Nearly half of medical cannabis patients who used tobacco reported reducing or quitting | Research

The takeaway

Among 650 Canadian medical cannabis patients who used tobacco or nicotine, 49% reported reducing use and 24.6% reported quitting after starting medical cannabis.

Tobacco cessation researchers, harm reduction advocates, and anyone interested in the relationship between cannabis and tobacco use.

49% of tobacco-using medical cannabis patients reported reducing tobacco use

What the researchers found

Of 650 current or former tobacco/nicotine users, 320 (49%) self-reported reductions in use after initiating medical cannabis, with 160 (24.6%) reporting no tobacco/nicotine use in the prior 30 days. Those who specifically intended to use cannabis to quit tobacco had nearly 3 times the odds of reducing use.

Why it matters

Tobacco remains the leading preventable cause of death globally. If medical cannabis genuinely helps some people reduce or quit tobacco, it could represent a novel harm reduction strategy, though this study's retrospective design means the association needs further investigation.

The numbers in context

2,102 total participants; 650 current/former T/N users; 49% reported reductions; 24.6% reported cessation; intent to quit via cannabis aOR = 2.79; age 55+ aOR = 2.56; >25 T/N uses/day aOR = 2.11

How the study worked

An online cross-sectional survey of 2,102 Canadian medical cannabis patients examined demographics, cannabis use patterns, and changes in tobacco/nicotine use before and after medical cannabis initiation. Univariate and multivariate logistic regressions assessed associations between key variables and tobacco reduction/cessation.

What this study cannot tell us

Cross-sectional retrospective design cannot establish causation. Self-reported data subject to recall bias. No biochemical verification of tobacco cessation. Self-selected medical cannabis patient population. No control group.

How to read the evidence

Large sample with multivariate analysis, but retrospective cross-sectional design and self-reported outcomes limit causal inference.

When this study was published

Published in 2021.

The bigger picture

The finding that intentional use of cannabis for tobacco cessation predicted greater odds of quitting is intriguing. It also challenges the common assumption that cannabis use necessarily promotes tobacco use.

Questions still open

Would a randomized trial confirm these associations? Which cannabis components or delivery methods are most effective for tobacco reduction? Why was involvement with traditional cessation treatments negatively associated with quitting?

Common questions

Did people who intended to use cannabis for quitting tobacco do better?

Yes. Those who specifically intended to use medical cannabis to quit tobacco had 2.79 times the odds of reducing use compared to those without that intention.

Did traditional quit methods help?

Surprisingly, involvement with traditional pharmacological or psychobehavioral cessation treatments was negatively associated with tobacco cessation in this sample (aOR = 0.39), though this likely reflects that people who had already failed other methods turned to cannabis as an alternative.

Read the original research

Self-reported reductions in tobacco and nicotine use following medical cannabis initiation: Results from a cross-sectional survey of authorized medical cannabis patients in Canada.

Journal of substance abuse treatment, 130, 108481

View on PubMed ↗Publisher’s paper ↗

Citation

Lucas, Philippe; Walsh, Zach; Hendricks, Peter S; Boyd, Susan; Milloy, M-J. (2021). Self-reported reductions in tobacco and nicotine use following medical cannabis initiation: Results from a cross-sectional survey of authorized medical cannabis patients in Canada.. Journal of substance abuse treatment, 130, 108481. https://doi.org/10.1016/j.jsat.2021.108481