Nicotine and Cannabis Co-Use are Associated with Higher Symptom Burden than Use of Either Drug Alone in Early Psychosis: Results from a Multisite Study

Background: Despite their high usage rates and associations with risk for psychosis and earlier age of symptom onset, few studies have examined relationships between nicotine and cannabis co-use and symptoms. Here we examined associations between symptom burden and cannabis/nicotine use/co-use in individuals with early psychosis (EP). Methods: This cross-sectional, multisite cohort study used data from 738 individuals (mean age 22 years, 62% male) from the Early Psychosis Intervention Network (EPI-NET). Relationships between cannabis and/or nicotine use and frequency (over the prior 30 day per

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