Trial reportDrug and alcohol dependence2025
A multi-site study examining the tobacco withdrawal trajectory in people with tobacco and cannabis co-use.
Trial report in Drug and alcohol dependence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The trial behind it
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Who cites it
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Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundApproximately 30 % of people who use tobacco also use cannabis, and rates of co-use are rising. Relative to people who use tobacco alone (TO), individuals who co-use tobacco and cannabis (TC) experience greater difficulty with tobacco cessation, yet mechanisms underlying this phenomenon remain unexplored. Leveraging data from a multi-site, double-blind clinical trial for tobacco cessation, we compared the trajectory of tobacco withdrawal, a strong predictor of relapse, between TC and TO during 11-weeks of tobacco treatment.
methodsPeople seeking treatment for tobacco were randomized to one of three arms (placebo, nicotine patch or varenicline) and followed for 11-weeks. Participants were parsed according to their cannabis use status determined by a cannabis-positive urine toxicology at screen (N = 1246). We selected participants with end-of-treatment biochemically verified 7-day point prevalence tobacco abstinence (N = 330; TC, n = 55 and TO, n = 275) and examined group differences in tobacco withdrawal severity using the Minnesota Nicotine Withdrawal Scale (MNWS) at baseline, week 1, 4, 8, and week 11 (end-of-treatment).
resultsControlling for age, treatment arm, and site, we found a significant interaction (group x time) effect for withdrawal severity (p < 0.01). Bonferroni-corrected post-hoc comparisons revealed that relative to TO, TC had elevated withdrawal scores at week 1 (TC, M=9.3 ± 5.5; TO, M=7.1 ± 5.6; p < 0.01); no other timepoints showed between-group differences.
conclusionsPeople who co-use experience greater tobacco withdrawal severity one-week post abstinence compared to people who only use tobacco. Personalized interventions that target immediate tobacco withdrawal and/or cannabis use may help improve tobacco cessation rates for people who co-use both substances.
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