Understanding the Clinical Pharmacology of Marijuana-Tobacco Co-administration (CANNIC)

Inclusion Criteria: Heart rate < 105 BPM* Systolic Blood Pressure < 160 and > 90* Diastolic Blood Pressure < 100 and > 50* *Considered out of range if both machine and manual readings are above/below these thresholds. Body Mass Index ≤ 38.0 (at investigator's discretion for higher BMI if no other concurrent health issues) Current regular user of cannabis who smokes or vapes cannabis or THC extracts at least three days a week for the past 3 months or more Test positive for D-9-tetrahydrocannabinol (THC) at screening and self-report of cannabis use Current user of inhaled forms of tobacco/nicotine (cigarette, cigars, e-cigarettes) who use the product daily for the past 3 months or more Saliva cotinine ≥ 30 ng/mL Exclusion Criteria: Unstable medical conditions: Heart disease Seizures Cancer Thyroid disease (okay if controlled with medication) Diabetes Hepatitis B or C or Liver disease Glaucoma Kidney disease or urinary retention An ulcer in the past year Active use of an inhaler for asthma or COPD Hypertension if uncontrolled (meaning participant has a diagnosis, but they are not taking medication/under treatment (e.g., diet or exercise plan) Drug/Alcohol Dependence Alcohol or illicit drug dependence within the past 12 months (currently in treatment) with the exception of those who recently completed an alcohol/drug treatment program Positive toxicology test at the screening visit (THC & prescribed medications okay) Opioid replacement therapy (including methadone, buprenorphine, or other) Psychiatric conditions Current or past schizophrenia, and/or current or past bipolar disorder Major depression, current or within the past year Major personality disorder Participants with current or past minor or moderate depression and/or anxiety disorders will be reviewed by the PI [study physician] and considered for inclusion History of psychiatric hospitalizations are not exclusionary, but study participation will be determined as per PI's [study physician's] approval Current regular use of any psychiatric medications with the exception of SSRIs and SNRIs and current evaluation by the PI that the participant is otherwise healthy, stable, and able to participate Congenital or acquired immunodeficiency disorders (i.e. HIV, congenital immune deficiency syndrome, chronic diseases) Other disorders (i.e. ICU, malnutrition, immunosuppressive therapy) Traumatic brain injury Recent onset or change (worsening) in cough, fever and/or abdominal symptoms (vomiting or pain) in the past two weeks Medications Use of medications that are inducers of nicotine metabolizing enzyme CYP2A6 (Example: rifampicin, dexamethasone, phenobarbital, and other anticonvulsant drugs) Concurrent use of nicotine-containing medications Any stimulant medications (ex. Adderall) generally given for ADHD treatment Other/Misc. Chronic Health Problems Oral thrush Fainting Other "life threatening illnesses" as per study physician's discretion Pregnancy Pregnancy (self-reported and urine pregnancy test) Breastfeeding (determined by self-report) Concurrent participation in another clinical trial Inability to communicate in English History of marijuana-induced psychosis or paranoia after smoking marijuana Scoring a 7 or higher on the Severity of Dependence Scale (SDS) for cannabis use Planning to quit smoking or vaping within the next 60 days Planning to quit cannabis use within the next 60 days Uncomfortable with getting blood drawn Willingness to abstain from tobacco smoking and all combustible products for 13 hours before admission Willingness to abstain from smoking/ingestion of cannabis 13 hours before Willingness to abstain from nicotine products 13 hours before each admission