Current Marijuana Users Were Twice as Likely to Still Be Smoking Tobacco and Far Less Likely to Have Quit for Good | Research

The takeaway

Among adults who had ever used tobacco, current marijuana users had 69% current tobacco use and only 22% sustained cessation, compared to 28% current use and 66% sustained cessation among never-marijuana users.

Readers who use both marijuana and tobacco and are considering quitting tobacco.

69% of current marijuana users still use tobacco vs. 28% of never-marijuana users

What the researchers found

Using nationally representative data from 2013-2014, the study examined tobacco use and cessation patterns among adults who had ever used tobacco, stratified by marijuana use status.

Current marijuana users who had ever used tobacco showed dramatically different tobacco patterns: 69.1% were current tobacco users, only 9.1% had recently quit, and only 21.8% had achieved sustained cessation (quit for more than 12 months). In contrast, among never-marijuana users who had ever used tobacco, only 28.2% were current tobacco users and 65.5% had achieved sustained cessation.

Former marijuana users fell in between: 38.5% current tobacco use, 53.1% sustained cessation.

On a positive note, from 2005 to 2014, current tobacco use declined and sustained cessation increased among all marijuana use groups, suggesting that even among marijuana users, tobacco cessation progress was being made.

Why it matters

Approximately 70% of adult marijuana users also use tobacco, making co-use the norm rather than the exception. If marijuana use significantly interferes with tobacco cessation, this has major public health implications given that tobacco remains the leading preventable cause of death.

The numbers in context

Current marijuana users: 69.1% current tobacco, 9.1% recent cessation, 21.8% sustained cessation. Former marijuana users: 38.5% current tobacco, 8.4% recent cessation, 53.1% sustained cessation. Never marijuana users: 28.2% current tobacco, 6.3% recent cessation, 65.5% sustained cessation. All groups showed improvement from 2005-2014.

How the study worked

Cross-sectional analysis of the National Survey on Drug Use and Health (NSDUH), 2005-2014. Nationally representative household survey of U.S. civilians aged 18+. Weighted estimates and logistic regression analyses compared tobacco use patterns by marijuana use status.

What this study cannot tell us

Cross-sectional design cannot determine whether marijuana use causes lower tobacco cessation rates or both are driven by shared risk factors. Self-report data may underestimate both marijuana and tobacco use. The study could not account for the mode of marijuana consumption (joint smoking versus edibles or vaporizing), which matters because joint smokers may maintain tobacco habits through the shared smoking behavior.

How to read the evidence

Moderate evidence from nationally representative survey data with decade-long trend analysis.

When this study was published

Published in 2017, using 2005-2014 data. Cannabis legalization has expanded since.

The bigger picture

The relationship between marijuana and tobacco use is bidirectional and complex. This study highlights that current marijuana use is associated with much lower rates of sustained tobacco cessation. Whether marijuana directly interferes with quitting tobacco (through shared behavioral patterns, social contexts, or neurobiological mechanisms) or simply serves as a marker for higher overall substance use propensity remains an important question.

Questions still open

Does marijuana use directly interfere with tobacco cessation or do shared risk factors explain the association? Would tobacco cessation interventions tailored for marijuana co-users be more effective? Does the mode of marijuana consumption (smoking vs. edibles) affect tobacco cessation success?

Common questions

Does marijuana make it harder to quit cigarettes?

This study found a strong association: current marijuana users had much higher tobacco use rates and lower cessation rates. However, the study cannot prove that marijuana causes the difficulty in quitting tobacco. Shared risk factors, social environments, or the habit of smoking itself may contribute to the link.

Are there tobacco cessation programs designed for marijuana users?

The study authors recommended developing interventions that address tobacco cessation in the context of marijuana and other substance use. At the time of publication, most tobacco cessation programs did not specifically account for concurrent marijuana use.

Read the original research

Prevalence, correlates, and trends in tobacco use and cessation among current, former, and never adult marijuana users with a history of tobacco use, 2005-2014.

Addictive behaviors, 73, 165-171

View on PubMed ↗Publisher’s paper ↗

Citation

Schauer, Gillian L; King, Brian A; McAfee, Timothy A. (2017). Prevalence, correlates, and trends in tobacco use and cessation among current, former, and never adult marijuana users with a history of tobacco use, 2005-2014.. Addictive behaviors, 73, 165-171. https://doi.org/10.1016/j.addbeh.2017.04.023