More than a third of medical cannabis patients also used nicotine products | Research

The takeaway

Among 697 medical cannabis dispensary patients, 39.3% currently used nicotine, with route of nicotine administration (smoking vs vaping) predicting how patients consumed their cannabis.

Medical cannabis dispensary staff, public health professionals, and patients who use both cannabis and nicotine.

39.3% of medical cannabis patients also used nicotine

What the researchers found

39.3% of medical cannabis patients reported current nicotine use, higher than the general population. E-cigarette users were approximately four times more likely to vape rather than smoke their cannabis. Nearly half of cigarette smokers planned to quit within 6 months.

Why it matters

If the way people use nicotine predicts how they use cannabis, dispensaries could leverage this relationship to steer patients toward less harmful consumption methods.

The numbers in context

697 patients. 39.3% current nicotine users. E-cigarette users 4x more likely to vape cannabis vs smoke it. 46.8% of cigarette smokers planned to quit in next 6 months. 31.6% planned to quit in next month. Psychiatric conditions associated with nicotine use and higher quit motivation.

How the study worked

Survey of 697 patients attending a medical marijuana dispensary (75.3% White, 60% male). Examined nicotine use, motivation to quit, routes of administration for both nicotine and cannabis, and qualifying medical conditions.

What this study cannot tell us

Single-dispensary sample, so results may not generalize to all medical cannabis populations. Self-reported data. Cross-sectional design cannot determine whether cannabis use influenced nicotine behaviors.

How to read the evidence

Moderate: substantial sample size at a medical dispensary, but single site and self-reported data.

When this study was published

Published in 2022.

The bigger picture

The high rate of nicotine use among medical cannabis patients represents both a health concern and an opportunity. Dispensaries could serve as an unconventional touchpoint for smoking cessation resources.

Questions still open

Should dispensaries routinely screen for nicotine use and offer cessation resources? Does switching cannabis consumption method help patients also switch their nicotine consumption method? Do psychiatric patients who use cannabis have different nicotine patterns than those who do not?

Common questions

Why does nicotine use matter for cannabis patients?

Smoking is a harmful delivery method regardless of the substance. If dispensary staff know a patient also smokes cigarettes, recommending vaporized cannabis could align with their existing nicotine habits and reduce combustion-related harm.

Did many smokers want to quit?

Yes. Nearly 80% of cigarette-smoking patients expressed plans to quit within 6 months, suggesting high readiness for cessation support.

Is nicotine use higher in medical cannabis patients than the general population?

Yes. The 39.3% nicotine use rate is substantially higher than the general adult population rate, consistent with known overlap between cannabis and nicotine use.

Read the original research

Tobacco/nicotine use among individuals using cannabis for therapeutic purposes.

The American journal on addictions, 31(6), 486-493

View on PubMed ↗Publisher’s paper ↗

Citation

Steinberg, Marc L; Rosen, Rachel L; Billingsley, Benjamin; Shah, Drashya; Bender, Michele; Shargo, Kyra; Aamir, Affan; Bridgeman, Mary Barna. (2022). Tobacco/nicotine use among individuals using cannabis for therapeutic purposes.. The American journal on addictions, 31(6), 486-493. https://doi.org/10.1111/ajad.13323