Support provided by stop smoking practitioners to co-users of tobacco and cannabis: a qualitative study

Nicotine Tob Res. 2023 Jul 10:ntad115. doi: 10.1093/ntr/ntad115. Online ahead of print.

ABSTRACT

INTRODUCTION: Co-use of tobacco and cannabis is highly prevalent among cannabis users and is associated with poorer tobacco cessation outcomes. This study explored the barriers and enablers influencing stop smoking practitioners’ ability to provide optimal support to co-users.

METHODS: Online semi-structured interviews were audio recorded. Interviewees (n = 20) were UK-based certified stop smoking practitioners. An interview schedule informed by the ‘capability’, ‘opportunity’, ‘motivation’ (COM-B) model was designed to explore participants’ perceived barriers and enablers in better supporting co-users to achieve abstinence of both substances or tobacco harm reduction. The transcripts were analysed using framework analysis.

RESULTS: Capability: practitioners’ lack of knowledge and skills undermines their delivery of smoking cessation interventions to co-users. Interestingly, when cannabis is used for medicinal reasons, practitioners feel unable to provide adequate support. Opportunity: service recording systems play an important role in screening for co-use and supporting co-users. When responding to clients’ specific needs and practitioners’ uncertainties, a positive therapeutic relationship and a support network of peers and other healthcare professionals are needed. Motivation: supporting co-users is generally perceived as part of practitioners’ roles but there are concerns that co-users are less likely to successfully stop smoking.

CONCLUSIONS: Practitioners are willing to support co-users, but their lack of knowledge and access to an appropriate recording system are barriers to doing so. Having a supportive team and a positive therapeutic relationship are perceived as important. Identified barriers can be mostly addressed with further training to improve tobacco cessation outcomes for co-users.

IMPLICATIONS: Supporting cannabis-related abstinence or harm reduction among co-users constitutes an essential part of stop smoking practitioners’ role. In order to offer adequate support, practitioners need appropriate recording, referral systems, as well as comprehensive training. By prioritizing these measures, practitioners shoud be able to better assist co-users and improve tobacco cessation outcome.

PMID:37429576 | DOI:10.1093/ntr/ntad115