Cannabis-tobacco co-users have high interest in quitting tobacco but low interest in quitting cannabis | Research

The takeaway

Among 282 cannabis-tobacco co-users, quit interest for tobacco averaged 7.1/10 versus only 2.4/10 for cannabis, and half reported increasing one substance when trying to quit the other.

Addiction clinicians, tobacco cessation counselors, and co-users considering quitting.

Tobacco 7.1 vs cannabis 2.4 quit interest

What the researchers found

About 80% had tried to quit tobacco vs 40% for cannabis. Quit interest was 7.07/10 for tobacco vs 2.39/10 for cannabis. When attempting tobacco cessation, 50% perceived increased cannabis use. When attempting cannabis cessation, 62% perceived increased tobacco use. This bidirectional substitution pattern complicates treatment.

Why it matters

Co-use of cannabis and tobacco is common but rarely addressed in treatment. The finding that people substitute one for the other during quit attempts has critical implications for how cessation programs should be designed.

The numbers in context

282 participants; 57% female; mean age 33.3; quit interest tobacco 7.07/10, cannabis 2.39/10; 80% tried quitting tobacco, 40% tried quitting cannabis; 50% increased cannabis during tobacco quit, 62% increased tobacco during cannabis quit.

How the study worked

Two online survey samples (Amazon MTurk) combined (N=282), assessing quit interest, treatment preferences, and perceived drug substitution among adult cannabis-tobacco co-users across the US.

What this study cannot tell us

Online convenience sample (MTurk) may not represent treatment-seeking populations. Self-reported perceived substitution, not objectively measured. Cross-sectional design.

How to read the evidence

Moderate: reasonable sample size with clear findings, but online convenience sample.

When this study was published

Published in 2019.

The bigger picture

The stark difference in quit motivation (high for tobacco, low for cannabis) suggests that forcing cannabis cessation on co-users seeking tobacco treatment may be counterproductive. Harm reduction approaches that address tobacco first may be more effective.

Questions still open

Could cannabis cessation be more effectively addressed by first achieving tobacco cessation? Would cannabis reduction (rather than cessation) goals improve engagement?

Common questions

Do people increase cannabis use when trying to quit tobacco?

In this survey, 50% of co-users perceived increased cannabis use when attempting tobacco cessation, suggesting a bidirectional substitution pattern.

Should co-users try to quit both at once?

The study suggests that reduction-based strategies for cannabis may be more acceptable than cessation, especially since cannabis quit interest was very low (2.4/10).

Read the original research

Tobacco and cannabis co-use: Drug substitution, quit interest, and cessation preferences.

Experimental and clinical psychopharmacology, 27(3), 265-275

View on PubMed ↗Publisher’s paper ↗

Citation

McClure, Erin A; Tomko, Rachel L; Salazar, Claudia A; Akbar, Saima A; Squeglia, Lindsay M; Herrmann, Evan; Carpenter, Matthew J; Peters, Erica N. (2019). Tobacco and cannabis co-use: Drug substitution, quit interest, and cessation preferences.. Experimental and clinical psychopharmacology, 27(3), 265-275. https://doi.org/10.1037/pha0000244