Feasibility of a group cessation program for co-smokers of cannabis and tobacco

Abstract

Introduction and Aims: This study aims to evaluate the feasibility and effects of a group cessation program for cannabis and tobacco co-smokers. Design and Methods: Using a repeated-measures design with pre-, post-and six months follow-up assessments, feasibility (intervention utilisation, safety and acceptability) and changes in substance use behaviour and mental health were evaluated. The intervention consisted of five to six group sessions and was based on current treatment techniques (e.g. motivational interviewing, cognitive-behavioural therapy, and self-control training). In total, 77 adults who used cannabis at least once weekly and cigarettes or similar products at least once daily participated in the study. Results: Within nine months, the target sample size was reached. Treatment retention was 62.3%, and only three participants discontinued treatment due to severe problems (concentration problems, sleeping problems, depressive symptoms, and/or distorted perceptions). In total, 41.5% and 23.4% reported abstinence from cigarettes, cannabis or both at the end of treatment and the follow-up, respectively. The individual abstinence rates for cigarettes and cannabis were 32.5% and 23.4% (end of treatment) and 10.4% and 19.5% (follow-up), and 13% (end of treatment) and 5.2% (follow-up) achieved dual abstinence validated for tobacco abstinence. Over the study period, significant decreases in tobacco and cannabis use frequencies and significant improvements in additional outcomes (drinking problems, symptoms of cannabis use disorder, nicotine dependence, depression and anxiety) were achieved. Discussion and Conclusions: The evaluated intervention for co-smokers is feasible regarding recruitment, intervention retention and safety. The promising results regarding substance use and mental health support a randomised controlled trial to evaluate effectiveness.

Marijuana and tobacco use and co-use among African Americans: Results from the 2013, National Survey on Drug Use and Health

“…For example, in a study of substance abuse program directors who also had clinical responsibilities, Richter (2006) found that the directors urged their patients to delay quitting smoking because they believed that patients should not try to change too many things at one time. However, recent studies have found that targeting tobacco during treatment for cannabis use disorders did not negatively impact marijuana outcomes (Becker, Haug, Kraemer, & Schaub, 2015;Lee et al, 2014). Additional studies are needed to identify effective prevention and treatment interventions for marijuana and tobacco co-users (Ramo et al, 2012).…”

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

“…Twelve studies were RCTs [39][40][41][42][43][44][45]47,48,[60][61][62] and eight were pilot or feasibility ('uncontrolled') studies [37,38,46,49,[56][57][58][59]. Fourteen studies were from the United States, two from Switzerland, two from the United Kingdom, one from France and one from Australia.…”

A scoping review and meta-analysis of psychosocial and pharmacological treatments for cannabis and tobacco use among African Americans.

“…Technology-based interventions and group interventions might serve as effective methods to reach African Americans who are less likely to engage in traditional treatment (Becker et al, 2012) and more likely to cite support as a necessary and important component of treatment (Burgess et al, 2014). For example, in a predominately White sample of adult cannabis and tobacco co-users participating in a group cessation program (MI/CBT and self-control training) for co-users, participants reported significant decreases in tobacco and cannabis use over a 6-month period (Becker, Haug, Kraemer, & Schaub, 2015). A similar approach might also work well for African Americans who use cannabis and tobacco.…”