Tobacco and cannabis co-use: Drug substitution, quit interest, and cessation preferences.

Abstract

The co-use of tobacco and cannabis is a common practice worldwide and carries with it substantial public health burden. Few interventions exist that target both substances and little is known about quit interest, treatment preferences, and drug substitution during past cessation attempts, which is critical to guide the development of treatment strategies. The goal of this study was to provide descriptive information regarding quit interest, treatment preferences, and perceived drug substitution among adult (age 18+) cannabis-tobacco co-users. Participants (N=282) from two independent survey samples (recruited from Amazon Mechanical Turk) from across the United States were combined. Among all participants, 57% were female, 79% were White, and average age was 33.31 (SD=9.54) years old. Approximately 80% had tried to quit smoking cigarettes at least once, while 40% had tried to quit using cannabis at least once. Of those who tried to quit, 50% self-reported a perceived increase in their cannabis use during tobacco cessation and 62% self-reported a perceived increase in their tobacco use during cannabis cessation. Average quit interest (10-point scale) for cannabis was 2.39 (SD=2.35) and for tobacco was 7.07 (SD=2.90). Results of this study suggest that tobacco use should be addressed among cannabis-tobacco co-users, but interventions should consider lack of interest in cannabis cessation. Reduction-based strategies for cannabis use appear to be more acceptable to this non-treatment seeking, co-using population. Drug substitution during quit attempts for one substance should be further explored as an important treatment consideration.

Prevalence of cannabis use among individuals with a history of cancer in the United States

“…These data are somewhat difficult to interpret in isolation given the examples of potential anticancer effects of cannabis components in preclinical studies of other malignancies, but it is important to note that there has not been evidence of improved clinical oncologic outcomes through cannabis use to date 5 . Outside of the laboratory, behavioral studies have noted riskier sexual practices and co‐use of substances such as tobacco and alcohol in those using cannabis 16‐20 . Linkage between sexual behaviors and both head and neck and gynecologic malignancies is well understood, as are relationships between substance use and malignancy (particularly tobacco and alcohol) 21,22 .…”

Marijuana Use and Adherence to Smoking Cessation Treatment Among Callers to Tobacco Quitlines

“…Quitline callers who reported current use had used marijuana an average of 14 days in the past month. Co-use of tobacco and marijuana has been shown to increase the addiction potential of marijuana (15,16). Furthermore, co-use of tobacco and marijuana complicates efforts to quit either substance.…”

A systematic review and Bayesian meta‐analysis of interventions which target or assess co‐use of tobacco and cannabis in single‐ or multi‐substance interventions

“…For those who coadminister tobacco and cannabis, the shared route of administration and overlapping withdrawal symptoms may act as cues to relapse of either substance, indicating that the efficacy of dual or multi-substance interventions in comparison to single-substance interventions warrants examination [14,28,29]. Additionally, compensatory use of one substance following cessation of the other is important to consider [30].…”