Cannabis Users Were Just as Successful at Quitting Tobacco as Non-Cannabis Users

In a large clinical trial of smoking cessation medications, people who also used cannabis were equally successful at quitting tobacco compared to tobacco-only smokers.

Rabin, Rachel A et al.·The American journal on addictions·2016·Moderate EvidenceRandomized Controlled Trial
RTHC-01244Randomized Controlled TrialModerate Evidence2016RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Among 1,246 treatment-seeking tobacco smokers in a randomized trial, 220 were also current cannabis users. Participants received 12 weeks of either varenicline, nicotine patch, or placebo, all with behavioral counseling.

After controlling for rate of nicotine metabolism, treatment arm, age, sex, alcohol use, and nicotine dependence level, cannabis users achieved biochemically verified 7-day abstinence from tobacco at the same rate as tobacco-only smokers.

This finding challenges the assumption that cannabis co-use undermines tobacco cessation efforts.

Key Numbers

1,246 tobacco smokers, 220 of whom were current cannabis users. Cannabis users had equal success rates for biochemically verified 7-day tobacco abstinence across all treatment arms.

How They Did This

This was a secondary analysis of a large randomized controlled trial. 1,246 treatment-seeking tobacco smokers were randomly assigned to placebo, nicotine patch, or varenicline for 12 weeks with behavioral counseling. The primary outcome was biochemically verified 7-day point prevalence abstinence at end of treatment. Logistic regression controlled for multiple potential confounders.

Why This Research Matters

Many clinicians assume that cannabis use makes it harder to quit tobacco, which could lead to withholding treatment or adjusting expectations. This study suggests cannabis co-use is not a barrier to tobacco cessation success when appropriate treatment is provided.

The Bigger Picture

Tobacco and cannabis are frequently used together, and many providers may hesitate to initiate tobacco cessation in active cannabis users. This finding removes one justification for that hesitation and supports treating tobacco dependence regardless of concurrent cannabis use.

What This Study Doesn't Tell Us

This was a secondary analysis, not the primary study aim. Cannabis use was defined as any use in the past 30 days, which includes a wide range of use patterns. The study did not examine whether cannabis use changed during or after the tobacco cessation attempt. Results reflect end-of-treatment outcomes, not long-term abstinence.

Questions This Raises

  • ?Does cannabis use affect long-term tobacco abstinence beyond the treatment period?
  • ?Do heavy daily cannabis users have different tobacco cessation outcomes than occasional users?
  • ?Would cannabis cessation alongside tobacco cessation improve or complicate outcomes?

Trust & Context

Key Stat:
220 cannabis users quit tobacco at the same rate as 1,026 tobacco-only smokers across all treatment arms.
Evidence Grade:
Moderate evidence from a well-powered secondary analysis of a large RCT, though the cannabis use analysis was not the primary study aim.
Study Age:
Published in 2016. Subsequent studies have continued to examine the tobacco-cannabis co-use relationship.
Original Title:
Does cannabis use moderate smoking cessation outcomes in treatment-seeking tobacco smokers? Analysis from a large multi-center trial.
Published In:
The American journal on addictions, 25(4), 291-6 (2016)
Database ID:
RTHC-01244

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

Frequently Asked Questions

Does cannabis use make it harder to quit tobacco?

Not according to this study. Cannabis users were equally successful at quitting tobacco compared to non-cannabis users when they received standard cessation treatment with medications and counseling.

Should I quit cannabis before trying to quit tobacco?

This study suggests that active cannabis use does not need to be addressed first. However, the study looked only at end-of-treatment outcomes, and individual circumstances vary. Discussing your specific situation with a provider may be helpful.

Read More on RethinkTHC

Cite This Study

RTHC-01244·https://rethinkthc.com/research/RTHC-01244

APA

Rabin, Rachel A; Ashare, Rebecca L; Schnoll, Robert A; Cinciripini, Paul M; Hawk, Larry W; Lerman, Caryn; Tyndale, Rachel F; George, Tony P. (2016). Does cannabis use moderate smoking cessation outcomes in treatment-seeking tobacco smokers? Analysis from a large multi-center trial.. The American journal on addictions, 25(4), 291-6. https://doi.org/10.1111/ajad.12382

MLA

Rabin, Rachel A, et al. "Does cannabis use moderate smoking cessation outcomes in treatment-seeking tobacco smokers? Analysis from a large multi-center trial.." The American journal on addictions, 2016. https://doi.org/10.1111/ajad.12382

RethinkTHC

RethinkTHC Research Database. "Does cannabis use moderate smoking cessation outcomes in tre..." RTHC-01244. Retrieved from https://rethinkthc.com/research/rabin-2016-does-cannabis-use-moderate

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.