Over a quarter of California tobacco quitline callers also used cannabis, and they quit smoking at lower rates (23.2% vs 28.9%), though 43% expressed intent to quit cannabis too.
Tobacco cessation professionals; quitline program designers.
27.2% of tobacco quitline callers also used cannabis
What the researchers found
Cannabis co-use was reported by 27.2% of quitline callers. Co-users were more likely to be male, younger, and have mental health conditions. After controlling for demographics and cessation services, co-users were significantly less likely to quit smoking at 7 months (23.2% vs 28.9%, p < .001). Among co-users, 42.9% intended to quit cannabis within 30 days.
Why it matters
Tobacco quitlines are one of the most widely used cessation resources. Learning that over a quarter of their callers also use cannabis -- and that co-use lowers quit rates -- identifies both a problem and an opportunity. The 43% expressing cannabis quit intentions suggests these callers are open to dual intervention.
The numbers in context
45,151 total callers. 27.2% co-used cannabis. 7-month quit rates: co-users 23.2% vs non-co-users 28.9% (p < .001). Similar rates of receiving counseling and FDA-approved cessation aids between groups. 42.9% of co-users intended to quit cannabis within 30 days. 3,545 evaluated at 7 months.
How the study worked
Analysis of Kick It California (state tobacco quitline) caller data from January 2020 through December 2023 (N=45,151). A subgroup (n=3,545) was randomly sampled for 7-month evaluation. Cessation rates compared between co-users and non-co-users, controlling for demographics and cessation service utilization.
What this study cannot tell us
Observational data from a single state quitline. Self-reported outcomes may overestimate quit rates. The association between co-use and lower quit rates could reflect shared underlying risk factors rather than a direct effect of cannabis on smoking cessation.
How to read the evidence
Moderate: very large quitline dataset with 7-month follow-up and controlled analyses, but single state and self-reported outcomes.
When this study was published
2024 study using 2020-2023 data.
The bigger picture
As cannabis use increases nationally while cigarette smoking declines, the co-use population represents a growing challenge for tobacco cessation. Quitlines that ignore cannabis co-use may be undermining their own effectiveness for over a quarter of their callers.
Questions still open
- Would adding cannabis cessation support to tobacco quitlines improve smoking quit rates? Does co-use interfere with smoking cessation through pharmacological mechanisms or behavioral patterns?
Common questions
Does cannabis make it harder to quit smoking?
Could quitlines help with cannabis too?
Read the original research
Tobacco Quitline Callers Who Use Cannabis and Their Likelihood of Quitting Cigarette Smoking.
American journal of preventive medicine, 67(2), 241-248
Citation
Zhu, Shu-Hong; Tedeschi, Gary J; Li, Shuwen; Wang, Jijiang; Aughinbaugh, Emily; Pratt, Andrea S; Zhuang, Yue-Lin. (2024). Tobacco Quitline Callers Who Use Cannabis and Their Likelihood of Quitting Cigarette Smoking.. American journal of preventive medicine, 67(2), 241-248. https://doi.org/10.1016/j.amepre.2024.03.007
Explore the wider topic
- Physical vs Psychological Cannabis Dependence: What Science Actually Shows
- The Gap Between Cannabis Perception and Science: Why What We Believe Outpaces What We Know
- Cannabis Use Disorder: Am I Addicted? Self-Assessment Guide
- Cross-Addiction After Quitting Weed: When One Habit Replaces Another
- Is Weed Addictive? What the Research Actually Shows
- Is Cannabis Addictive? What the DSM-5 and Brain Science Say
- Quitting Weed and Alcohol Together: What to Know About Dual Cessation
- Is Rehab Necessary for Weed? An Honest Assessment
- Signs You May Have Cannabis Use Disorder: An Honest Self-Assessment
- Weed Vape Pen Addiction: Why Vaping Makes It Harder to Quit
- Blunts vs Joints vs Spliffs: What's Actually Different