Treating Alcohol Addiction Also Reduces Cannabis and Cigarette Use — Even When That's Not the Goal
Participants in an alcohol use disorder trial spontaneously reduced cigarette and cannabis use without being prompted, and cannabis reduction in early treatment was inversely associated with alcohol consumption.
Quick Facts
What This Study Found
Cigarette use declined significantly over 12 weeks (p=.002); cannabis decreased early (p=.006) then rebounded (p=.03); early cannabis reduction was negatively associated with drinks per drinking day, suggesting a compensatory relationship.
Key Numbers
102 participants (61M/41F); significant cigarette reduction (p=.002); cannabis decrease early (p=.006) then increase (p=.03); cannabis changes inversely associated with drinks/drinking day (p<.05).
How They Did This
Secondary analysis of a 12-week RCT of ibudilast for AUD (N=102), examining unprompted changes in cigarette and cannabis use and their associations with drinking outcomes.
Why This Research Matters
The finding that treating one substance problem can ripple across others challenges the single-substance treatment model — and suggests comprehensive substance use screening should be standard in addiction trials.
The Bigger Picture
The early cannabis reduction followed by rebound could represent a substitution pattern — patients may initially reduce all substances but then return to cannabis as a coping alternative to alcohol.
What This Study Doesn't Tell Us
Secondary analysis not powered for these outcomes; relatively small sample; co-occurring use patterns make it difficult to isolate individual substance effects; ibudilast effects on other substances unknown.
Questions This Raises
- ?Is the cannabis rebound a substitution effect?
- ?Would targeting all three substances simultaneously improve outcomes?
- ?Should AUD trials routinely track cannabis and tobacco use?
Trust & Context
- Key Stat:
- Evidence Grade:
- Secondary analysis of a well-designed RCT with appropriate statistical methods, but limited by small sample and post-hoc nature.
- Study Age:
- Published in 2026, contributing to the growing evidence for comprehensive substance use assessment in addiction treatment.
- Original Title:
- Reductions in cigarette and cannabis use during a randomized clinical trial for alcohol use disorder.
- Published In:
- Alcohol and alcoholism (Oxford, Oxfordshire), 61(2) (2026)
- Authors:
- Belnap, Malia A, McManus, Kaitlin R, Kirsch, Dylan E(2), Grodin, Erica N, Ray, Lara A
- Database ID:
- RTHC-08115
Evidence Hierarchy
Frequently Asked Questions
Does treating alcohol addiction affect other substance use?
Yes — participants in this alcohol treatment trial spontaneously reduced cigarette and cannabis use without being asked to, suggesting treatment effects can extend beyond the targeted substance.
Is cannabis use related to alcohol consumption?
This study found an interesting pattern: early cannabis reduction was associated with lower alcohol consumption, but cannabis use rebounded later in treatment — possibly as a substitute coping mechanism.
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Cite This Study
https://rethinkthc.com/research/RTHC-08115APA
Belnap, Malia A; McManus, Kaitlin R; Kirsch, Dylan E; Grodin, Erica N; Ray, Lara A. (2026). Reductions in cigarette and cannabis use during a randomized clinical trial for alcohol use disorder.. Alcohol and alcoholism (Oxford, Oxfordshire), 61(2). https://doi.org/10.1093/alcalc/agag006
MLA
Belnap, Malia A, et al. "Reductions in cigarette and cannabis use during a randomized clinical trial for alcohol use disorder.." Alcohol and alcoholism (Oxford, 2026. https://doi.org/10.1093/alcalc/agag006
RethinkTHC
RethinkTHC Research Database. "Reductions in cigarette and cannabis use during a randomized..." RTHC-08115. Retrieved from https://rethinkthc.com/research/belnap-2026-reductions-in-cigarette-and
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.