Center for Tobacco Control Research and Education, University of California San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California San Francisco, CA, USA.
Department of Psychiatry, Yale School of Medicine, CT, USA; Yale Cancer Center, CT, USA.
Addict Behav. 2024 Nov;158:108118. doi: 10.1016/j.addbeh.2024.108118. Epub 2024 Jul 21.
There are no clinical practice guidelines addressing the treatment of tobacco-cannabis co-use and a dearth of studies to inform treatment for co-use. This narrative review aims to (1) summarize promising intervention components used in published co-use treatment studies, (2) describe key gaps and emerging issues in co-use, and (3) provide recommendations and considerations in the development and evaluation of co-use interventions.
We conducted a literature search in June 2024 across several databases to update previous reviews on tobacco-cannabis co-use treatment. We found 9 published intervention studies that specifically addressed treatment for both substances. Data from these studies were manually extracted and summarized.
Most of the 9 included studies (1) focused on acceptability and/or feasibility, (2) provided both psychosocial/behavioral and pharmacotherapy intervention components, (3) were conducted in adults, and (4) were delivered in-person, with some having digital asynchronous components, for a 5-to-12-week duration. The most common psychosocial/behavioral strategies used were Cognitive Behavioral Therapy, Motivational Interviewing, and Contingency Management; while the most common pharmacotherapy was Nicotine Replacement Therapy. There was no evidence of compensatory use of tobacco or cannabis when providing simultaneous treatment for both substances.
The literature to date provides support for well-integrated multi-component interventions of psychosocial/behavioral and pharmacotherapy strategies for co-use treatment. This review reinforces an urgent need for treatments targeting tobacco and cannabis co-use. Future interventions should address key gaps, including co-use of vaporized products among youth and young adults, tailored interventions for priority populations, and digital applications to increase reach and advance health equity.
目前尚无针对烟草-大麻共用治疗的临床实践指南，也缺乏相关研究为共用治疗提供依据。本叙述性综述旨在：(1)总结发表的共用治疗研究中使用的有前途的干预措施成分；(2)描述共用治疗中的关键差距和新兴问题；(3)为共用干预措施的制定和评估提供建议和考虑因素。
我们于 2024 年 6 月在多个数据库中进行了文献检索，以更新之前关于烟草-大麻共用治疗的综述。我们发现了 9 项专门针对两种物质治疗的已发表干预研究。这些研究的数据被手动提取并进行了总结。
9 项纳入研究中的大多数：(1)侧重于可接受性和/或可行性；(2)提供心理社会/行为和药物治疗干预措施；(3)在成年人中进行；(4)以面对面的方式进行，其中一些具有数字异步组件，持续 5 至 12 周。使用最普遍的心理社会/行为策略是认知行为疗法、动机访谈和条件管理；最常见的药物治疗是尼古丁替代疗法。在同时提供两种物质的治疗时，没有证据表明会出现烟草或大麻的补偿性使用。
迄今为止的文献为心理社会/行为和药物治疗策略相结合的综合多成分干预措施提供了支持，共用于治疗。本综述强调了急需针对烟草和大麻共用的治疗方法。未来的干预措施应解决关键差距，包括青少年和年轻人中雾化产品的共用、针对重点人群的定制干预措施，以及数字应用以扩大服务范围并促进健康公平。
