Do Young Smokers Prefer Apps or Face-to-Face Therapy—and How Does Cannabis Fit In?

Observational study of 98 young adult smokers at the University of Granada. 35 self-selected into app-based CBT, 63 into face-to-face CBT. Measures: nicotine dependence (FTND), behavioral and substance addictions (MULTICAGE CAD-4), cannabis dependence (SDS), and motivation (Decisional Balance Questionnaire). Logistic and stepwise regression analyses.

Understanding what undermines quit motivation in young smokers is essential for designing effective cessation programs. The finding that cannabis dependence reduces perceived disadvantages of smoking suggests these co-occurring conditions may need to be addressed together—young people who don't see smoking as problematic are unlikely to engage with cessation programs.

This connects to the broader cessation literature. RTHC-00166 found 80% of young vapers wanted help quitting but disagreed on methods—a preference diversity that this study's app vs. face-to-face split also reflects. RTHC-00154 and RTHC-00156 examined how cannabis use affects nicotine cessation outcomes; this study adds the motivational dimension, showing that cannabis dependence may reduce the perceived need to quit in the first place.

Small sample from a single Spanish university—limited generalizability. Self-selection into treatment format (not randomized). The study can't determine whether cannabis dependence causes reduced quit motivation or whether both reflect a common underlying factor. Spanish young adult smoking patterns may differ from other countries. The decisional balance framework captures perceived pros/cons but may not predict actual quit behavior.