Cognitive Behavioral Therapy and the Nicotine Transdermal Patch for Dual Nicotine and Cannabis Dependence: A Pilot Study

Am J Addict. May-Jun 2013;22(3):233-8. doi: 10.1111/j.1521-0391.2012.12007.x.

Abstract

Background and objectives: We assessed the feasibility of a new cognitive behavioral therapy (CBT) manual, plus transdermal patch nicotine replacement therapy (NRT), to treat co-occurring nicotine and cannabis dependence.

Method: Seven of 12 (58.3%) adults with DSM-IV diagnoses of both nicotine and cannabis dependence completed 10 weeks of individual CBT and NRT.

Results: Participants smoked 12.6 ± 4.9 tobacco cigarettes per day at baseline, which was reduced to 2.1 ± 4.2 at the end of treatment (F[5] = 23.5, p < .0001). The reduction in cannabis use from 10.0 ± 5.3 inhalations per day at baseline to 8.0 ± 5.3 inhalations per day at 10 weeks was not significant (F[5] = 1.12, p = .37). There was a significant decrease from the mean baseline Fagerstrom Test for Nicotine Dependence scores at weeks 4, 6, 8, and 10 of treatment (F[4] = 19.8, p < .001) and mean Client Satisfaction Questionnaire scores were uniformly high (30.6 ± 1.9).

Conclusions and scientific significance: A CBT plus NRT treatment program significantly reduced tobacco smoking but did not significantly reduce cannabis use in individuals with co-occurring nicotine and cannabis dependence. There was no compensatory increase in cannabis use following the reduction in tobacco smoking, suggesting that clinicians can safely pursue simultaneous treatment of co-occurring nicotine and cannabis dependence. The intervention was well-liked by the 7 of the 12 enrollees who completed the study.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Analysis of Variance
  • Carbon Monoxide / analysis
  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy
  • Cotinine / analysis
  • Dronabinol / urine
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Marijuana Abuse / drug therapy*
  • Marijuana Abuse / therapy
  • Nicotine / therapeutic use*
  • Pilot Projects
  • Smoking Cessation / methods*
  • Surveys and Questionnaires
  • Tobacco Use Cessation Devices*
  • Tobacco Use Disorder / drug therapy*
  • Tobacco Use Disorder / therapy

Substances

  • Nicotine
  • Dronabinol
  • Carbon Monoxide
  • Cotinine