Cutting Back on Tobacco Was Linked to Cutting Back on Cannabis Too

In a smoking cessation program, people who reduced their cigarette, e-cigarette, or cigar use also reduced their cannabis use over 3 months, suggesting the substances track together.

Nguyen, Nhung et al.·Journal of addiction medicine·2022·Moderate EvidenceLongitudinal Cohort
RTHC-04100Longitudinal CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
N=487

What This Study Found

Changes in cigarette frequency (β=0.17), e-cigarette frequency (β=0.11), and cigar frequency (β=0.19) were all positively associated with changes in cannabis use frequency over 3 months.

Key Numbers

Sample: 487 participants, mean age 25.4, 39.6% male, 40.3% White. Cigarette-cannabis association: β=0.17 (95% CI 0.10-0.24). E-cigarette: β=0.11 (95% CI 0.05-0.17). Cigar: β=0.19 (95% CI 0.06-0.32). Sexual minority participants and those with high school education or less showed greater increases in cannabis use.

How They Did This

Longitudinal analysis of 487 cigarette smokers (mean age 25.4) enrolled in a 3-month Facebook-based smoking cessation program in the San Francisco Bay Area (2016-2020). Cannabis use frequency was measured at baseline and 3-month follow-up alongside tobacco product use.

Why This Research Matters

If tobacco and cannabis use genuinely move in tandem, then tobacco cessation programs might produce a secondary benefit of reducing cannabis use, offering a "two-for-one" public health opportunity.

The Bigger Picture

This aligns with the broader concept that substance use patterns tend to cluster. The finding that all three tobacco product types showed the same association with cannabis strengthens the case that this reflects a real behavioral link rather than a coincidence.

What This Study Doesn't Tell Us

The study was observational within a cessation program, so the association could reflect general motivation to change substance use rather than a direct causal link. The Bay Area sample may not represent other populations. Cannabis use was self-reported.

Questions This Raises

  • ?Is the tobacco-cannabis link driven by shared social environments, shared neurobiological pathways, or general motivation to change?
  • ?Would explicitly addressing cannabis in tobacco cessation programs improve outcomes for both substances?

Trust & Context

Key Stat:
All three tobacco products showed positive associations with cannabis use changes
Evidence Grade:
Moderate: prospective data from a real-world cessation program with adequate sample size, though observational and limited to one geographic area.
Study Age:
Published in 2022.
Original Title:
Longitudinal Associations Between Use of Tobacco and Cannabis Among People Who Smoke Cigarettes in Real-world Smoking Cessation Treatment.
Published In:
Journal of addiction medicine, 16(4), 413-419 (2022)
Database ID:
RTHC-04100

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Does quitting tobacco cause people to quit cannabis?

This study found an association, not causation. People who reduced tobacco also tended to reduce cannabis, but the study cannot determine whether one caused the other or whether both reflected a general motivation to change substance use.

Did the cessation program address cannabis use?

No. The program targeted tobacco cessation specifically. The reduction in cannabis use appeared to be a secondary effect rather than a direct program goal.

Read More on RethinkTHC

Cite This Study

RTHC-04100·https://rethinkthc.com/research/RTHC-04100

APA

Nguyen, Nhung; Neilands, Torsten B; Lisha, Nadra E; Lyu, Joanne Chen; Olson, Sarah S; Ling, Pamela M. (2022). Longitudinal Associations Between Use of Tobacco and Cannabis Among People Who Smoke Cigarettes in Real-world Smoking Cessation Treatment.. Journal of addiction medicine, 16(4), 413-419. https://doi.org/10.1097/ADM.0000000000000920

MLA

Nguyen, Nhung, et al. "Longitudinal Associations Between Use of Tobacco and Cannabis Among People Who Smoke Cigarettes in Real-world Smoking Cessation Treatment.." Journal of addiction medicine, 2022. https://doi.org/10.1097/ADM.0000000000000920

RethinkTHC

RethinkTHC Research Database. "Longitudinal Associations Between Use of Tobacco and Cannabi..." RTHC-04100. Retrieved from https://rethinkthc.com/research/nguyen-2022-longitudinal-associations-between-use

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.