Clinician's perceptions and experiences with tobacco treatment in people who use cannabis: a qualitative study

Abstract

Canabis; Política de salud; Servicios de atención sanitaria

Cannabis; Health policy; Healthcare services

Cànnabis; Política de salut; Serveis sanitaris

Global demand for the treatment of cannabis use disorder has increased significantly, prompting a need to understand effective strategies for addressing concurrent cannabis and tobacco use. This study focuses on clinicians' experiences and perceptions in delivering tobacco cessation services to people who use cannabis.

Fifteen participants (12 females, 3 males) participated in three homogenous focus groups, including two groups with extensive experience in providing tobacco cessation among the substance use population in Catalonia, Spain, and one group of clinicians without such experience. Thematic analysis was conducted to identify key patterns and insights in their discourse, focusing on shared themes and divergences across groups.

Five main themes and 17 subthemes emerged: Individual characteristics, Clinician characteristics, Models of intervention, Organizational healthcare models, and Health policies. Clinicians stressed the importance of intervention models and the active role of professionals in addressing tobacco use within routine care, as tobacco cessation could mitigate social and chronic stigma among people who use cannabis, especially those engaged in polydrug use.

Recommendations included integrating tobacco cessation into all services, reducing healthcare service fragmentation, improving resource accessibility, enhancing clinical documentation, and advocating for stronger population-level tobacco control policies.

The ACT-ATAC project has been successfully registered at Clinicaltrials.gov [NCT04841655].

This work was supported by the Instituto de Salud Carlos III (ISCIII) (Grant: PI18/01420) Fondo Europeo de Desarrollo Regional (FEDER) “Una manera de hacer Europa”. The Tobacco Control Research Group is partly supported by the Ministry of Business and Knowledge from the Government of Catalonia [2017SGR319] and by Instituto de Salud Carlos III, Government of Spain (CIBERES CB19/06/00004). CMM received funding for a research stay at the University of California San Francisco from the Ministry of Health in Spain (BAE: 20220021). We thank CERCA Programme/Generalitat de Catalunya for institutional support.