Tobacco increases the risk of mental illness – another reason to support “Toke Pure”.

Tobacco smokers are more likely to develop mental illness than non smokers apparently.

It has long been the view of this website that tobacco represents the biggest health threat to cannabis users and it’s a view that’s easy to justify: Tobacco is highly addictive and a known carcinogen, whatever the risks associated with cannabis use it cannot be a good idea to add those presented by tobacco into the mix. Yet this is precisely what most cannabis users in the UK (and other places) do, the tobacco joint has long been the “traditional” way to smoke cannabis and is sadly still the most common method used by tokers.

This is  why UKCIA has been trying – so far without success – to get drug advice agencies and in particular the government’s rather useless “Talk to Frank” advertising campaign to undertake something akin to the UKCIA “Toke pure” campaign. So far no “official” advice service has seen fit to support Toke pure – or to come up with their own version – although most now do advise users not to smoke with tobacco, but it’s all pretty low key. Talk to Frank actually make it plain that tobacco spliffs are the normal way to smoke cannabis.

Most people mix cannabis with tobacco and smoke it as a spliff or a joint.

Whereas this is probably true, it’s a pretty daft concept to re-enforce.

Now one of the worries about cannabis use given a great deal of publicity over recent years is the claim – possibility, call it what you will – that cannabis use can lead to mental ill health. One of the reasons for adopting an anti tobacco campaign for cannabis users is based on the addictive nature of tobacco leading to excessive use of cannabis as non-cigarette smoking tokers roll joints simply to satisfy a tobacco craving, hence leading to more cannabis use.

This new study seems to provide an even greater reason to develop a “Toke pure” type campaign; tobacco use in and of itself is apparently associated with higher levels of mental illness and much more besides.

So this blog makes no apology for dragging all this tobacco stuff up again, as a report in the Guardian carried the interesting headline on Monday 11th Ocober

Smokers ‘more likely’ to binge drink, eat badly and face mental illness

This was a report about a paper by Dr. Sarah Whitehead from the Cardiff Institute of Society and Health which found that:

half of all smokers drink more than official limits recommend, but under 40% of those who have never smoked do. That trend is especially pronounced in men. And while 35% of smokers binge drink, only 23% of non-smokers and 31% of ex-smokers do.

39% of non-smokers eat the five portions of fruit and vegetables a day everyone is advised, only 28% of cigarette users do. The differences are particularly stark in mental health. While 8% of both non-smokers and ex-smokers have been treated for some form of mental illness, 14% of smokers have been.

Now without wanting  to apply a Daily Mail style of reporting to this, it would seem that smoking tobacco almost doubles the risk of developing a mental illness. Now of course many of the lurid claims we’ve heard about the risk of cannabis causing mental illness have been carried out amongst a cannabis using population which co-uses tobacco. It’s been a feature of just about all the studies into cannabis and mental health that no consideration has been given for the role of tobacco as a confounding (ie complicating) factor, this would now seem to be a serious mistake if this report is to be believed.

An important health warning of course; correlation does not prove cause. It may be that some other influence causes people who go on to develop mental illness also to smoke, perhaps people who develop mental illness “get something” from the tobacco smoke that (for want of a better term) “normal” people simply don’t experience.  Indeed, the fact that the majority of people with severe mental illness smoke like chimneys comes close to proving there is something if not causal then certainly interactive with tobacco and mental illness. Strangely this is brushed under the carpet by mental health campaigners and even the mental health services, often justified by the apparently beneficial effects of smoking on the symptoms of mental illness which itself should suggest some kind of active drug link.

However, the fact that this association between tobacco and mental illness does seem to exist and the fact that tobacco is highly addictive surely clinches the argument that there needs to be a safer use campaign aimed at cannabis users to break this deadly tobacco link? The precautionary principle would seem to suggest that it’s worth doing even if the link isn’t actually proven, let alone for all the other reasons.

The report does more than “just” expose the the link with mental illness however, if also finds a link between tobacco use and heavy drinking. Now this shouldn’t come as a great surprise as tobacco and alcohol have long gone hand in hand – the “fag and pint down the pub” culture ran very deep in this country until impacted by the smoking ban recently, although the sight of smokers huddling together outside pubs in the deep midwinter shows how strong the link is still.

Where this affects the cannabis debate of course is the old mantra of prohibitionists that cannabis is a “gateway” drug, the first step on the ladder towards hard core drug addiction. It used to be a common sight to see reformed addicts wheeled out, now “free of drugs”, telling how they “started on cannabis” as they puffed away on a cigarette. In truth the first drug most people come into contact with is nicotine via tobacco smoking. It’s often the way people come into contact with cannabis as well actually.

Yes, it’s another example of an association which doesn’t prove anything.  But what is non the less true is that most if not all problem drug users – heavy drinkers, heroin addicts and yes, people with a cannabis problems – are also tobacco smokers, usually heavy tobacco smokers. On a personal level all – without exception – of the problem drug users I’ve known have been heavy tobacco users. Why is this? There might be a simple explanation.

Tobacco is a perfect “mixer” drug. It seems to do nothing in and of itself but it amplifies the pleasure derived from taking other drugs greatly. Hence a pint with a fag, or a cannabis spliff with tobacco is so very much more enjoyable than either without the tobacco. Ask any tobacco user, that’s the answer they’ll always give. It makes these drugs far more “moreish” than they are alone.

It’s odd then that the Misue of Drugs Act doesn’t include tobacco within its remit. The supposed aim of the MoD Act is to control any drug which is causing or is likely to cause a problem for public health, yet the government refuses to include tobacco (and alcohol) because (from the Drug Equality Alliance  website)

This stance recognises that whilst alcohol and tobacco pose health risks and may have anti-social effects, their use is embedded in society, and responsible use of alcohol and tobacco is possible and commonplace.”

Given the extreme addiction posed by tobacco and the serious risks to health it poses really justify excluding it from the drugs laws because of its widespread use? The problem is that the MoD Act is wrongly interpreted as simply being a tool of prohibition by politicians, whereas in fact it could be so much more – a genuine way to actually control drug use.

To argue that tobacco should be thought of as a drug and included in the drugs laws isn’t to argue that it should be prohibited in the same disastrous way that cannabis is, but that the MoD Act should be able to encompass proper regulation and control of a legal market as instruments of control. As has often been pointed out the exercise of controls on the legal use of tobacco has been very successful at reducing the use of tobacco without creating a black market selling an uncontrolled contaminated product by organised crime.

One great step that could be taken in the fight to reduce tobacco use would be to get cannabis users to quit the evil weed, but it needs a properly run campaign and the government won’t have any of it. Tobacco use is the elephant in the room when it comes to drugs policy.

Although other reports about Dr Sarah Whitehead’s study can be found through Google there doesn’t seem to be an abstract online – nor the full text. If someone can dig this out it would be appreciated.

18 thoughts on “Tobacco increases the risk of mental illness – another reason to support “Toke Pure”.

  1. Some very good points. If the government thinks it’s its business to promote clean needles, then this is just as valid.

    I’ve smoked “pure” for years. Even during my last bout of nicotine addiction (thankfully now over for a couple of years), I still smoked my weed pure in joints and my hash pure in a pipe.

    You get a much better buzz.

  2. Nicotine is a known antipsychotic chemical thats why people with mental disorders smoke like chimneys.

  3. From wikipedia:

    It has been noted that the majority of people diagnosed with schizophrenia smoke tobacco[citation needed]. Estimates for the proportion of schizophrenics who smoke range from 75% to 90%. It was recently argued that the increased level of smoking in schizophrenia may be due to a desire to self-medicate with nicotine.[75][76] More recent research has found that mildly dependent users got some benefit from nicotine, but not those who were highly dependent.[77] All of these studies are based only on observation, and no interventional (randomized) studies have been done. Research on nicotine as administered through a patch or gum is ongoing.

    When the metabolites of nicotine were isolated and their effect on first the animal brain and then the human brain in people with schizophrenia were studied, it was shown that the effects helped with cognitive and negative symptoms of schizophrenia. Therefore, the nicotinergic agents, as antipsychotics which do not contain nicotine but act on the same receptors in the brain are showing promise as adjunct antipsychotics in early stages of FDA studies on schizophrenia. The prepulse inhibition (PPI) is a phenomenon in which a weak prepulse attenuates the response to a subsequent startling stimulus. Therefore, PPI is believed to have face, construct, and predictive validity for the PPI disruption in schizophrenia, and it is widely used as a model to study the neurobiology of this disorder and for screening antipsychotics.[82] Additionally, studies have shown that there are genes predisposing people with schizophrenia to nicotine use.[83]

    Therefore with these factors taken together the heavy usage of cigarettes and other nicotine related products among people with schizophrenia may be explained and novel antipsychotic agents developed that have these effects in a manner that is not harmful and controlled and is a promising arena of research for schizophrenia.

  4. Self-medication article on wikipedia:

    Food can also be medicine have recently found out about food containing melatonine a sleep hormone. So by eating walnuts and bananas before bedtime i sleep better (and not eating food with melatonine for brakfast makes me more awake during the day 🙂

  5. Hi Sweetleaf

    Nicotine is a known antipsychotic chemical thats why people with mental disorders smoke like chimneys.

    Toacco use seems to act against the workings of some antipsychotic drugs

    Several studies have reported that smokers require higher levels of antipsychotics than nonsmokers (7,31,35). Smoking can lower the blood levels of some antipsychotics by as much as 50 percent, requiring a corresponding increase in dosage to achieve therapeutic blood levels. For example, Ziedonis and associates (29) found that the average antipsychotic dosage for smokers in their sample was 590 mg in chlorpromazine equivalents compared with 375 mg for nonsmokers.

    This is all complicated stuff which I don’t pretent to understand, but what is clear is that tobacco is certainly not a passive substance when it comes to brain chemistry.

  6. I concur with the idea that mental health patients smoke more than others (from many years of personal experience visiting people on psychiatric wards) but not really possible to say what the cause is. On the subject of smokers being more likely to have unhealthy lifestyles and diets – this seems a little obvious ! People who care more about their health are unlikely to smoke so that solves that association.

    On the subject of cannabis and tobacco – Cannabis is about as harmful as coffee – if you smoke it then it becomes more harmful – if you mix it with tobacco it becomes significantly more harmful and also addictive. Most research neglects to mention the habits of the users studied but if it is UK then it is probably a tobacco mixture – if USA then it is most likely just cannabis.
    We are talking about 3 different substances really


    It suits those seeking to hide the truth to keep the blurring of the categories in place but category 3 is probably deserving of much of the reputation cannabis (cat 1/2) has for addictiveness and adverse effects on health

    Eat IT, Drink IT or Vaporise IT or best of all ….. leave it alone 😎

  7. TooMuchCoffeeMan (great comic) but seriously coffee isnt good for your brain, was a heavy coffee drinker over a few cold winter months, then i quit but drank one cup after a few weeks and almost had a epileptic seizure sort of a flashing visual disorder. No more coffee for me. Personally I only vape the buds and make muffins with the duff. Cannabis is natural medicine, but still medicine so take with care. Good for ex. sleep, pain, depression. But I now have a rule of 3 months clean then 3 months on weed but then also clean Tuesdays and Thursdays. Seems to be working for me and my condition which is life in geneneral 😉 If you suspect people to have mental problems get them help before its to late (people can go seriously crazie). Dont let them self medicate with the frustrating cocktail of alcohol, tobacco and weed, and maybe other stuff. Maybe its a bit too taboo to have problems with coping with anger and feelings and other more serious mental disorders.

  8. One Further Point, Toke Pure ,best idea. However Toke pure is something to aim for. Sadly i know from my City at 50 euro for 2 odd grams of’s not going to happen any time soon. Yes i agree with it totaly, as a nicotine addict. I totaly agree in fact. I’m sure if Cannabis were legal id be able to toke tobbacco free. Im posative many would but without a legal means to grow our own or buy it from a licenced Provider Toke pure remains the Goal. Me personaly ive given up at times for weeks but the drug addict in me gets bored. That said if i had Cannabis when needed rather then when available id be able to Stop my personal madness. Like i said I agree toke pure is the Best option open to us but thanks to Our uncaring Governments and the general public we are stuck in a Catch 22 position. People like me could quite nicotine for ever but do they realy want us quiting a drug that kills mainly the poor, not really you have to think!.

  9. As Derek rightly says, the elephant in the room is tobacco– let me go on to say marketing tobacco addiction to minors is the #1 plague genocide conspiracy in the history of the planet. In today’s world its central support pillar on which the entire empire depends is the high-profit hot burning overdose 700-mg. “commercial” $igarette.

    The hotburnhucksters have succeeded in getting a majority of Europeans to think the English word “joint” means the joining of cannabis and tobacco in the same $igarette. Look at the first paragraph of the article, “Joint”, in the Nederlands language division of Wikipedia. I have been replacing a three-part illustration, showing how to mix tobacco and cannabis in a joint, with a two-parter showing how to roll one with just green-looking cannabis, on various WP “Joint” articles which is tricky because sometimes you have to adjust the captions in their language. Help is appreciated.

    phrtao, hate to disappoint you, or maybe you already know that though in the USA a joint “is most likely cannabis”, there is also something called a “blunt” where the user rolls up cannabis in a $igar skin which contains– guess what– nicotine! In the 90’s various monster corporations– you know their names– fed money into the music business to assdure that “(w)Rap” artists mentioned “blunts” in the lyrics of their songs. Now at a bus shelter or even on a bus you can find a pile of tobacco, a little baggy and maybe even a little paper band telling what $igar was cru$ified. The poor young puffsucker paid $10 for the baggy of weed and $1 for the $igar and smoked it away in minutes, that’s my definition of insanity.

    BINGE DRINKING– this is part of the Oligopoly’s Grand Plan for surviving decades longer. Kids are scared into trying to assure “coolness”, i.e. immunity to being teased, picked on, beat up and shot at, by appearing at some party and proving they can drinik as many beers as the other guys do. Then they suffer hangover, headache, etc. and someone tells them “a $igarette or two” will get rof the hangover and help them stay awake all night studying for the Big Test on which their grade point average and admittance to Ivy League and the world of high paying jobs depend(s). That is the beginning of Nicotine Dependency is many cases. That’s why Big 2WackGo doesn’t want to see alcoholism go down, and why Ronald “Chesterfield is my $igarette” Reagan, Margaret “Tobacco Institute” Thatcher and Pope “Art Treasures of the Vatican Exhibit sponsored by Philip Morris” John Paul 2 shot the Soviet Union out from under Mikhail Gorbachev who was threatening to “do something about alcoholism.”

  10. APOLOGY: in the above, “a $igarette or two will get rof the hangover” should read “get rid of the hangover”. The five-minute warning on this anonymous big city computer excised the “id” from my analysis.

    “First drug most people come in contact with is nicotine.” This begins when your mother, at puberty when YOU were eggforming, inhaled nicotine from any source. In the 40’s on the radio program “Lucky Strike Hit Parade” girls in the studio audience were coached to scream when “Frankie” Sinatra stepped out to light up a $igarette and $ing:

    Light up a lucky, it’s light-up time,
    Be happy go lucky, it’s light-up time,
    For the taste that you like,
    Light up a Lucky Strike,
    Relax, it’s light-up time.

    (Note that the word “LIE” appears six times, reinforced by Luck, Luck and Lax. Dr. Pack-a-day Goebbels must have liked that.)

    Now millions of boys listening to the radio at home hoping to learn how to get girls were learning from Frankie that you have to light up a $igarette and fill the air with nicotine which will be in the cytoplasm of 20,000 eggs within seven seconds. By the 1960’s over 50% of young adult males in USA were hooked on $igarettes.

    “Their use is embedded in society”– as excuse for not including tobacco and alcohol in drug prohibitions. This very Embeddedness in Society is the achievement on which the tobacco industry spent a $trillion over the last two centuries in form of hatefearteasing oops, “ad ver tising”. heh heh. Then there’s the money they spent on lobbyists and contributions to the politicians’ campaigns etc etc.

    “Very successful at reducing the use of tobacco”– shall we congratulate ourselves? In USA for example addiction fell from over 40% to under 20%. Enter Stephen Levitt, “Freakonomics”. He suggests the drop in crime rates, for which politicians like Giuliani were given credit, neatly matches the period when the children aborted since 1973 (Roe vs. Wade) would have been reaching their late teens. These are children who were aborted because their mother didn’t want a child, didn’t feel ready to do the parenting, felt guilty about nicotine qaddiction etc. The very children who would have been most at risk to grow up criminal. Oh yes, most at risk to get hooked on nicotine $igarettes! Who really deserves credit for the tobacco addiction reduction– abortionists??

    (Note: certain right wing talk shows say God is angry over 40,000,000 abortions in the USA since 1973. In the same period there were 400,000,000 abortions in China under the one-child-per-family policy. Would these right-wingers want an unstable, crime-ridden China of 1,800,000,000 facing us today?)

    Summary: the #1 reason for cannabis prohibition is to protect the hot burning overdose nicotine $igarette empire from immediately richly deserved total extermination. Cannabis can (a) help some addicts kick the nicotine habit by replacing tobacco with cannabis and (B) help nicotine addicts discover the vaporizer, the one-hitter and other Downdosage Revolution devices already known to many cannabis users.

  11. “guess what– nicotine! In the 90′s various monster corporations– you know their names– fed money into the music business to assdure that “(w)Rap” artists mentioned “blunts” in the lyrics of their songs”


    Sorry tokerdesigner, your heart appears to be in the right place, but you are quite frankly raving!

  12. I admit the claim about the money is a hypothesis. The whole thing could happen “unconsciously” i.e. (w)Rappers who have equipped themselves with Significant names like Tupac and Cool just “sense” they will get gigs easier if they mention something in a song that helps sell tobacco.

    “It must be money or…”– how do you explain something like the 2004-5 findings that 89% of all Bollywood movies (and Bollywood makes more feature movies than any other country on the planet) contain depiction of “tobacco use” and that in 75% the stars of the picture were handling the tobacco (almost always $igarettes)?

    Often the sums reported given to political candidates seem small, for instance in US Presidential race 2008 “Crack down on pot” Giuliani got the most tobacco money with $100,000 which seems small compared to spending $hundreds of millions in an election. I think the key is that this gift buys the company the far more valuable “right” to send an EXQuisitely trained lobbyist to hang out with the candidate and his staff, schmooze with everybody and create an “atmosphere” of concensus on what should be done, which will of course be whatever helps tobacco companies keep getting more kids hooked on nicotine.

    In USA Republicans get twice as much tobacco money as Democrats. Would-be House Speaker John Boehner (R., Ohio) has an advisory council on which sit a man named Gates from Philip Morris and one John H. Fish listed as a former staffworker for Mr. Boehner and now “Vice President for Legislative Affairs” at R. J. Reynolds (note the “revolving door”). Now you see who will be in charge if the RauchpuffliCons win, pardon my fr—-.)

  13. I agree about the use of ‘Blunts’ and almost put this in my original post but it does not change the fact that traditionally cannabis is smoked separate from tobacco in USA. A blunt has a smaller tobacco proportion than the traditional British ‘spliff’ which has somewhere between 50% and 90% tobacco (Often from a cigarette).

    On the idea of not being able to afford to ‘toke pure’ – eventually you will actually use less weed – since you will smoke fewer joints every day e.g some one I know used to –

    Smoke 10 joints a day (approx. 50/50 mix) – 15 grammes weed per week

    Then quit tobacco and smoked 6 joints per day (pure cannabis) – 20 grammes weed per week

    This dropped off to 3 joints a day after a couple of months- 10 grammes weed per week (note less than when smoking with tobacco)

    Then he used his vaporiser more and more (better hit off less weed) – eventually he had 3 vaporisers a day and reduced consumption to 5 grammes per week ! and was higher, happier and healthier.

    Hope this helps make the case for sticking with toking pure – it is a transition process and not easy but it can be done. Unfortunately no official organisation will ever tell you this.

  14. Phrtao:

    On the idea of not being able to afford to ‘toke pure’ – eventually you will actually use less weed

    I meant to come back on this comment made by Declan that quitting tobacco and using pure cannabis instead of smoking joints would be more expensive – nothing could be further from the truth.

    Tobacco is often thought of as just being a passive “filler” used to pad out the spliff and dilute the cannabis, thus making the weed go further.

    Actually it drives consumption, tobacco addicted tokers often smoke for the tobacco hit rather than the cannabis, they smoke more often and more regularly. It is rare – almost unknown for a tobacco joint smoker to put a spliff out half way through for example. Pure cannabis toking is entirely different; it’s only done for the cannabis hit. Pure tokers often let a half smoked pipe or whatever go out, to be relit later.

    In the experience of UKCIA, which is largely based on reports from many people who have quit tobacco and also on personal experience cannabis consumption drops by around 50% when the tobacco is kicked. So not only do you use less cannabis, you also don’t have to buy the tobacco, so you end up spending a lot less money.

    You also have a far less demanding habit without the main driving force of the physical and psychological addiction of the tobacco hit or the very real health damaging effects of tobacco.

  15. It is a challenge giving up that mixture – harder than quitting just tobacco – but well worth it. This is the real public health problem associated with cannabis use but education (not Prohibition) is the only way to solve it.

    One other point my friend found out just how poor some of the weed was when the tobacco was not there to mask the awful taste and keep it burning when wet – this may of course make it even more difficult for many people to attempt giving up tobacco.

  16. Good point about the tobacco masking impurities in weed. For 3 years I’ve been trying to insert this various ways into Wikipedia cannabis-related articles and other editors kept throwing it out as “OR=Original Research”, “POV=not a Neutral Point of View” or on grounds that proper sources are not cited.

    If you can find any research publications which nail this down and get the citations into WP articles, well you’ll be saving millions of lives as we know. By the way on Bing etc. for “Cannabis smoking” the #1 (most consulted) source listed of millions is the Wikipedia article; #2 is UKCIA!

  17. It was a pleasure to reread this thread, especially to be reminded that Derek and Peter Reynolds agree on something!

    The riddle of why schizophrenics and European cannabis users disproportionately smoke tobacckgo $igarettes: I am drawn to think they are trying to self-medicate their way out of a feeling of drowsiness and its consequent vulnerability. Nicotine precipitates a reaction in which glycogen from the liver is converted into glucose in the bloodstream (“Pleasure” really means Bloodsugar), which, reaching the brain (which runs on sugar), causes wakefulness (but not wisdom, otherwise they’d quit).

    Typical early victim: a youngster hoping to be alert and ready with a retort when taunted by a bully at some “high” school. Or able to stay awake all night studying for Finals. In this way school and bully, like pincers, co-manipulate children into addiction, and politicians say, “It is embedded in society, nothing can be done.”

    I think (prove me wrong) that not cannabis but carbon monoxide– from faulty “smoking” technique– is causing the drowsiness (“Gee, I’m stoned!”) attributed to cannabis, which many nicotine-“joint”-smokers are trying to medicate away (before someone notices how drowsy they are and accuses them of being “stoners”).

    The cure for this, and key to Toke Pure, is a single-toke utensil which admits 25-mg. of only cannabis, making the tobacckgo supplement irrelevant. Conservatives and Liberal Democrats worried over deficits and unemployment should consider promoting a private sector One-hitter manufacturing industry to replace the present-day corporate $igarette oligopoly and eliminate the disastrous National Health Service costs resulting from $igarette addiction.

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