Quitting smoking was linked to reduced cannabis use among US veterans

Veterans who quit cigarette smoking had 75% higher odds of also reducing cannabis use two years later, though quitting smoking did not improve psychiatric symptoms or pain.

Ban, Kaoon Francois et al.·PloS one·2024·Moderate Evidenceemulated trial
RTHC-05110Emulated trialModerate Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
emulated trial
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Quitting smoking was associated with improvement in cannabis use (adjusted OR 1.75, 95% CI 1.00-3.06), unhealthy alcohol use (OR 2.10), and cocaine use (OR 2.25). However, quitting smoking was not associated with improvement in depressive symptoms, anxiety, or pain.

Key Numbers

4,165 eligible smokers, 419 quitters, 2,330 continued smokers. Cannabis improvement OR: 1.75 (1.00-3.06). Alcohol OR: 2.10 (1.01-4.35). Cocaine OR: 2.25 (1.20-4.24). Opioid OR: 1.10 (not significant). Depression OR: 0.78 (not significant).

How They Did This

Emulated hypothetical randomized trial using longitudinal data from the Veterans Aging Cohort Study (2003-2015). Inverse probability weighting adjusted for confounding and selection bias among 4,165 HIV-positive and HIV-negative veteran smokers.

Why This Research Matters

The idea that quitting one substance helps with others has important treatment implications. This study suggests smoking cessation may cascade to reduced cannabis and other substance use, but psychiatric symptoms need separate intervention.

The Bigger Picture

The finding that substance use improved but psychiatric symptoms did not suggests these conditions may have different underlying mechanisms. Smoking cessation programs that add mental health support could address both pathways simultaneously.

What This Study Doesn't Tell Us

Emulated trial design does not guarantee causation. Veterans may not represent the general population. Self-reported smoking cessation and substance use. Cannabis improvement was borderline significant (lower CI = 1.00).

Questions This Raises

  • ?Does the substance use improvement sustain beyond two years?
  • ?Would adding psychiatric treatment to smoking cessation programs improve both substance and mental health outcomes?

Trust & Context

Key Stat:
OR 1.75 for cannabis improvement after quitting smoking
Evidence Grade:
Emulated trial design with inverse probability weighting is stronger than standard observational, but cannot fully establish causation.
Study Age:
2024 analysis of Veterans Aging Cohort Study data from 2003-2015
Original Title:
Does smoking cessation reduce other substance use, psychiatric symptoms, and pain symptoms? Results from an emulated hypothetical randomized trial of US veterans.
Published In:
PloS one, 19(7), e0298576 (2024)
Database ID:
RTHC-05110

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Frequently Asked Questions

Does quitting smoking help quit cannabis?

This study found veterans who quit smoking had 75% higher odds of also reducing cannabis use within two years, though the finding was borderline significant.

Did quitting smoking help with depression or anxiety?

No. Despite improved substance use outcomes, quitting smoking was not associated with improvement in depressive symptoms, anxiety symptoms, or pain.

Read More on RethinkTHC

Cite This Study

RTHC-05110·https://rethinkthc.com/research/RTHC-05110

APA

Ban, Kaoon Francois; Rogers, Erin; Khan, Maria; Scheidell, Joy; Charles, Dyanna; Bryant, Kendall J; Justice, Amy C; Braithwaite, R Scott; Caniglia, Ellen C. (2024). Does smoking cessation reduce other substance use, psychiatric symptoms, and pain symptoms? Results from an emulated hypothetical randomized trial of US veterans.. PloS one, 19(7), e0298576. https://doi.org/10.1371/journal.pone.0298576

MLA

Ban, Kaoon Francois, et al. "Does smoking cessation reduce other substance use, psychiatric symptoms, and pain symptoms? Results from an emulated hypothetical randomized trial of US veterans.." PloS one, 2024. https://doi.org/10.1371/journal.pone.0298576

RethinkTHC

RethinkTHC Research Database. "Does smoking cessation reduce other substance use, psychiatr..." RTHC-05110. Retrieved from https://rethinkthc.com/research/ban-2024-does-smoking-cessation-reduce

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.