Many US Adults Try Cannabis to Quit Smoking, but the Trade-Off May Be Steep

For millions of Americans, quitting nicotine is a grinding, relapse-prone process, and it should come as little surprise that some smokers are reaching for an alternative that is increasingly legal, increasingly available, and widely perceived as benign: cannabis. A new research report published in the Journal of General Internal Medicine by Deanna M. Halliday of the University of California, San Francisco’s Center for Tobacco Control Research and Education, together with Stephanie Wu, Nhung Nguyen, Katherine J. Hoggatt, Salomeh Keyhani, and Beth E. Cohen, examines exactly this phenomenon. In a survey of US adults, the team set out to measure how commonly people use cannabis as an aid to stop smoking or vaping nicotine, and to probe what consequences that strategy might carry. The work arrives at a moment when state-level legalization has transformed cannabis from an illicit substance into a consumer product that sits, often literally, on the same shelf as the nicotine devices smokers are trying to abandon.

The scientific rationale for the idea is not frivolous. Nicotine withdrawal is driven by irritability, craving, difficulty concentrating, and disrupted sleep, and it is precisely these somatic and motivational symptoms that cause most quit attempts to collapse within days. Animal research has long suggested a plausible pharmacological overlap between the two drugs. A frequently cited study by Balerio and colleagues, referenced in the new report, demonstrated that delta-9-tetrahydrocannabinol, the principal psychoactive constituent of cannabis, decreases both the somatic and the motivational manifestations of nicotine withdrawal in mice. In other words, in controlled laboratory conditions, THC appears to blunt at least some of the physiological distress that makes quitting nicotine so punishing. That finding has fed a quiet folk belief among smokers that a little cannabis can take the edge off a quit attempt, and the new survey is among the efforts to quantify how far that belief has spread into actual behavior.

Halliday and her colleagues framed their study around two linked questions. The first is prevalence: among US adults who smoke or otherwise use nicotine, what proportion report using cannabis deliberately as a cessation aid? The second is consequence: among those who do, does the strategy appear to help them quit, or does it simply substitute one inhaled, smoked, or vaped product for another? The distinction matters enormously for public health. Cigarette smoking remains, by the Centers for Disease Control and Prevention’s own accounting, one of the leading preventable causes of disease and death in the United States, and any intervention that genuinely improves cessation rates would be welcome. But if cannabis use merely maintains nicotine dependence while adding a second substance to the picture, the net effect on health could be negative rather than positive.

The survey was conducted by the research firm Ipsos among a nationally relevant sample of US adults, with the Committee of Human Subject Research at the University of California, San Francisco exempting the survey from full review under federal criteria for exempt research. Participants were informed of the study’s purpose and the confidentiality of their responses. The research was funded by the Tobacco-Related Disease Research Program of the University of California, Office of the President, which supported both Halliday’s work on the analysis and the primary data collection overseen by Cohen. Parts of the analyses were presented earlier as a poster at the annual conference of the Society for Research on Nicotine and Tobacco in March 2025, a signal that the findings have been circulating within the tobacco-control research community before their formal publication.

What makes the study timely is the shifting landscape of nicotine delivery itself. The research team and their collaborators have previously documented the tangled relationship between cannabis and modern nicotine products. In earlier work published in Addictive Behaviors Reports, Halliday, Song, and Nguyen examined e-cigarette and cannabis use among current and recently quit smokers, describing patterns of co-use and co-cessation, the phenomenon in which people attempt to abandon both substances at once or find that quitting one destabilizes the other. Separately, Rosen and Steinberg had documented substantial interest in quitting e-cigarettes among US adults, underscoring that the population trying to exit nicotine is not limited to conventional cigarette smokers. The new survey extends this line of inquiry by asking directly whether cannabis is being recruited into the quitting process, and with what apparent results.

The answer to the consequence question, based on the broader evidence base the authors situate their findings within, is sobering. In the International Tobacco Control Four Country Smoking and Vaping Surveys covering 2016 to 2018, Driezen, Gravely, Wadsworth, and colleagues found that increasing cannabis use was associated with poorer cigarette smoking cessation outcomes. That is, among smokers followed over time, those whose cannabis use grew were less likely to succeed in stopping cigarettes. Cohn and Chen, analyzing the Population Assessment of Tobacco and Health study, further described how tobacco and marijuana co-users differ from tobacco-only users in the prevalence and popularity of individual tobacco products across age groups, highlighting how intertwined the two behaviors have become. Against this backdrop, the new survey’s examination of cannabis-as-cessation-aid sits at the junction of hope and hazard.

There is a mechanistic reason to expect the hazard. Nicotine and cannabis are, for many users, paired behaviors: the two are smoked or vaped in overlapping settings, shared socially, and reinforced by the same rituals and cues. A smoker who adds cannabis to a quit attempt may find that the cannabis use itself becomes a cue that re-triggers craving for nicotine, or that the two substances become functionally interchangeable, so that abstaining from one simply increases reliance on the other. The withdrawal-relief pathway identified in animal studies, meanwhile, may not translate cleanly to humans, where dosing, product potency, and patterns of use vary enormously. Modern high-THC cannabis products bear little pharmacological resemblance to the controlled doses administered to laboratory mice, and the therapeutic window, if one exists, has never been established in clinical trials.

The measurement challenge is also considerable, and the field has developed careful instruments to meet it. The revised Wisconsin Smoking Withdrawal Scale, described by Smith, Piper, Bolt, Kaye, Fiore, and Baker in Psychological Assessment, provides brief and long validated forms for quantifying the withdrawal symptoms that any putative cessation aid must relieve. Studies of cannabis as a quitting strategy ultimately have to be judged against outcomes measured with tools of this kind: not whether people feel better in the moment, but whether they achieve sustained abstinence from nicotine without accruing new harms. Survey research such as the new report cannot by itself establish causation, but it can establish scale, and scale is what determines whether a phenomenon deserves clinical trials, regulatory attention, and a place in cessation counseling conversations.

That place may already exist informally. Clinicians who counsel patients on quitting tobacco rarely ask whether those patients are using cannabis to help, and patients, for their part, may not volunteer the information, particularly in states where cannabis remains illegal or where they fear judgment. The new findings suggest that this silence is a gap worth closing. If a meaningful share of US adults attempting to quit nicotine are substituting or supplementing with cannabis, cessation programs need to know, because the standard advice they offer may be interacting with an unreported variable. Conversely, if the practice is common but ineffective or counterproductive, as the international survey evidence on poorer cessation outcomes implies, patients deserve to hear that clearly rather than relying on anecdote.

The study, published as a concise research report in the Journal of General Internal Medicine on 13 October 2026, does not settle whether cannabis can ever be harnessed as a genuine cessation therapy. What it does is document, in a nationally framed sample of US adults, that the practice exists, that it is measurable, and that its potential consequences warrant scrutiny. The authors declare no conflicts of interest, and de-identified data are available upon reasonable request, opening the door to replication and secondary analysis. As legalization expands and cannabis products grow more potent and more pervasive, the question the research raises will only grow more urgent: for the millions of Americans locked in battle with nicotine, is cannabis a bridge out of addiction, or simply a second road into it? The evidence assembled by Halliday and her colleagues suggests that anyone betting on the bridge should look closely at the toll.

Subject of Research: Prevalence and consequences of cannabis use as a nicotine cessation aid among US adults

Article Title: Cannabis as a Nicotine Cessation Aid: Prevalence of Use and Potential Consequences in a Survey of US Adults

Article References: Halliday, D. M., Wu, S., Nguyen, N., Hoggatt, K. J., Keyhani, S., & Cohen, B. E. (2026). Cannabis as a Nicotine Cessation Aid: Prevalence of Use and Potential Consequences in a Survey of US Adults. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10916-3

Image Credits: AI Generated

DOI: 10.1007/s11606-026-10916-3

Keywords: cannabis, nicotine cessation, smoking cessation, THC, tobacco co-use, e-cigarettes, nicotine withdrawal, survey research, public health, Journal of General Internal Medicine, substance use, tobacco control