Characterization of tobacco use among people who start a substance use treatment for alcohol and/or cannabis: ACT_ACT study

Introduction While the prevalence of tobacco use is fairly significant among people in treatment for substance abuse, its pattern has not been well described in Spain. The objective of this work is to characterize the pattern of tobacco use among people who start treatment for alcohol and/or cannabis use disorder in Substance Abuse Programs (SAP). Material and Methods We conducted a cross-sectional analysis of the baseline ACT_ATAC study. This is a follow-up study carried out among people who started a therapeutic process for alcohol and/or cannabis use in 12 SAPs in Catalonia. Recruitment was carried out between November 2020 and December 2022. All the participants (N=126) were adults, smokers, enrolled in a therapeutical treatment for alcohol and/or cannabis use disorder, and had a telephone to be followed up. Results 126 individuals agreed to participate (67% men and 33% women). 63% of participants were alcohol users, 33% were cannabis users and 4% were dual users. People with alcohol use were on average 13 years older than those with cannabis use (49y vs. 36 y; p<0.01). 96% of the sample had used tobacco in the last 7 days prior to the interview. 67% of participants had a moderate-high nicotine dependence and the average motivation to quit was 6.4 out of 10. By type of substance, 59% of participants with an alcohol use used manufactured cigarettes while for cannabis users 39% did (p=0.053); and 34% of alcohol users consumed roll-your-own cigarettes (RYO) versus 43% of cannabis users (p=0.398). All cannabis smokers reported that they mixed cannabis with tobacco and most of them had more tobacco than cannabis in the joint. Conclusions People with substance use disorder is more likely to consume RYO use than general population. It is necessary to develop specific motivational and therapeutic strategies to encourage smoking cessation in people undergoing treatment for other substances due to their moderate-high dependence and moderate motivation. The ACT-ATAC Project is registered with Clinicaltrials.gov [NCT04841655].