Using both marijuana and tobacco is a concern because co-use may affect the cessation of one or the other in individuals who are trying to quit, according to new research in Addictive Behaviors.
“We are seeing rates of marijuana use increase in adults, with more people using it in general for recreational purposes and some for medical reasons,” says Erin A. McClure, PhD, assistant professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina (MUSC), who led the addiction investigators as they conducted an online survey of the smoking habits of those who had used both marijuana and tobacco within a 30-day period. “It’s very concerning. We feel that if someone is trying to quit smoking cigarettes, they may be at an increased risk of relapse because of the way they use the two substances together.”
During the past couple of years, Dr. McClure notes, there has been a shift in how people view marijuana. More and more states have legalized medical marijuana and some have decriminalized its recreational use. “We don’t have enough data to know how harmful marijuana is, which makes it very challenging,” Dr. McClure says. “It is hard to encourage people to quit when we don’t fully understand just how problematic it can be in adults.”
She notes that for adolescents and young adults, there is a lot of data showing that marijuana is “extremely problematic. For adults, who are occasional users, there isn’t as much health-related data.”
The increased rates of tobacco and marijuana co-use may have occurred for several reasons. “Smoking a cigarette may lead the user to want to smoke marijuana,” Dr. McClure says. “Or smoking one may lead to an increased craving for the other.”
Tobacco and marijuana traditionally have had the same method of administration in that they are both methods of smoking, she notes. “But that has shifted now as marijuana is not necessarily combusted. There are other means of consuming it.”
The researchers who published the study in Addictive Behaviors noted that while reasons for co-use of marijuana and tobacco have been explored with younger users, there is not a lot of data out there for more experienced users who have an entrenched pattern of co-use. They found that participants tended to use tobacco and marijuana sequentially rather than simultaneously, smoking a tobacco cigarette after smoking marijuana rather than mixing marijuana with tobacco. More than a quarter of the participants said they had smoked most of their cigarettes while they were high or were using marijuana. These users tended to have a greater tobacco dependence and to smoke more cigarettes in a day.
“If someone is going to use marijuana and tobacco together or sequentially and they are trying to quit smoking cigarettes, it may be a lot harder for them if they are still using marijuana than it is for someone who uses both but their use is unrelated,” says Dr. McClure.
She says that she is hoping researchers can figure out who will have trouble quitting tobacco if they are using marijuana. “The question is whether, with an appropriate study design and enough smokers, does marijuana use impact tobacco cessation,” she says. “If so, we have a clear recommendation for what to tell people, that they will have more trouble quitting.”
Most tobacco users say they want to quit, Dr. McClure says. And, she adds that in addition to many free “quit smoking” apps and information on the Internet from reputable sources, there are nicotine replacement therapies. A person trying to quit may use a combination of fast-action nicotine replacements (gums, lozenges) with a slow-acting nicotine replacement (patches.)
“New data has come out on the safety of Chantix, the medication for smokers who want to quit,” she says. She also recommended the National Institutes of Health’s app, called QuitStart.
Last updated on 9/27/19.