Injection Drug Users Who Smoked Marijuana Were More Likely to Have Attempted Quitting Tobacco | Research

The takeaway

Among 670 injection drug users in Tijuana, 90% smoked cigarettes, and those who also smoked marijuana were 38% more likely to have made a recent tobacco quit attempt.

Read this if you are interested in the relationship between marijuana use and tobacco cessation motivation.

Marijuana smoking associated with 38% higher likelihood of tobacco quit attempts

What the researchers found

Six hundred seventy injection drug users in Tijuana, Mexico were interviewed, with 89.7% being current cigarette smokers. Among smokers, 31.6% contemplated quitting in the next 6 months, 22% had previously quit for a year or more, and 20.6% had made a recent quit attempt.

In multivariable analysis, recent tobacco quit attempts were positively associated with higher income, smoking marijuana (PR=1.38), and smoking heroin (PR=1.85), and negatively associated with number of daily cigarettes. The positive association between marijuana smoking and tobacco quit attempts was unexpected and counterintuitive.

Why it matters

The finding that marijuana users made more tobacco quit attempts, not fewer, challenges the assumption that polysubstance use uniformly reduces cessation motivation. This could reflect marijuana smokers being more health-conscious or more aware of smoking harms, warranting further investigation.

The numbers in context

670 IDUs. 89.7% current smokers. 31.6% contemplated quitting. 20.6% recent quit attempt. Marijuana smoking: PR=1.38 for quit attempts. Heroin smoking: PR=1.85. Higher income: PR=2.30.

How the study worked

Cross-sectional study of 670 IDUs recruited through community outreach in Tijuana, Mexico. In-person interviews. Multivariable Poisson regression for prevalence ratios of tobacco quit attempts.

What this study cannot tell us

Tijuana IDU population may not generalize to other populations. Cross-sectional design limits causal inference. The marijuana-quit attempt association has multiple possible explanations. Self-reported quit attempts may not reflect genuine attempts. The study could not assess quit success, only attempts.

How to read the evidence

Cross-sectional study with appropriate analysis; preliminary evidence for a counterintuitive association.

When this study was published

Published in 2013. The relationship between marijuana use and tobacco cessation continues to be explored.

The bigger picture

Injection drug users are often excluded from tobacco cessation research despite extremely high smoking rates. This study demonstrates that even in this heavily substance-using population, one in five had recently attempted to quit tobacco. The marijuana-quit attempt association adds complexity to our understanding of polysubstance use.

Questions still open

Why would marijuana users be more likely to attempt quitting tobacco? Does marijuana substitute for tobacco in some users? Would integrated cessation programs for multiple substances work in this population? Could the association reflect a personality trait (willingness to try new things)?

Common questions

Does marijuana help people quit tobacco?

This study found that marijuana smokers were more likely to have attempted quitting tobacco, but this does not mean marijuana helped them quit. The association could reflect that marijuana smokers are more experimental (willing to try quitting), that marijuana partially substitutes for tobacco, or that shared social contexts encourage health awareness. The study measured attempts, not success.

Why are tobacco quit rates so low in injection drug users?

Despite 90% smoking rates, only 20% had recently tried to quit. Injection drug users face enormous barriers to tobacco cessation: nicotine provides one of few accessible mood regulators, smoking is deeply embedded in drug-using social networks, stress levels are extremely high, and healthcare access is limited. Standard cessation programs rarely reach or serve this population effectively.

Read the original research

Cigarette smoking and quit attempts among injection drug users in Tijuana, Mexico.

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 15(12), 2060-8

View on PubMed ↗Publisher’s paper ↗

Citation

Shin, Sanghyuk S; Moreno, Patricia Gonzalez; Rao, Smriti; Garfein, Richard S; Novotny, Thomas E; Strathdee, Steffanie A. (2013). Cigarette smoking and quit attempts among injection drug users in Tijuana, Mexico.. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 15(12), 2060-8. https://doi.org/10.1093/ntr/ntt099