Cannabis Co-Use Made Smokers Less Likely to Quit Cigarettes

Among over 8,000 established cigarette smokers tracked in the PATH Study, those who also used cannabis had 19% lower odds of successfully quitting smoking compared to smokers who did not use cannabis.

RTHC-07609ObservationalStrong Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Strong Evidence
Sample
N=26,381

What This Study Found

Cannabis co-use was associated with decreased odds of cigarette discontinuation (aOR: 0.81, 95% CI: 0.72-0.93, p=0.0018) and decreased odds of discontinuing all combustible tobacco products (aOR: 0.75, 95% CI: 0.65-0.86, p<0.0001). Over one-third (35.9%) of cigarette smokers reported cannabis co-use during the study, and this proportion increased over time.

Key Numbers

8,218 adults, 26,381 observations across 5 waves. 35.9% of smokers reported cannabis co-use. Cigarette discontinuation: aOR 0.81 (95% CI: 0.72-0.93). All combustible tobacco discontinuation: aOR 0.75 (95% CI: 0.65-0.86). Cannabis co-use increased over the study period.

How They Did This

Longitudinal analysis of 26,381 observations from 8,218 adults with established cigarette use (100+ lifetime cigarettes) across waves 1-5 of the Population Assessment of Tobacco and Health (PATH) Study. Weighted GEE models adjusted for demographics, behavioral characteristics, and substance use problems.

Why This Research Matters

As cannabis becomes more accessible, the proportion of cigarette smokers who also use cannabis is growing. This study reveals a previously underappreciated barrier to tobacco cessation: cannabis co-use may reduce the likelihood of quitting smoking, complicating public health efforts to reduce tobacco use.

The Bigger Picture

This finding creates a tension between cannabis legalization and tobacco control goals. If cannabis use makes it harder to quit smoking, then the two public health issues cannot be addressed in isolation. Tobacco cessation programs may need to specifically address concurrent cannabis use.

What This Study Doesn't Tell Us

Observational design cannot prove cannabis caused lower quit rates. Cannabis users may differ from non-users in ways not captured by covariates. Self-reported cannabis and tobacco use subject to reporting biases. PATH Study waves 1-5 span a period of changing cannabis policies.

Questions This Raises

  • ?Whether cannabis-specific cessation support improves tobacco quit rates in co-users
  • ?Whether the method of cannabis use (smoking vs. edibles) matters for tobacco cessation outcomes

Trust & Context

Key Stat:
Evidence Grade:
Large nationally representative longitudinal study with validated measures and appropriate statistical methods, providing strong observational evidence.
Study Age:
Published 2025, using PATH Study waves 1-5 data.
Original Title:
Cannabis Use and Subsequent Cigarette Discontinuation Among U.S. Adults in the Population Assessment of Tobacco and Health Study, Waves 1-5.
Published In:
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 27(2), 208-216 (2025)
Database ID:
RTHC-07609

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

Why might cannabis make it harder to quit smoking?

Several mechanisms are possible: shared smoking behavior reinforces the hand-to-mouth habit, cannabis and tobacco are often used together (blunts, spliffs), both activate reward pathways, and cannabis may reduce the perceived urgency of quitting smoking.

Should tobacco cessation programs screen for cannabis use?

This study suggests yes. Over one-third of smokers also used cannabis, and co-users had significantly lower quit rates. Addressing both substances together, rather than treating them separately, may improve cessation outcomes.

Read More on RethinkTHC

Cite This Study

RTHC-07609·https://rethinkthc.com/research/RTHC-07609

APA

Sedani, Ami E; Frank-Pearce, Summer G; Beebe, Laura A; Campbell, Janis E; Peck, Jennifer D; Chou, Ann F; Cohn, Amy M. (2025). Cannabis Use and Subsequent Cigarette Discontinuation Among U.S. Adults in the Population Assessment of Tobacco and Health Study, Waves 1-5.. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 27(2), 208-216. https://doi.org/10.1093/ntr/ntae202

MLA

Sedani, Ami E, et al. "Cannabis Use and Subsequent Cigarette Discontinuation Among U.S. Adults in the Population Assessment of Tobacco and Health Study, Waves 1-5.." Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2025. https://doi.org/10.1093/ntr/ntae202

RethinkTHC

RethinkTHC Research Database. "Cannabis Use and Subsequent Cigarette Discontinuation Among ..." RTHC-07609. Retrieved from https://rethinkthc.com/research/sedani-2025-cannabis-use-and-subsequent

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.