Marijuana use did not affect success at quitting cigarettes, but alcohol use did
Among 739 smokers in cessation trials, marijuana use had no association with quitting success, while alcohol use after quitting increased smoking urges through positive-reinforcement cravings.
Quick Facts
What This Study Found
Researchers analyzed data from 739 adult cigarette smokers across three randomized cessation trials. Alcohol use after a quit attempt increased positive-reinforcement urges to smoke (the desire to smoke for pleasure), and these urges partially explained why drinkers were less likely to stay quit.
Marijuana use, however, was not associated with tobacco abstinence outcomes at any timepoint (weeks 12, 24, 36, or 52). This suggested that modifying marijuana use might not be critical to successful cigarette cessation.
Pretreatment alcohol use also predicted worse outcomes, but through a different mechanism than the positive-reinforcement urge pathway, indicating multiple routes by which alcohol undermines quit attempts.
Key Numbers
739 participants across 3 trials. Follow-up: weeks 12, 24, 36, 52. Marijuana use: no association with abstinence at any timepoint. Alcohol after quitting: increased positive-reinforcement urge, which mediated reduced abstinence.
How They Did This
Secondary analysis of 739 participants from 3 randomized smoking cessation clinical trials. Alcohol and marijuana use assessed pre-treatment and post-cessation. Biochemically verified 7-day point-prevalence smoking abstinence at weeks 12, 24, 36, and 52. Mediation analysis tested urge pathways.
Why This Research Matters
Clinicians often advise patients to stop all substance use when quitting cigarettes. This study suggested marijuana use does not need to be addressed for tobacco cessation to succeed, while alcohol use is a clear risk factor that does need attention.
The Bigger Picture
The practical implication was that smoking cessation programs should focus on alcohol management but need not require marijuana cessation as a precondition. This is relevant for patients in medical marijuana programs who also want to quit tobacco.
What This Study Doesn't Tell Us
Secondary analysis of existing trial data. Marijuana use was likely underreported. The sample may have had low rates of heavy marijuana use. Self-reported marijuana use without biochemical verification.
Questions This Raises
- ?Would heavy marijuana users show different results?
- ?Does vaping marijuana (which involves hand-to-mouth behavior similar to cigarettes) have different effects on smoking cessation?
- ?Should cessation programs actively address alcohol use?
Trust & Context
- Key Stat:
- Marijuana use: no effect on quitting cigarettes at any timepoint
- Evidence Grade:
- Secondary analysis of three RCTs with good sample size and longitudinal follow-up. Strong for the alcohol finding; marijuana finding limited by potentially low use rates.
- Study Age:
- Published in 2012. The relationship between cannabis and tobacco use has been studied more as dual-use patterns evolved.
- Original Title:
- Alcohol and marijuana use in the context of tobacco dependence treatment: impact on outcome and mediation of effect.
- Published In:
- Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 14(8), 942-51 (2012)
- Authors:
- Hendricks, Peter S(3), Delucchi, Kevin L(6), Humfleet, Gary L, Hall, Sharon M
- Database ID:
- RTHC-00572
Evidence Hierarchy
Enrolls participants and follows them forward in time.
What do these levels mean? →Frequently Asked Questions
Do I need to quit marijuana to quit cigarettes?
This study found no association between marijuana use and tobacco cessation outcomes. However, drinking alcohol after quitting cigarettes significantly increased smoking urges and relapse. Focusing on alcohol management may be more important than marijuana cessation.
Why does alcohol make it harder to quit smoking?
Alcohol increased "positive-reinforcement urges," the desire to smoke for pleasure. The social context of drinking often involves smoking, and alcohol reduces inhibition and decision-making quality, making it easier to give in to cravings.
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Cite This Study
https://rethinkthc.com/research/RTHC-00572APA
Hendricks, Peter S; Delucchi, Kevin L; Humfleet, Gary L; Hall, Sharon M. (2012). Alcohol and marijuana use in the context of tobacco dependence treatment: impact on outcome and mediation of effect.. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 14(8), 942-51. https://doi.org/10.1093/ntr/ntr312
MLA
Hendricks, Peter S, et al. "Alcohol and marijuana use in the context of tobacco dependence treatment: impact on outcome and mediation of effect.." Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2012. https://doi.org/10.1093/ntr/ntr312
RethinkTHC
RethinkTHC Research Database. "Alcohol and marijuana use in the context of tobacco dependen..." RTHC-00572. Retrieved from https://rethinkthc.com/research/hendricks-2012-alcohol-and-marijuana-use
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.