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

The takeaway

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.

Parents and clinicians wondering whether to address vaping and cannabis separately or together, and young people who use both substances.

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

Who was studied

N=1,829 young adults and N=1,016 adolescents, US-based vaping cessation trials

What this study cannot 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.

How to read the evidence

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.

When this study was published

Published in 2025 with data reflecting current vaping and cannabis products.

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.

Replication

Not stated in abstract.

Funding

Not reported in abstract.

Conflicts of interest

Not reported in abstract.

Questions still open

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?

Read the original research

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

Substance Abuse Treatment, Prevention, and Policy is a peer-reviewed journal focusing on substance use and its treatment.

View on PubMed ↗Publisher’s paper ↗

Citation

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