Review of tobacco and cannabis co-use treatment

Abstract

Co-use of cannabis and tobacco whether it is co-administered or concurrent is a phenomenon of increasing tendency, especially among young people. Co-use has important clinical implications that should be clarified given the diversity of existing treatment approaches.
A narrative review of the literature on the treatment of cannabis and tobacco use was carried out. Several recommendations emerge from this review: The joint approach for both uses, the aim towards complete and indefinite abstinence, the individualization of the treatment and the importance of addressing the diverse sub-goals towards cessation. Among the psychological treatments, the effectiveness of motivational interviewing, cognitive-behavioral therapy and incentive therapy with community reinforcement is well-established. Among the pharmacological treatments, there is evidence of the use of nicotine replacement therapy, bupropion and varenicline for tobacco dependence; In the case of cannabis, there are no approved medications, although there are interesting lines of work with naltrexone, n-acetylcysteine, gabapentin and cannabinoid agonists. Finally, recent years have seen an explosion of mobile applications (mHealth) that offer important advantages and that have already been subject to systematic review.