Tobacco/Nicotine Use Among Individuals Using Cannabis for Therapeutic Purposes
OBJECTIVE: While the relationship between recreational cannabis and nicotine use is well established, little is known about nicotine use among users of cannabis for therapeutic purposes (CTP). METHOD: Patients attending a medical marijuana dispensary (N = 697; 75.3% White; 60.0% male) completed a survey examining nicotine use, routes of administration of nicotine and cannabis, and CTP qualifying conditions. RESULTS: More than one-third (39.3%) of participants reported current nicotine use. Compared to exclusive cigarette smokers, non-users of nicotine, and e-cigarette users were approximately four times more likely to vape, rather than to smoke, cannabis. Almost a third of those reporting e-cigarette use (30.6%) and more than half (56.7%) of those reporting smoking cigarettes reported stopping for one day or longer in the past year because they were trying to quit. Furthermore, 46.8% of cigarette smokers reported plans to quit smoking in the next six months (but not in the next month) and an additional 31.6% planned to quit in the next month. Having a psychiatric condition was associated with nicotine use and higher motivation to quit smoking. CONCLUSIONS: Users of CTP are more likely to use nicotine products than the general population. Importantly, the route of administration of nicotine products is related to the route of administration of CTP. If aerosolized (vaped) CTP is a less harmful route of administration than smoked CTP, dispensary staff should be aware of this relationship and take this into account when recommending a non-combustible route.