Study Finds Cannabis Use Doesn’t Block Success in Quitting Nicotine Vaping

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Cannabis use did not reduce success in quitting nicotine vaping among teens and young adults, according to research published in JAMA Network Open.

Nicotine vaping and cannabis use often go hand in hand among teens and young adults, with up to half of those who vape also reporting cannabis use, raising concerns about whether using cannabis might make it harder to quit vaping nicotine. However, current research shows mixed findings, with some studies indicating that co-use of cannabis can lead to increased difficulty with quitting tobacco, while others found no link between the two.

“There is a critical need to clarify the relationship between cannabis use and nicotine cessation outcomes to inform whether more effective, tailored interventions should be developed for individuals who regularly use both substances,” said a team of investigators led by Jodi Gilman, Ph.D., director of Neuroscience for the Center for Addiction Medicine in the Mass General Brigham Department of Psychiatry.

The Study

The current study investigated whether cannabis use affected success in stopping nicotine vaping among people ages 16 to 25 who were trying to quit.

The team of investigators analyzed data from a clinical trial involving 261 young people who regularly vaped nicotine but did not smoke cigarettes. Participants received one of three approaches to help them quit vaping: a prescription medication called varenicline plus counseling, a placebo plus counseling, or referral to a text-based quitting program.

Before treatment started, participants reported how often they used cannabis and whether they had symptoms of cannabis use disorder, as assessed via the Cannabis Use Disorder Identification Test.

Investigators then measured whether participants had successfully stopped vaping nicotine after 12 weeks, using biochemical testing to confirm abstinence. About a quarter of participants did not use cannabis at all in the past month, while others reported using it one to three days per week (38%) or four to seven days per week (30%).

The mean age of participants was 21.5 years, and 53% were female.

Key Findings

Results showed that cannabis use did not make it harder to quit nicotine vaping. Whether participants used cannabis rarely, frequently or not at all, their chances of quitting nicotine vaping were similar.

Cannabis use also did not reduce how well varenicline worked. In fact, varenicline was effective in helping young people stop vaping nicotine regardless of how often they used cannabis or whether they had symptoms of cannabis use disorder.

Investigators noted some limitations, including that patients reported their own cannabis use, which may not be perfectly accurate, and that the study may not have been large enough to detect smaller effects of cannabis or alcohol on vaping cessation. Plus, the findings may only apply to young people who are motivated to quit nicotine vaping and who do not regularly smoke traditional cigarettes.

The Bottom Line

These findings suggest that young people who vape nicotine should not delay or avoid quitting because they also use cannabis. Effective treatments for nicotine vaping, including medication and counseling, can still work even when cannabis use is present. For clinicians and families, the study supports offering evidence-based vaping cessation treatment without requiring cannabis abstinence first.

“We need to increase use of nicotine vaping cessation treatment by young people, and we know that cannabis use is widespread in this population,” said Gilman. “It’s fantastic news that cannabis use doesn’t appear to be a barrier to successful vaping cessation with varenicline treatment, and we can use our findings to inform screening, treatment, planning and public health messaging moving forward.”