Varenicline helped tobacco-cannabis co-users quit tobacco, while nabilone eased cannabis withdrawal
In a controlled study, the smoking cessation drug varenicline helped tobacco-cannabis co-users achieve tobacco abstinence (46% vs 24%), while the synthetic cannabinoid nabilone reduced cannabis withdrawal symptoms but didn't prevent relapse.
Quick Facts
What This Study Found
Varenicline doubled cotinine-verified tobacco abstinence (46% vs 24%) and reduced mood disturbance and cigarette craving. Nabilone attenuated cannabis withdrawal in both groups but did not affect cannabis relapse. Age of first cigarette and cigarette craving were independent predictors of cannabis relapse.
Key Numbers
Tobacco abstinence: 46% varenicline vs 24% placebo. Nabilone attenuated cannabis withdrawal but not relapse. Age of first cigarette and cigarette craving predicted cannabis relapse outcomes independently.
How They Did This
Two-phase study: 15-day outpatient phase with randomized active or placebo varenicline plus tobacco abstinence instruction, followed by 16-day inpatient phase with crossover nabilone/placebo and cannabis exposure, withdrawal, and relapse paradigms. Non-treatment-seeking tobacco-cannabis co-users.
Why This Research Matters
Tobacco and cannabis are frequently co-used, and tobacco use worsens cannabis cessation outcomes. This study is among the first to test medications specifically for this co-use pattern, finding that addressing tobacco (varenicline) may be key to improving cannabis outcomes.
The Bigger Picture
The finding that tobacco-related variables predicted cannabis relapse challenges the common approach of treating cannabis and tobacco use as separate problems. Addressing tobacco dependence may be a necessary component of cannabis cessation treatment for co-users.
What This Study Doesn't Tell Us
Small sample of non-treatment-seeking participants. Laboratory relapse model may not reflect real-world conditions. Short duration. Nabilone dosing may not have been optimized for relapse prevention.
Questions This Raises
- ?Would combining varenicline and nabilone produce better cannabis cessation outcomes than either alone?
- ?Should cannabis treatment programs routinely address tobacco use?
- ?Does the type of tobacco product (cigarettes vs vaping) affect the co-use relationship?
Trust & Context
- Key Stat:
- Varenicline: 46% vs 24% tobacco abstinence; tobacco craving predicted cannabis relapse
- Evidence Grade:
- Moderate: randomized design with biological verification, but small sample and non-treatment-seeking participants.
- Study Age:
- Published in 2019.
- Original Title:
- Varenicline and nabilone in tobacco and cannabis co-users: effects on tobacco abstinence, withdrawal and a laboratory model of cannabis relapse.
- Published In:
- Addiction biology, 24(4), 765-776 (2019)
- Authors:
- Herrmann, Evan S(10), Cooper, Ziva D(28), Bedi, Gillinder(10), Ramesh, Divya, Reed, Stephanie Collins, Comer, Sandra D, Foltin, Richard W, Haney, Margaret
- Database ID:
- RTHC-02072
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
If I use both tobacco and cannabis, which should I quit first?
This study suggests addressing tobacco may help with both. Varenicline improved tobacco abstinence, and tobacco-related factors (age of starting, craving) independently predicted cannabis relapse outcomes.
Can nabilone help with cannabis withdrawal?
Yes, in this study nabilone reduced cannabis withdrawal symptoms. However, it did not prevent cannabis relapse in the laboratory model, suggesting withdrawal relief alone may not be sufficient for long-term abstinence.
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Cite This Study
https://rethinkthc.com/research/RTHC-02072APA
Herrmann, Evan S; Cooper, Ziva D; Bedi, Gillinder; Ramesh, Divya; Reed, Stephanie Collins; Comer, Sandra D; Foltin, Richard W; Haney, Margaret. (2019). Varenicline and nabilone in tobacco and cannabis co-users: effects on tobacco abstinence, withdrawal and a laboratory model of cannabis relapse.. Addiction biology, 24(4), 765-776. https://doi.org/10.1111/adb.12664
MLA
Herrmann, Evan S, et al. "Varenicline and nabilone in tobacco and cannabis co-users: effects on tobacco abstinence, withdrawal and a laboratory model of cannabis relapse.." Addiction biology, 2019. https://doi.org/10.1111/adb.12664
RethinkTHC
RethinkTHC Research Database. "Varenicline and nabilone in tobacco and cannabis co-users: e..." RTHC-02072. Retrieved from https://rethinkthc.com/research/herrmann-2019-varenicline-and-nabilone-in
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.