Can Young People Quit Vaping and Cannabis at the Same Time?

About a third of adolescent dual users achieved abstinence from both nicotine vaping and cannabis at 7 months—and quitting vaping appeared to help with quitting cannabis too.

Graham, Amanda L et al.·Substance abuse treatment·2025·Moderate EvidenceRandomized Controlled Trial·1 min read
RTHC-06580Randomized Controlled TrialModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
N=2,845
Participants
N=1,829 young adults and N=1,016 adolescents, US-based vaping cessation trials

What This Study Found

This analysis drew from two large text-message-based vaping cessation trials—one for adolescents and one for young adults. The overlap between vaping and cannabis use was enormous: 74.6% of adolescents and 59.2% of young adults in the trials also used cannabis.

At seven months, 31.7% of adolescents had quit both substances entirely. Among young adults, 15.6% achieved dual abstinence. These rates are encouraging given that neither trial specifically targeted cannabis use—the cessation support focused entirely on nicotine vaping.

The most intriguing finding was the link between vaping cessation and cannabis outcomes. Adolescents who successfully quit vaping were significantly more likely to also have quit cannabis compared to those who continued vaping. This suggests a gateway-out effect: successfully quitting one substance may build the confidence or break the behavioral patterns that sustain the other.

The text-message intervention itself didn't directly affect cannabis use outcomes, but it didn't need to—the act of quitting vaping appeared to carry over.

Key Numbers

Adolescents: 74.6% were dual users at baseline; 31.7% achieved dual abstinence at 7 months. Young adults: 59.2% were dual users at baseline; 15.6% achieved dual abstinence. Adolescents who quit vaping were significantly more likely to also quit cannabis.

How They Did This

Secondary analysis of two randomized controlled trials of text-message-based nicotine vaping cessation: one in adolescents (n = 1,016 with complete 7-month data) and one in young adults (n = 1,829). Participants categorized as Exclusive E-cigarette Users or Dual Users at baseline. Outcomes assessed at 7 months: dual abstinence, exclusive e-cigarette use, exclusive cannabis use, or continued dual use.

Why This Research Matters

Three-quarters of adolescent vapers in these trials also used cannabis—a co-use rate that's become the norm rather than the exception. Knowing that vaping cessation programs don't need to separately address cannabis (and may indirectly help with it) is practically useful for designing interventions. It also challenges the assumption that dual users are harder to treat.

The Bigger Picture

This complements RTHC-00154's finding that cannabis use didn't prevent vaping cessation in a clinical trial. Together, they suggest that the relationship between vaping and cannabis isn't a one-way escalation—quitting one may actually facilitate quitting the other. The much higher dual abstinence rate in adolescents versus young adults (31.7% vs. 15.6%) raises questions about whether earlier intervention is more effective or whether adolescent substance use patterns are simply less entrenched.

What This Study Doesn't Tell Us

Self-reported substance use (no biochemical verification for cannabis). Neither trial was designed to test cannabis cessation. The correlation between vaping cessation and cannabis cessation doesn't prove causation—a third factor (like motivation or life circumstances) could drive both.

Questions This Raises

  • ?Would adding even brief cannabis-focused content to vaping cessation programs boost dual abstinence rates further?
  • ?What explains the large gap in dual abstinence between adolescents and young adults?
  • ?Does the gateway-out effect work in reverse—does quitting cannabis help with quitting vaping?

Trust & Context

Key Stat:
Evidence Grade:
Secondary analysis of two large randomized controlled trials with 7-month follow-up, though cannabis outcomes were self-reported and not the primary study target.
Study Age:
Published in 2025 with data reflecting current vaping and cannabis products.
Original Title:
Dual abstinence from nicotine vaping and cannabis use among young people: secondary analyses from two U.S.-based randomized controlled trials of vaping cessation.
Published In:
Substance abuse treatment, prevention, and policy, 20(1), 48 (2025)Substance Abuse Treatment, Prevention, and Policy is a peer-reviewed journal focusing on substance use and its treatment.
Database ID:
RTHC-06580

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

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Cite This Study

RTHC-06580·https://rethinkthc.com/research/RTHC-06580

APA

Graham, Amanda L; Cha, Sarah; Do, Elizabeth K; Jacobs, Megan A; Edwards, Giselle; Papandonatos, George D. (2025). Dual abstinence from nicotine vaping and cannabis use among young people: secondary analyses from two U.S.-based randomized controlled trials of vaping cessation.. Substance abuse treatment, prevention, and policy, 20(1), 48. https://doi.org/10.1186/s13011-025-00679-1

MLA

Graham, Amanda L, et al. "Dual abstinence from nicotine vaping and cannabis use among young people: secondary analyses from two U.S.-based randomized controlled trials of vaping cessation.." Substance abuse treatment, 2025. https://doi.org/10.1186/s13011-025-00679-1

RethinkTHC

RethinkTHC Research Database. "Dual abstinence from nicotine vaping and cannabis use among ..." RTHC-06580. Retrieved from https://rethinkthc.com/research/graham-2025-dual-abstinence-from-nicotine

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.