# Cannabis, nicotine led US adult substance use trends in 2025 > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/cannabis-nicotine-led-us-adult-substance-use-trends-in-2025/ > **Published:** 2026-08-12T12:10:24-04:00 | **Last Modified / Clinically Audited:** 2026-09-09T10:01:23-04:00 > **Clinical Summary:** 2025 data on cannabis nicotine co-use among adults. Clinical screening and risk assessment for primary care providers. --- ✦ New CED Clinical Relevance #67 Notable Clinical Interest Emerging findings or policy developments worth monitoring closely. ResearchPolicySafetyMental HealthTHCIndustryPain Why This Matters Clinicians need to recognize that cannabis and nicotine are now leading [substance use](https://cedclinic.com/stroke-risk-assessment-substance-use/) trends among US adults, requiring updated screening protocols and [patient education](https://cedclinic.com/medical-cannabis-patient-education-basics/) in primary care and mental health settings. This shift in prevalence patterns affects clinical decision-making around drug interactions, mental health comorbidities, and pregnancy counseling, as patients are increasingly likely to be using these substances. Understanding current epidemiologic trends enables clinicians to have informed conversations with patients about risks specific to cannabis potency and nicotine dependence while identifying populations most affected. Clinical Summary # Clinical Summary Recent longitudinal data from the Monitoring the Future panel study demonstrate that cannabis and nicotine use continue to rise among US adults in 2025, reflecting a significant shift in [substance use](https://cedclinic.com/stroke-risk-assessment-substance-use/) epidemiology that clinicians need to recognize. These trends suggest that cannabis is becoming increasingly normalized and prevalent in the adult population, potentially affecting the clinical presentation, comorbidity patterns, and [public health](https://cedclinic.com/cannabis-mold-contamination-risks-recall-safety/) burden that physicians encounter in their practices. The concurrent elevation of both cannabis and nicotine use raises concerns about polysubstance use, drug interactions, and compounded respiratory or cardiovascular risks that warrant clinical attention during patient assessments. Clinicians should be prepared to screen for and counsel on both substances, as their rising prevalence indicates they are becoming more entrenched in adult lifestyle patterns and may require integrated cessation or [harm reduction](https://cedclinic.com/can-you-mix-weed-and-alcohol/) strategies. Understanding these population-level trends helps contextualize individual patient [substance use](https://cedclinic.com/stroke-risk-assessment-substance-use/) within a broader epidemiologic framework and informs preventive counseling. Physicians should routinely inquire about both cannabis and nicotine use during office visits and consider the cumulative health risks when multiple substances are involved in a single patient. Dr. Caplan’s Take “What we’re seeing in the MTF Longitudinal Panel data reflects real shifts in how adults are using substances, and cannabis prevalence is certainly part of that picture, but I’d want to see the full methodology and peer review before drawing clinical conclusions about causation or [public health](https://cedclinic.com/cannabis-mold-contamination-risks-recall-safety/) impact.” Clinical Perspective 💨 As [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) continues to rise among U.S. adults alongside nicotine consumption, clinicians should be prepared to screen for and counsel on both substances during routine care. The concurrent use patterns documented in longitudinal data suggest that patients may not view cannabis and nicotine as distinct health risks, particularly given shifting social acceptability and variable legal status across jurisdictions. However, interpretation of prevalence trends requires caution, as increased reporting may reflect changing attitudes toward disclosure as well as actual behavior change, and long-term health outcomes—especially for cannabis—remain incompletely characterized in adult populations. Clinicians should integrate cannabis and nicotine use assessment into standard substance use histories, provide individualized counseling on potential harms (including respiratory effects, dependence risk, and drug interactions), and remain alert to the possibility of polysubstance use patterns that may complicate both diagnosis and treatment planning. 💬 Join the Conversation Have a question about how this applies to your situation? [Ask Dr. Caplan →](https://benjamincaplan.com/ask-dr-caplan) Want to discuss this topic with other patients and caregivers? [Join the forum discussion →](https://cedclinic.com/interact/discussion-forums/) Have thoughts on this? 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