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The relatively stable co-use trends may reflect substitution dynamics whereby some individuals replace cigarettes with cannabis, preventing co-use from rising in tandem with cannabis-only use. Other researchers have also separately observed a similar trend where cannabis is increasingly used as an alcohol substitute

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Studies have shown that early use of marijuana may increase a persons risk of developing psychosis (a severe mental disorder in which there is a loss of contact with reality), including delusions, hallucinations, etc