Smokers with cannabis use disorder reported the highest barriers to quitting tobacco across addiction, internal, and external domains, while smokers using cannabis without CUD had the lowest interest in quitting.
Tobacco cessation counselors, addiction treatment professionals, public health researchers, and clinicians managing patients who use both cannabis and tobacco.
What the researchers found
Adults with CUD had the highest total barriers to smoking cessation (score 20.3 vs. 15.2 for cannabis without CUD vs. 16.4 for no cannabis use), with significantly higher scores across addiction (p=0.03), external (p=0.02), and internal (p<0.001) barrier subscales.
Why it matters
As cannabis and tobacco co-use increases, understanding how cannabis use disorder specifically amplifies barriers to quitting smoking can help design targeted dual-use interventions.
The numbers in context
n=2,271 current smokers; total barrier scores: CUD 20.3, cannabis without CUD 15.2, no cannabis 16.4; CUD higher on all subscales (Addiction p=0.03, External p=0.02, Internal p<0.001); readiness/confidence similar across groups
How the study worked
National online survey of 2,271 US adults currently smoking cigarettes in 2023, examining associations between past 30-day cannabis use (with and without CUD) and smoking cessation outcomes using the Barriers to Cessation Scale.
What this study cannot tell us
Cross-sectional design; self-reported cannabis use and CUD; online convenience sample; cannabis use measured as past 30 days only; CUD assessment may not capture full spectrum; barriers measured don't include all possible factors.
How to read the evidence
Large national survey with validated instruments, but cross-sectional design and self-report measures limit causal inference.
When this study was published
Published 2026; survey conducted in 2023.
The bigger picture
The distinct patterns — lower interest in quitting among cannabis users without CUD vs. higher barriers among those with CUD — suggest these groups need different intervention approaches.
Questions still open
- Would treating CUD improve tobacco cessation outcomes? Do integrated cannabis+tobacco cessation programs outperform tobacco-only approaches? Does cannabis route of administration (e.g., blunts) affect cessation barriers?
Common questions
Does cannabis use make it harder to quit smoking?
Should tobacco cessation programs address cannabis use too?
Read the original research
The impact of cannabis co-use and cannabis use disorder on interest in and barriers to tobacco cessation.
Addictive behaviors, 175, 108609
Citation
Graham, Francis Julian L; Pravosud, Vira; Keyhani, Salomeh; Hoggatt, Katherine J; Ling, Pamela; Hasin, Deborah; Nguyen, Nhung; Cohen, Beth E. (2026). The impact of cannabis co-use and cannabis use disorder on interest in and barriers to tobacco cessation.. Addictive behaviors, 175, 108609. https://doi.org/10.1016/j.addbeh.2026.108609
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