Associations of Cannabis- and Tobacco-Related Problem Severity with Reward and Punishment Sensitivity and Impulsivity in Adolescent Daily Cigarette Smokers

Cannabis and tobacco use and related disorders have been separately associated with sensitivity to reward (SR), sensitivity to punishment (SP), and impulsivity. Given the frequent co-occurrence of cannabis and tobacco consumption in adolescents, it is important to understand how SR, SP, and impulsivity may relate to both cannabis use and tobacco use co-occurrences and problem severities. Presently, 65 adolescents (14-21 years, 65% male), including 36 adolescents with daily tobacco smoking and regular cannabis use and 29 non-smoking healthy controls (HCs), completed self-report questionnaires assessing substance use, addiction severity, SR, SP, and impulsivity. Adolescent smokers had decreased SP and increased impulsivity compared to HCs. SR and impulsivity were independent predictors of concurrent cannabis-related problem severity among smokers. These findings suggest that specific approach/avoidance motives and impulsivity warrant further investigation as potential treatment targets in adolescents who consume both tobacco and cannabis.