First Combined Tobacco-Cannabis Quit Program Developed and Well-Received by Participants | Research

The takeaway

Researchers developed and pilot-tested the first group cessation program designed for people who want to quit both tobacco and cannabis simultaneously, finding positive acceptability from both participants and instructors.

Read this if you use both tobacco and cannabis and want to quit both at the same time.

First integrated cessation program for tobacco and cannabis co-users

What the researchers found

Through expert interviews, focus groups with former smokers, and an online survey, researchers confirmed strong demand for an integrated cessation program targeting both tobacco and cannabis. Current programs typically address only one substance.

The resulting six-session group program incorporated motivational interviewing, cognitive behavioral therapy, and self-control training. Both participants and instructors evaluated the program positively, particularly valuing the group discussions and modules on managing cravings, withdrawal, and high-risk situations during simultaneous cessation.

Why it matters

Tobacco and cannabis use are strongly interrelated, with many users co-smoking (mixing tobacco and cannabis or using both regularly). Addressing only one substance while ignoring the other can undermine cessation efforts. This was the first program designed to tackle both simultaneously.

The numbers in context

Six course sessions developed. Combined motivational interviewing, CBT, and self-control training. Expert interviews, focus groups, and online survey conducted in preliminary phase. Both participants and instructors evaluated the program positively.

How the study worked

Multi-phase development: preliminary study (expert interviews, user focus groups, online survey) to assess demand and content preferences; interdisciplinary expert team program development; acceptability evaluation by participants and instructors. Trial registered: ISRCTN15248397.

What this study cannot tell us

This was a development and acceptability study, not an efficacy trial. Positive acceptability does not guarantee the program will actually help people quit. The study did not include a control group or measure cessation rates. The experts and focus group participants who guided development may not represent all co-users.

How to read the evidence

Development and acceptability study only; no efficacy data yet.

When this study was published

Published in 2013. Integrated tobacco-cannabis cessation programs have continued to be developed and tested.

The bigger picture

In Europe especially, mixing tobacco and cannabis in joints is common practice. When someone quits cannabis but continues smoking tobacco in the same way, or vice versa, the behavioral and physiological associations can trigger relapse. An integrated program addresses this interconnection directly.

Questions still open

Does the integrated program produce better quit rates than substance-specific programs? Would the approach work for people using cannabis without tobacco? What modifications would be needed for different cultural contexts of co-use?

Common questions

Why quit tobacco and cannabis together?

The two substances are often used together, especially in Europe where mixing tobacco and cannabis in joints is common. Quitting one while continuing the other can trigger relapse because the smoking ritual, cravings, and social contexts overlap. An integrated approach addresses these shared factors.

What does the program include?

The six-session group program uses motivational interviewing (building motivation to change), cognitive behavioral therapy (identifying and changing patterns), and self-control training. Key modules cover managing cravings, dealing with withdrawal from both substances, and navigating high-risk situations during simultaneous cessation.

Read the original research

Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability.

Substance abuse treatment, prevention, and policy, 8, 33

View on PubMed ↗Publisher’s paper ↗

Citation

Becker, Julia; Hungerbuehler, Ines; Berg, Oliver; Szamrovicz, Maciej; Haubensack, Andreas; Kormann, Adrian; Schaub, Michael P. (2013). Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability.. Substance abuse treatment, prevention, and policy, 8, 33. https://doi.org/10.1186/1747-597X-8-33