Tobacco and Cannabis Use Disorders: Similarities, Differences and Therapeutic Approaches.

Antwi P.; Matheson J.; Le Foll B. · Annual review of pharmacology and toxicology · 2026

**Background & Methods** This is a narrative review article examining the pharmacological, neurobiological, and clinical features of cannabis use disorder (CUD) and tobacco use disorder (TUD). The review synthesizes current literature on the similarities and differences between these two commonly used substances, their co-use patterns, diagnostic criteria, and evidence-based treatment approaches. **Key Findings** • Cannabis and tobacco both produce use disorders through dopaminergic reward system involvement and neurobiological changes in motivational circuitry, with compulsive use patterns despite harm; however, they differ in specific neurobiological pathways, diagnostic profiles, and available pharmacotherapies. • Co-use of cannabis and tobacco is common and significantly influences disorder severity and clinical outcomes, with important implications for treatment planning and prognosis. • Approved pharmacological treatments exist for tobacco use disorder (such as nicotine replacement therapy and medications like varenicline and bupropion), whereas no FDA-approved medications currently exist for cannabis use disorder, though psychosocial interventions are effective for both conditions. **Dosage & Administration** Not reported. This review article does not focus on specific dosage or administration protocols for cannabis or tobacco use. **Safety & Adverse Effects** Not reported in detail. The review acknowledges that withdrawal symptoms are a shared feature of both CUD and TUD, and notes that mental health comorbidities are common to both disorders, but specific adverse effects profiles are not comprehensively detailed in the abstract provided. **Evidence Quality** As a narrative review article, this publication synthesizes existing literature rather than presenting original research data. The evidence quality is limited by the review format, which inherently reflects the authors' selection and interpretation of published studies. The review addresses an important clinical gap by comparing two prevalent substance use disorders using standardized diagnostic frameworks (DSM-5 and ICD-11), enhancing its clinical utility. However, the conclusions are constrained by the quality and scope of underlying primary literature. The 2026 publication date suggests inclusion of recent evidence, potentially improving contemporary relevance. Clinicians should view this as a comprehensive overview suitable for informing practice and identifying research gaps, rather than as definitive evidence for specific clinical interventions.

More recent cannabis research