Association between Smoking Cannabis and Quitting Cigarettes in a Large American Cancer Society Cohort

• Type of Material: Article
• Authors: Johann Westmaas, Emory University; Sara E Strollo, American Cancer Society; Christina C Newton, American Cancer Society; Brian D Carter, American Cancer Society; Ryan W Diver, American Cancer Society; William Flanders, Emory University; Victoria Stevens, Emory University; Alpa Patel, American Cancer Society; Kassandra Alcaraz, Georgia State University; Johannes Thrul, Johns Hopkins Bloomberg School of Public Health; Eric Jacobs, Emory University
• Language: English
• Date: 2021-10-01
• Publisher: AMER ASSOC CANCER RESEARCH
• Publication Version: Final Published Version
• Copyright Statement: ©2021 The Authors; Published by the American Association for Cancer Research
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1158/1055-9965.EPI-20-1810
• Title of Journal or Parent Work: CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
• Volume: 30
• Issue: 10
• Start Page: 1956
• End Page: 1964
• Keywords: UNITED-STATES; DRUG-USE; PREVENTION; Science & Technology; TOBACCO CESSATION OUTCOMES; HISTORY; DEPENDENCE; Life Sciences & Biomedicine; ALCOHOL; Oncology; MARIJUANA USE; NICOTINE; Public, Environmental & Occupational Health; PREVALENCE
• Research Categories: Health Sciences, Oncology; Health Sciences, Public Health

Abstract

Background: Cannabis use is increasing, including among smokers, an at-risk population for cancer. Research is equivocal on whether using cannabis inhibits quitting cigarettes. The current longitudinal study investigated associations between smoking cannabis and subsequently quitting cigarettes. Methods: Participants were 4,535 adult cigarette smokers from a cohort enrolled in the American Cancer Society’s Cancer Prevention Study-3 in 2009–2013. Cigarette quitting was assessed on a follow-up survey in 2015–2017, an average of 3.1 years later. Rates of quitting cigarettes at follow-up were examined by retrospectively assessed baseline cannabis smoking status (never, former, recent), and by frequency of cannabis smoking among recent cannabis smokers (low: ≤3 days/month; medium: 4–19 days/month; high: ≥20 days/month). Logistic regression models adjusted for sociodemographic factors, smoking- and health-related behaviors, and time between baseline and follow-up. Results: Adjusted cigarette quitting rates at follow-up did not differ significantly by baseline cannabis smoking status [never 36.2%, 95% confidence interval (CI), 34.5–37.8; former 34.1%, CI, 31.4–37.0; recent 33.6%, CI, 30.1–37.3], nor by frequency of cannabis smoking (low 31.4%, CI, 25.6–37.3; moderate 36.7%, CI, 30.7–42.3; high 34.4%, CI, 28.3–40.2) among recent baseline cannabis smokers. In cross-sectional analyses conducted at follow-up, the proportion of cigarette smokers intending to quit smoking cigarettes in the next 30 days did not differ by cannabis smoking status (P ¼ 0.83). Conclusions: Results do not support the hypothesis that cannabis smoking inhibits quitting cigarette smoking among adults. Impact: Future longitudinal research should include follow-ups of >1 year, and assess effects of intensity/frequency of cannabis use and motivation to quit on smoking cessation.