Clinicians Say Tobacco Cessation Should Be Integrated Into Cannabis Treatment Services | Research

The takeaway

Focus groups with clinicians in Spain found that tobacco cessation is rarely addressed in cannabis treatment settings, despite overlap between the two habits and potential benefits of integrated care.

Healthcare providers working in addiction treatment and policymakers designing integrated substance use services.

5 themes identified for integrating tobacco cessation into cannabis care

What the researchers found

Five themes emerged from clinician focus groups: individual characteristics, clinician characteristics, intervention models, organizational healthcare models, and health policies. Clinicians emphasized that integrating tobacco cessation into cannabis treatment could reduce chronic stigma and improve overall health outcomes, but organizational fragmentation and lack of training were barriers.

Why it matters

Many cannabis users also smoke tobacco, often mixing the two. Addressing tobacco use within cannabis treatment settings represents a missed opportunity for reducing overall health harms, particularly respiratory risks from smoked cannabis-tobacco mixtures.

The numbers in context

15 clinicians (12 female, 3 male) in 3 focus groups. 5 main themes and 17 subthemes identified.

How the study worked

Qualitative study with 15 clinicians in three focus groups in Catalonia, Spain. Two groups had extensive experience with tobacco cessation in substance use populations; one group did not. Thematic analysis identified patterns across experienced and inexperienced groups.

What this study cannot tell us

Small qualitative study limited to one region of Spain. Clinician perspectives may not reflect patient experiences or preferences. The healthcare system context in Catalonia may differ from other settings.

How to read the evidence

Small qualitative study providing clinician perspectives. Hypothesis-generating rather than definitive.

When this study was published

Published in 2025.

The bigger picture

Healthcare service fragmentation means that tobacco cessation and cannabis treatment often operate in silos. This study argues that bridging these services could improve outcomes for the large population of people who use both substances.

Questions still open

Would integrated tobacco-cannabis treatment improve quit rates for either substance? Do patients want these services combined, or do they prefer separate treatment paths?

Common questions

Why address tobacco in cannabis treatment?

Many cannabis users mix cannabis with tobacco or smoke both. Addressing tobacco alongside cannabis could reduce respiratory harms and improve overall health outcomes for this population.

What barriers did clinicians identify?

Key barriers included fragmented healthcare services, lack of clinician training in dual tobacco-cannabis intervention, and organizational models that treat each substance separately.

Read the original research

Clinician's perceptions and experiences with tobacco treatment in people who use cannabis: a qualitative study.

Substance abuse treatment, prevention, and policy, 20(1), 3

View on PubMed ↗Publisher’s paper ↗

Citation

Martínez, Cristina; Pla, Marga; Feliu, Ariadna; Enríquez, Marta; Saura, Judith; Cabezas, Carmen; Colom, Joan; Suelves, Josep M; Mondon, Sílvia; Barrio, Pablo; Andreu, Magalí; Raich, Antònia; Bernabeu, Jordi; Roca, Xavier; Narváez, Maite; Fernández, Esteve. (2025). Clinician's perceptions and experiences with tobacco treatment in people who use cannabis: a qualitative study.. Substance abuse treatment, prevention, and policy, 20(1), 3. https://doi.org/10.1186/s13011-024-00632-8