Cognitive behavioral therapy and the nicotine transdermal patch for dual nicotine and cannabis dependence: a pilot study.

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 perpendicular to 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.