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

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

Kevin P Hill  1 , Lindsay H Toto, Scott E Lukas, Roger D Weiss, George H Trksak, John M Rodolico, Shelly F Greenfield
Affiliations
Clinical Trial

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

Kevin P Hill et al. Am J Addict. 2013 May-Jun.

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.

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Figures

FIGURE 1
FIGURE 1
Flow diagram of participants recruited to trial.
FIGURE 2
FIGURE 2
Cigarettes per Day during 10 Weeks of CBT and NRT. CBT= cognitive behavioral therapy; NRT= nicotine replacement therapy. There was a significant reduction in cigarette smoking over the course of the 10-week treatment (F[5] = 23.5, p<0.0001).
FIGURE 3
FIGURE 3
FTND Scores during 10 Weeks of CBT and NRT. FTND= Fagerstrom Test for Nicotine Dependence; CBT= cognitive behavioral therapy; NRT= nicotine replacement therapy. Repeated measures ANOVA revealed a significant decrease from the average baseline FTND scores at weeks 4, 6, 8, and 10 of treatment (F[4] = 19.8, p<0.001).
FIGURE 4
FIGURE 4
Cannabis Use during 10 Weeks of CBT and NRT. CBT= cognitive behavioral therapy; NRT= nicotine replacement therapy. The change in participants' cannabis use as measured by number of inhalations per day was not significant by repeated measures ANOVA (F[5] = 1.12, p=.37).
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