Web-based tools briefly boosted readiness to quit tobacco and cannabis together | Research

The takeaway

Brief web-based interventions temporarily increased co-smokers' readiness to quit tobacco and cannabis simultaneously, but the effect faded by 8 weeks and did not change actual use patterns.

Read this if you use both tobacco and cannabis and want to understand approaches to quitting both.

Brief readiness boost faded by 8 weeks with no actual use changes

What the researchers found

In a three-arm randomized trial of 325 tobacco-and-cannabis co-smokers, all three web-based interventions (personalized feedback, motivational interviewing-based, and psychoeducation control) produced a significant short-term increase in readiness to quit both substances simultaneously. However, no differences emerged between the three approaches, and the readiness increase did not persist at the 8-week follow-up.

None of the interventions produced significant changes in actual tobacco or cannabis use frequency at any time point. The finding that even simple psychoeducation produced the same short-term motivational effect as more sophisticated personalized techniques suggests that brief engagement with the topic itself, rather than any specific intervention technique, drove the initial readiness boost.

Why it matters

Tobacco and cannabis co-use is common, and quitting one often leads to increased use of the other. Finding effective ways to motivate simultaneous cessation is important, though this study showed that brief web-based tools alone were insufficient to change behavior.

The numbers in context

2,467 assessed, 325 randomized. Short-term readiness increase: B = 0.33 (95% CI: 0.10-0.56, P = .006). No significant effect at 8-week follow-up (P = .69). No differences between intervention types. No changes in use frequency.

How the study worked

Three-arm randomized trial comparing: (1) personalized normative feedback based on dependence/use assessment, (2) motivational interviewing-based web intervention, and (3) psychoeducational information only (active control). 325 co-smokers were randomized from 2,467 screened website visitors. Readiness to quit was measured before, immediately after, and 8 weeks post-intervention.

What this study cannot tell us

High attrition from screening to randomization (325 of 2,467). The interventions were brief and fully automated. The 8-week follow-up may have been too short to detect delayed behavior change. Self-selected online participants may not represent all co-smokers.

How to read the evidence

Well-designed three-arm RCT, but the null behavioral outcome and lack of differential effects between arms limit the practical significance.

When this study was published

Published in 2014.

The bigger picture

The substitution effect between tobacco and cannabis is well documented. When co-smokers try to quit one substance, they often increase use of the other. While these brief web interventions did not solve this problem, they established that co-smokers can be reached online and that readiness is modifiable, even if briefly.

Questions still open

Would more intensive or longer web-based programs produce lasting change? Could combining online tools with in-person support improve outcomes? What maintains the substitution effect between tobacco and cannabis, and how can it be disrupted?

Common questions

Can online tools help people quit tobacco and cannabis at the same time?

This study found that brief web-based interventions temporarily increased readiness to quit both, but did not actually change use behavior. More intensive approaches may be needed.

Why is quitting tobacco and cannabis at the same time important?

When co-smokers try to quit only one substance, they often increase use of the other (the substitution effect). Simultaneous cessation avoids this problem but is harder to motivate.

Read the original research

Effectiveness of different Web-based interventions to prepare co-smokers of cigarettes and cannabis for double cessation: a three-arm randomized controlled trial.

Journal of medical Internet research, 16(12), e273

View on PubMed ↗Publisher’s paper ↗

Citation

Becker, Julia; Haug, Severin; Sullivan, Robin; Schaub, Michael Patrick. (2014). Effectiveness of different Web-based interventions to prepare co-smokers of cigarettes and cannabis for double cessation: a three-arm randomized controlled trial.. Journal of medical Internet research, 16(12), e273. https://doi.org/10.2196/jmir.3246