Nearly half of adult smokers in primary care also used cannabis or e-cigarettes

Among 601 adult cigarette smokers in primary care, over half also used cannabis, e-cigarettes, or both, but cessation counseling did not consistently account for poly-use.

Thrul, Johannes et al.·Addictive behaviors·2020·Moderate EvidenceCross-Sectional
RTHC-02880Cross SectionalModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

48.6% smoked cigarettes only. 30.4% also used cannabis. 10.5% also used e-cigarettes. 10.5% used all three products. Smoking behavior and motivation to quit did not differ between groups, but dual cigarette-e-cigarette users were more likely to receive complete cessation counseling.

Key Numbers

601 smokers studied. 48.6% cigarette-only. 30.4% cigarette + cannabis. 10.5% cigarette + e-cigarette. 10.5% all three. Mean age 50.8, 38.1% female.

How They Did This

Cross-sectional secondary analysis from a smoking cessation trial in 3 diverse primary care clinics in San Francisco (2014-2015). 601 current cigarette smokers reported on past 30-day cigarette and e-cigarette use and past 3-month cannabis use.

Why This Research Matters

Treating cigarette smoking without addressing concurrent cannabis or e-cigarette use may undermine cessation efforts. This study highlights how common poly-use is among smokers seeking primary care.

The Bigger Picture

Smoking cessation programs have traditionally focused on cigarettes alone. As cannabis and e-cigarette use become more common, providers need screening tools and guidelines that address multiple products simultaneously.

What This Study Doesn't Tell Us

Cross-sectional design from a single city (San Francisco) between 2014-2015. Self-reported substance use may undercount actual use. Cannabis and e-cigarette markets have changed significantly since data collection.

Questions This Raises

  • ?Does concurrent cannabis use reduce the likelihood of successful cigarette cessation?
  • ?How should cessation counseling be adapted for poly-users?
  • ?Have these patterns changed since cannabis legalization in California?

Trust & Context

Key Stat:
51.4% of smokers also used cannabis, e-cigarettes, or both
Evidence Grade:
Secondary analysis from a clinical trial in a single city. Useful prevalence data but limited generalizability.
Study Age:
2020 publication using 2014-2015 data. Cannabis and e-cigarette use patterns may have shifted since data collection.
Original Title:
Patterns of cigarette, e-cigarette, and cannabis use among adult smokers in primary care 2014-2015.
Published In:
Addictive behaviors, 100, 106109 (2020)
Database ID:
RTHC-02880

Evidence Hierarchy

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

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Were poly-users less motivated to quit smoking?

No. Smoking behavior and motivation to quit did not significantly differ between cigarette-only smokers and those who also used cannabis or e-cigarettes.

Did providers counsel poly-users differently?

Dual cigarette-e-cigarette users were more likely to receive all five cessation counseling steps (5As), but cannabis co-users were not counseled differently from cigarette-only smokers.

Read More on RethinkTHC

Cite This Study

RTHC-02880·https://rethinkthc.com/research/RTHC-02880

APA

Thrul, Johannes; Vijayaraghavan, Maya; Kalkhoran, Sara; Satterfield, Jason M. (2020). Patterns of cigarette, e-cigarette, and cannabis use among adult smokers in primary care 2014-2015.. Addictive behaviors, 100, 106109. https://doi.org/10.1016/j.addbeh.2019.106109

MLA

Thrul, Johannes, et al. "Patterns of cigarette, e-cigarette, and cannabis use among adult smokers in primary care 2014-2015.." Addictive behaviors, 2020. https://doi.org/10.1016/j.addbeh.2019.106109

RethinkTHC

RethinkTHC Research Database. "Patterns of cigarette, e-cigarette, and cannabis use among a..." RTHC-02880. Retrieved from https://rethinkthc.com/research/thrul-2020-patterns-of-cigarette-ecigarette

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.