Using blunts during a cigarette quit attempt did not significantly reduce chances of quitting | Research

The takeaway

Among 500 Black adults in a smoking cessation trial, those who used blunts (cannabis-tobacco wraps) had similar quit rates to non-blunt users at both 12 and 26 weeks, regardless of whether they received varenicline or placebo.

Smoking cessation counselors, researchers studying tobacco disparities, and clinicians treating Black adult smokers

15% used blunts; quit odds were similar to non-blunt users

What the researchers found

Of 500 participants, 75 (15%) reported blunt use during the study. Blunt users had similar odds of quitting at Week 12 (OR 0.68, 95% CI 0.31-1.5) and Week 26 (OR 0.84, 95% CI 0.38-1.87) as non-blunt users. There was no interaction between blunt use and varenicline treatment on cessation outcomes.

Why it matters

Blunt use has been a concern in cessation research because the nicotine in tobacco wraps could undermine quit attempts. This finding suggests blunt use may not be the barrier to quitting that clinicians feared.

The numbers in context

500 participants (300 varenicline, 200 placebo); 75 (15%) used blunts; mean age 45.6; 42% female; quit odds at Week 12: OR 0.68 (95% CI 0.31-1.5); Week 26: OR 0.84 (95% CI 0.38-1.87); no treatment interaction

How the study worked

Secondary analysis of a double-blind, placebo-controlled RCT comparing varenicline (n = 300) to placebo (n = 200) for smoking cessation among Black adults. Blunt use was assessed at baseline and weeks 4, 8, 12, 16, and 26. Abstinence was verified by salivary cotinine.

What this study cannot tell us

Secondary analysis with relatively small blunt user subgroup (75); may be underpowered to detect meaningful differences; blunt use was not the primary study focus; cannot assess impact of blunt frequency or quantity; results specific to Black adults

How to read the evidence

Secondary analysis of a well-designed RCT with biochemical verification, but limited by small blunt user subgroup and potential lack of statistical power.

When this study was published

2024 study

The bigger picture

For Black adults who use blunts, this finding suggests they should not be excluded from or discouraged from cigarette cessation efforts. However, blunts still expose users to combusted tobacco products.

Questions still open

Would targeting all combustible products (including blunts) simultaneously improve overall cessation? Does blunt use change after cigarette cessation?

Common questions

Did using blunts make it harder to quit cigarettes?

Not significantly. Participants who used blunts had similar quit rates at both 12 and 26 weeks compared to those who did not use blunts. The odds ratios (0.68 and 0.84) suggested a slight numeric disadvantage but did not reach statistical significance.

Did varenicline work differently for blunt users?

No. There was no interaction between blunt use and varenicline treatment, meaning the medication appeared to work similarly regardless of whether participants also used blunts during their quit attempt.

Read the original research

The impact of blunt use on smoking abstinence among Black adults: Secondary analysis from randomized controlled smoking cessation clinical trial.

Addictive behaviors, 148, 107877

View on PubMed ↗Publisher’s paper ↗

Citation

Lambart, Leah; Nollen, Nicole L; Mayo, Matthew S; Funk, Olivia; Leavens, Eleanor; Cruvinel, Erica; Brown, Alexandra; Ahluwalia, Jasjit S; Sanderson Cox, Lisa. (2024). The impact of blunt use on smoking abstinence among Black adults: Secondary analysis from randomized controlled smoking cessation clinical trial.. Addictive behaviors, 148, 107877. https://doi.org/10.1016/j.addbeh.2023.107877