Cigarette smokers face high hurdles when trying to quit tobacco, particularly if they are also smoking cannabis (marijuana).  In the last 10 years there has been a significant increase in the use of marijuana among cigarette smokers.  A study out of New York observed that the prevalence of smoking was 3 time higher in persons who use cannabis and have cannabis use disorder. A sobering static comes from the 2019 National Survey of Drug Use and Health.  This study found that 15.9% of Americans aged 12 and older have used marijuana in the past year.

    Cannabis use disorder is diagnosed when an individual has clinically significant impairment due to the recurrent use of cannabis.  Specific diagnostic criteria include a variety of general health problems, persistent or increasing use and failure to meet major responsibilities at work, school or home.

    Quitting smoking is hard and the smoking of marijuana makes it even harder.  In 2016 the quit percentages for cannabis users and those with cannabis use disorder were 23% and 15% respectively.  Those with no cannabis use and no cannabis use disorder had a 51% and 49% quit rate, respectively.

    This data suggests that people who use cannabis or have cannabis use disorder should be questioned about their use of combustible tobacco and e-cigarettes.  These patients should be encouraged to join tobacco cessation programs, along with programs designed to help them quit their cannabis use.  Physicians should not only ask their patients about smoking, but associated cannabis use as well.