Treating Cannabis and Tobacco Addiction at the Same Time

A combined computer-assisted treatment for cannabis and tobacco use disorders was feasible and did not negatively affect cannabis outcomes, while showing promising reductions in tobacco use.

Lee, Dustin C et al.·Drug and alcohol dependence·2015·Preliminary EvidencePilot Study
RTHC-00998Pilot StudyPreliminary Evidence2015RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Pilot Study
Evidence
Preliminary Evidence
Sample
N=32

What This Study Found

Researchers enrolled 32 people who met criteria for cannabis use disorder and also smoked tobacco daily in a 12-week program that simultaneously treated both addictions. The cannabis component used computer-assisted behavioral treatment, while the tobacco component added tailored counseling and nicotine replacement therapy.

Participants achieved an average of 3.6 consecutive weeks of cannabis abstinence, comparable to a historical control group that received cannabis treatment only (3.1 weeks). Over half (56%) initiated tobacco quit attempts, and 28% achieved at least two consecutive weeks of tobacco abstinence.

Tobacco use (cigarettes per day) decreased more in the combined treatment group than in controls, though formal tobacco abstinence rates were not statistically different.

Key Numbers

32 participants; 12-week treatment; 3.6 weeks mean cannabis abstinence (vs. 3.1 in controls); 78% completed at least one tobacco module; 44% started NRT; 56% attempted tobacco quit; 28% achieved 2+ weeks tobacco abstinence

How They Did This

Pilot study of 32 participants with cannabis use disorder and daily tobacco use. Received 12-week computer-assisted behavioral treatment for both substances, including nicotine replacement therapy for tobacco. Cannabis outcomes compared to a historical control group that received cannabis treatment alone.

Why This Research Matters

Cannabis and tobacco use frequently co-occur, and tobacco use predicts worse cannabis treatment outcomes. This study demonstrated that adding tobacco treatment does not undermine cannabis cessation efforts, addressing a common concern among clinicians.

The Bigger Picture

The tradition of treating one addiction at a time may be unnecessarily conservative. Integrated approaches that address multiple substance use disorders simultaneously could improve overall outcomes without compromising either target.

What This Study Doesn't Tell Us

Small sample without randomization. Comparison to historical controls introduces potential confounding. 12-week follow-up is short. No long-term outcome data. Selection bias in participants willing to address both substances.

Questions This Raises

  • ?Would a larger randomized trial confirm these findings?
  • ?Does quitting tobacco improve long-term cannabis cessation rates?
  • ?What is the optimal timing and intensity for integrated substance use treatment?

Trust & Context

Key Stat:
56% of participants attempted to quit tobacco during cannabis treatment
Evidence Grade:
Small pilot study without randomization, compared to historical controls. Demonstrates feasibility but cannot establish efficacy.
Study Age:
Published in 2015. Digital and app-based treatment tools have advanced considerably since this study.
Original Title:
Outcomes from a computer-assisted intervention simultaneously targeting cannabis and tobacco use.
Published In:
Drug and alcohol dependence, 155, 134-40 (2015)
Database ID:
RTHC-00998

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A small preliminary study to test whether a larger study is feasible.

What do these levels mean? →

Frequently Asked Questions

Should you quit cannabis and tobacco at the same time?

This study suggests it is feasible. Treating both simultaneously did not make cannabis outcomes worse, and many participants successfully reduced tobacco use. However, individual circumstances vary.

Why do cannabis and tobacco use often go together?

Many cannabis users also smoke tobacco, and tobacco use is associated with worse outcomes in cannabis treatment. The two substances share some neurobiological pathways and behavioral patterns, making co-use common.

Read More on RethinkTHC

Cite This Study

RTHC-00998·https://rethinkthc.com/research/RTHC-00998

APA

Lee, Dustin C; Budney, Alan J; Brunette, Mary F; Hughes, John R; Etter, Jean-Francois; Stanger, Catherine. (2015). Outcomes from a computer-assisted intervention simultaneously targeting cannabis and tobacco use.. Drug and alcohol dependence, 155, 134-40. https://doi.org/10.1016/j.drugalcdep.2015.08.001

MLA

Lee, Dustin C, et al. "Outcomes from a computer-assisted intervention simultaneously targeting cannabis and tobacco use.." Drug and alcohol dependence, 2015. https://doi.org/10.1016/j.drugalcdep.2015.08.001

RethinkTHC

RethinkTHC Research Database. "Outcomes from a computer-assisted intervention simultaneousl..." RTHC-00998. Retrieved from https://rethinkthc.com/research/lee-2015-outcomes-from-a-computerassisted

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.