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Drug Alcohol Depend. 2019 Nov 20;206:107756. doi: 10.1016/j.drugalcdep.2019.107756. [Epub ahead of print]

Is cannabis use associated with tobacco cessation outcome? An observational cohort study in primary care.

Author information

1
Nicotine Dependence Services, Centre for Addiction and Mental Health, 175 College St., Toronto, Ontario, M5T 1P7, Canada. Electronic address: sabrina.voci@camh.ca.
2
Nicotine Dependence Services, Centre for Addiction and Mental Health, 175 College St., Toronto, Ontario, M5T 1P7, Canada; Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada. Electronic address: laurie.zawertailo@camh.ca.
3
Nicotine Dependence Services, Centre for Addiction and Mental Health, 175 College St., Toronto, Ontario, M5T 1P7, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada. Electronic address: dolly.baliunas@camh.ca.
4
Nicotine Dependence Services, Centre for Addiction and Mental Health, 175 College St., Toronto, Ontario, M5T 1P7, Canada. Electronic address: zara.masood@camh.ca.
5
Nicotine Dependence Services, Centre for Addiction and Mental Health, 175 College St., Toronto, Ontario, M5T 1P7, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada; Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada. Electronic address: peter.selby@camh.ca.

Abstract

BACKGROUND:

Some studies suggest cannabis use negatively affects tobacco cessation outcomes, but findings have been mixed. We examined whether cannabis use was associated with tobacco cessation outcomes in a real-world primary care setting.

METHODS:

The analytic dataset consisted of 35,246 patients who enrolled between 2014 and 2016 in a primary care-based smoking cessation program in Ontario, Canada. Past 30-day cannabis use, for recreational or medical purposes, was self-reported at enrollment. Thirty-day point prevalence tobacco smoking abstinence was self-reported via online or telephone survey at 6 months post-enrollment.

RESULTS:

Thirty days prior to enrollment, 79.9 % of patients had not used cannabis, 16.3 % used cannabis for recreational purposes only, and 3.8 % used cannabis for medical purposes. Unadjusted and adjusted odds of tobacco cessation at 6 months were reduced for patients using cannabis compared to non-users (ORs = 0.76-0.86, ps<0.05). When cannabis use was categorized by purpose, both unadjusted and adjusted odds of cessation were significantly lower for recreational users (ORs = 0.77-0.84, ps<0.05). Medical users had decreased odds of cessation in unadjusted analysis (OR = 0.74, 95 % CI = 0.61-0.89, p = 0.001), but not after adjustment for potential confounders. However, post-estimation contrasts did not indicate a significant difference between the effect of recreational and medical cannabis use.

CONCLUSIONS:

In a large real-world sample of patients seeking smoking cessation treatment, concurrent cannabis use was associated with decreased success with quitting smoking. Recreational cannabis use was consistently related to poorer cessation outcomes, but medical use was not. Additional research is needed to inform treatment strategies for this growing sub-population of smokers.

KEYWORDS:

Cannabis; Medical marijuana; Smoking cessation; Tobacco

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