller hippocampal brain volume and marijuana use(13)

The hippocampus is a brain structure that has been studied extensively for its prominent role in memory and cognition.

Francesca Filbey, Ph.D., the study’s lead investigator and Director of Cognitive Neuroscience of Addictive Behaviors at the Center for BrainHealth reveals that approximately 70% of individuals who use marijuana also use tobacco. 

However, most studies do not account for tobacco use, and the said research by Filbey and her team was the first to examine the unique effects of each substance on the brain as well as their combined effects.

Future studies need to address the cumulative effects of substances, as the interaction between marijuana and nicotine may be complicated due to several mechanisms at work.  

Still, scientists said there was an association between smaller hippocampal brain volume and marijuana use. 

Although the size of the hippocampus was significantly smaller in both the marijuana group and marijuana plus tobacco group compared to that of individuals who used tobacco exclusively, the relationship to memory performance was unique(14).

What does a small hippocampal size mean?

According to researchers, recent human studies show smaller hippocampal volume in individuals with the stress-related psychiatric condition post-traumatic stress disorder (PTSD)(15).

Animal research, meanwhile, has provided compelling evidence that exposure to severe and chronic stress can damage the hippocampal formation(16).

Cannabis Use and the Brain

A study published in Drug and Alcohol Dependence examined the relationship between cannabis use and the brain.

However, the effect of cannabis on the brain was found to depend on various factors, including the ratio of THC to CBD, the two primary cannabinoids or constituents of cannabis. 

Researchers noted that higher THC and lower CBD was associated with hippocampal volume reduction indicating neurotoxic effects of THC and neuroprotective effects of CBD(17).  

Can another stimulant be a substitute for nicotine so CBD oil can be taken?

In a study that examined the potential adverse side effects and drug-drug interactions with CBD use, results indicated that stimulants-CBD interactions caused reduced appetite, weight decrease, and insomnia or sleep disturbance(18)

Sleep disturbances may also coincide with increased anxiety or mood changes, which should also not be managed by additional drugs as the potential for adverse side effects is high, the researchers of the same study said.

These effects should be considered in the assessment of risk vs. benefits of CBD therapy and those using CBD. Consumers are advised to be aware of potential safety issues with CBD use.

Thus, the best current strategy would be to avoid any stimulant when taking CBD.

Can CBD replace nicotine?

No study explicitly recommends CBD as a replacement for the stimulant, nicotine. However, CBD has been shown to possess some characteristics of nicotine as a stimulant.

Nicotine creates an immediate sense of calm and relaxation, so people smoke, believing that it reduces anxiety and stress. 

This feeling of relaxation is transient and soon gives way to withdrawal symptoms and increased cravings, according to an article by the Mental Health Foundation(19).

In the United States, more people are addicted to nicotine than to any other drug(20). According to Smokefree.gov of the National Cancer Institute (NCI), some people use smoking as a way to manage stress or other unpleasant feelings(21)

Meanwhile, CBD oil has been shown to be a promising health tool for managing stress and emotions. There have also been findings indicating the potential use of CBD oil to manage anxiety.

CBD has recently attracted interest for its anxiolytic (anti-anxiety) properties(22)

CBD, although a component of the cannabis plant, has also been shown to be non-psychoactive(23). This characteristic enables CBD to deliver its therapeutic benefits without the user experiencing a euphoric high. 

More importantly, CBD has been shown as a potentially useful treatment in nicotine dependence.

A study published in the New England Journal of Medicine on nicotine addiction indicated that some ingredients of cigarette smoke, aside from nicotine, contribute to nicotine addiction(24).

Study author, Dr Neal Benowitz of the University of California, San Francisco, noted: “In addition to delivering nicotine to the brain quickly, cigarettes have been designed with additives and engineering features to enhance its addictiveness.” 

Similarly, results showed that nicotine’s fast absorption rates and access into the brain produced an intense ‘rush’, which strengthened the drug’s effects. 

Inhaled nicotine rapidly enters the system through the lungs and goes into the brain within seconds. The fast absorption and entry into the brain cause a strongly-felt ‘rush’ and reinforce the effects of the drug, according to the researchers(25).

In a 2013 study published in the Addictive Behaviors journal, researchers tested the efficacy of inhaled cannabidiol (CBD) on smokers who wanted to stop smoking cigarettes(26).

The study was conducted on 24 test subjects over a period of one week. Twelve were given CBD, and the other twelve a placebo. 

When the test subjects felt the urge to have a cigarette, they were told to first use the CBD or placebo inhalant provided to them. 

Over the treatment week, placebo-treated smokers showed no differences in the number of cigarettes smoked. 

In contrast, those treated with CBD significantly reduced the number of cigarettes smoked by about 40% during treatment. 

The results of the studies suggest that CBD may be a potent stimulant that is non-addictive, unlike nicotine. However, further exploration is needed.

Still, a consultation with a doctor experienced in cannabis use is advised before replacing nicotine with CBD or before trying to combat nicotine dependence with CBD.

Smoking vs Vaping: Is one better than the other?

Some smokers might be enticed to use electronic cigarettes (e-cigarettes, vape pens, and other vaping devices) to ease the shift from smoking traditional cigarettes to not smoking at all(27). 

But is smoking e-cigarettes (vaping) a better method of using tobacco products?

Michael Blaha, M.D., M.P.H., director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, says, “Vaping is less harmful than smoking, but it is still not safe.”

E-cigarettes heat nicotine, flavorings, and chemicals to create an aerosol that vapers inhale. While e-cigarettes may contain fewer toxic chemicals than traditional cigarettes, the specific chemical constituents in e-cigarettes are unknown, says Blaha.

Also, there has been an upsurge of lung injuries and deaths linked to vaping.  As of Jan. 21, 2020, the Centers for Disease Control and Prevention (CDC) has confirmed 60 deaths in patients with e-cigarette or vaping product use-associated lung injury (EVALI).

“These cases appear to predominantly affect people who modify their vaping devices or use black market modified e-liquids. This is especially true for vaping products containing tetrahydrocannabinol (THC),” explains Blaha(28).

What is CBD vape juice, and how is it different from regular e-liquids?

CBD vape juice, CBD vape oil, CBD e-liquid, and CBD e-juice are different names used to describe a smokable CBD-based liquid that vapers can put into vaping devices. 

A CBD vape pen, vaporizer, or e-cigarette are standard vape tools used when vaping CBD. Always use only high-quality CBD products to vape CBD.

A CBD tincture (also called CBD oil, hemp extract or hemp oil) is formulated to be used orally. It is typically hemp oil produced by extracting CBD from hemp plants using CO2 or alcohol extraction methods. 

Then, the extract is diluted with a carrier oil like olive, hemp seed, or coconut. Other ingredients can be added for flavor, as well.

CBD vape juice is any vape juice that contains CBD instead of nicotine. A regular e-liquid usually contains propylene glycol, glycerin, nicotine, flavorings, and additives.

CBD vape juice may be a pure additive that mixes in with existing flavors, or it can be a  pre-mixed blend.

What is sub-ohm vaping? 

Sub-ohm vaping, also known as sub-ohming, is a style of vaping that produces massive clouds of vapor. Sub-ohm devices utilize low resistance coils that are less than one ohm, hence the name sub-ohm.

There are two types of vape tanks. The regular tank is excellent for vaping beginners, while the sub-ohm tank is recommended for the more experienced vapers.

Using a sub-ohm device is excellent for those who want an increased dose of CBD with every puff, although it is not a perfect system.

Conclusion

Giving up tobacco is one of the crucial steps people can take for their health, but it is also challenging. 

UCSF (University of California, San Francisco) Health reveals that 70 percent of smokers report wanting to quit. However, many of them wait until they develop a significant tobacco-related disease such as heart disease, cancer, or stroke.

Fortunately, tobacco addiction is treatable, and tobacco users who receive counseling and medication during their attempts to stop smoking are much more likely to succeed than those who do not get such support(29).

Meanwhile, CBD has been found to possess several health benefits. Aside from its anti-anxiety and antipsychotic characteristics, it is also non-addictive. 

However, it is not advisable to combine CBD with stimulants, like nicotine, due to the potential adverse side effects that may be caused by their interaction.

 Although research mentioned earlier indicated that CBD could also be a potentially useful treatment to nicotine dependence, there has been no study that explicitly recommends CBD as a nicotine replacement. 

A consultation with a doctor experienced in cannabis use is the best course of action before deciding to replace nicotine with CBD or before trying to combat nicotine dependence with CBD.


  1. Smokefree.gov. Stress and Smoking. Retrieved from https://smokefree.gov/challenges-when-quitting/stress/stress-smoking.
  2. Julien, R., Advokat, C., & Comaty, J. (eds.). (2011). A primer of drug action (12th ed.). New York: Worth Publishing. 
  3. Crippa et al. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. J Psychopharmacol. 2011 Jan;25(1):121-30. doi: 10.1177/0269881110379283. Epub 2010 Sep 9. DOI: 10.1177/0269881110379283; Pellati F, Borgonetti V, Brighenti V, Biagi M, Benvenuti S, Corsi L. Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer. Biomed Res Int. 2018;2018:1691428. Published 2018 Dec 4. doi:10.1155/2018/1691428.
  4. Brown JD, Winterstein AG. Potential Adverse Drug Events and Drug-Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use. J Clin Med. 2019;8(7):989. Published 2019 Jul 8. doi:10.3390/jcm8070989.
  5. Morgan, Celia & Das, Ravi & Joye, Alyssa & Curran, Helen & Kamboj, Sunjeev. (2013). Cannabidiol reduces cigarette consumption in tobacco smokers: Preliminary findings. Addictive behaviors. 38. 2433-2436. 10.1016/j.addbeh.2013.03.011.
  6. Alcohol and Drug Foundation. What is nicotine? Retrieved from https://adf.org.au/drug-facts/nicotine/.
  7. ibid.
  8. American Cancer Society. (2013). Other forms of tobacco favoured by young people. Retrieved from https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer.html.
  9. Julien, R., Advokat, C., & Comaty, J. (eds.). (2011). A primer of drug action (12th ed.). New York: Worth Publishing.
  10. Alcohol and Drug Foundation. E-Cigarettes. Retrieved from https://adf.org.au/drug-facts/e-cigarettes/
  11. DrugBank.ca. Nicotine. Retrieved from https://www.drugbank.ca/drugs/DB00184.
  12. Center for Brain Health, The UNiversity of Texas. Grant. I. Study Finds Nicotine Changes Marijuana’s Effect on the Brain. Retrieved from https://brainhealth.utdallas.edu/study-finds-nicotine-changes-marijuanas-effect-on-the-brain/.
  13. Filbey, F.M., McQueeny, T., Kadamangudi, S., Bice, C., & Ketcherside, A. (2015). Combined effects of marijuana and nicotine on memory performance and hippocampal volume. Behavioural Brain Research, 293, 46-53; Center for Brain Health, The UNiversity of Texas. Grant. I. Study Finds Nicotine Changes Marijuana’s Effect on the Brain. Retrieved from https://brainhealth.utdallas.edu/study-finds-nicotine-changes-marijuanas-effect-on-the-brain/.
  14. Center for Brain Health, The University of Texas. Grant. I. Study Finds Nicotine Changes Marijuana’s Effect on the Brain. Retrieved from https://brainhealth.utdallas.edu/study-finds-nicotine-changes-marijuanas-effect-on-the-brain/.
  15. Gilbertson MW, Shenton ME, Ciszewski A, et al. Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma. Nat Neurosci. 2002;5(11):1242–1247. doi:10.1038/nn958.
  16. Sapolsky RM, Uno H, Rebert CS, Finch CE. Hippocampal damage associated with prolonged glucocorticoid exposure in primates. J Neurosci. 1990;10:2897–2902; McEwen BS. In: The Cognitive Neurosciences. Gazzaniga MS, editor. MIT Press; Cambridge, Massachusetts: 1995. pp. 1117–1135.
  17. Demirakca T et al. Diminished gray matter in the hippocampus of cannabis users: possible protective effects of cannabidiol. Drug Alcohol Depend. 2011 Apr 1;114(2-3):242-5. doi: 10.1016/j.drugalcdep.2010.09.020. Epub 2010 Nov 2.DOI: 10.1016/j.drugalcdep.2010.09.020.
  18. Brown JD, Winterstein AG. Potential Adverse Drug Events and Drug-Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use. J Clin Med. 2019;8(7):989. Published 2019 Jul 8. doi:10.3390/jcm8070989.
  19. MHF. Smoking and Mental Health. Retrieved from  https://www.mentalhealth.org.uk/a-to-z/s/smoking-and-mental-health.
  20. American Society of Addiction Medicine. Public Policy Statement on Nicotine Addiction and Tobacco. Chevy Chase (MD): American Society of Addiction Medicine, 2008. 
  21. Smokefree.gov. Stress and Smoking. Retrieved from https://smokefree.gov/challenges-when-quitting/stress/stress-smoking.
  22. Crippa et al. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. J Psychopharmacol. 2011 Jan;25(1):121-30. doi: 10.1177/0269881110379283. Epub 2010 Sep 9. DOI: 10.1177/0269881110379283.
  23. Pellati F, Borgonetti V, Brighenti V, Biagi M, Benvenuti S, Corsi L. Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer. Biomed Res Int. 2018;2018:1691428. Published 2018 Dec 4. doi:10.1155/2018/1691428.
  24. Benowitz NL. Nicotine addiction. N Engl J Med. 2010;362(24):2295–2303. doi:10.1056/NEJMra0809890.
  25. ibid.
  26. Morgan, Celia & Das, Ravi & Joye, Alyssa & Curran, Helen & Kamboj, Sunjeev. (2013). Cannabidiol reduces cigarette consumption in tobacco smokers: Preliminary findings. Addictive behaviors. 38. 2433-2436. 10.1016/j.addbeh.2013.03.011.
  27. Blaha, M. 5 Vaping Facts You Need to Know. Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/5-truths-you-need-to-know-about-vaping.
  28. ibid.
  29. UCSF Health. Nicotine Dependence. Retrieved from https://www.ucsfhealth.org/conditions/nicotine-dependence
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