ArticleDrug and alcohol dependence2026
Exploring tobacco, cannabis, and pain-related sleep disturbance among people with and without HIV enrolled in a tobacco smoking cessation trial.
Article in Drug and alcohol dependence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveFew studies have evaluated the influence of cannabis use and pain-related sleep disturbance on tobacco smoking outcomes despite a greater prevalence of smoking among people with pain and cannabis use to manage pain. This study examined cannabis use and pain-related sleep disturbance in relation to end of treatment (EOT) tobacco smoking abstinence.
methodsParticipants (N = 175; 42.3% HIV+; 57.7% HIV-) were treatment-seeking adults who completed a pre-quit laboratory phase assessing smoking related factors, then an 8-week cessation treatment. Cannabis use was measured via urine drug screen. Pain was measured with a single item (pain interference with sleep). Logistic regression models were used to test whether pain-related sleep disturbance and cannabis co-use predicted abstinence. Covariates included baseline pain, baseline cannabis use, and HIV status.
resultsEOT pain-related sleep disturbance was associated with lower odds of abstinence (OR=0.57, 95%CI: 0.37-0.89, p = 0.012). The cannabis use by pain-related sleep disturbance interaction was significant (OR=1.72, 95%CI: 0.29-3.15, p = 0.018), suggesting that pain-related sleep disturbance was associated with lower odds of abstinence among those not using cannabis (p = 0.012). This relationship was not significant among those using cannabis (p = 0.6). DISCUSSION: Pain-related sleep disturbance and cannabis use may be risk factors for return to use as pain-related sleep disturbance during a quit attempt was related to abstinence, and the additive effect of EOT cannabis use and pain-related sleep disturbance was associated with the highest odds of abstinence. Further evaluations of pain-related sleep disturbance and cannabis use are needed to understand individual and additive influences on smoking abstinence.
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