Simultaneous versus sequential cessation of tobacco and cannabis: Preferences of young adults who co-use in France (2026)

INTRODUCTION: Co-use of tobacco and cannabis is common among young adults and is associated with higher dependence and quitting difficulties. Little is known about the preference for simultaneous or sequential dual cessation in this population. We aimed to explore preferences for the timing of dual cessation and the methods most likely to be used by young adults who co-use.
METHODS: Data came from an online nationwide cross-sectional survey of people co-using tobacco and cannabis in France. Preferences for the timing of dual cessation were modelled using binary logistic and multinomial regressions among participants aged 18-30 years. We also described cessation methods (for tobacco and cannabis separately) previously tried and those considered likely to be used in future quit attempts.
RESULTS: Among 357 young adults (54.9% men; median age 24), those using tobacco daily and cannabis 20 days/month had a 56% lower likelihood of preferring simultaneous over sequential cessation (adjusted odds ratio 0.44 [0.21-0.90], p = 0.024) compared with participants with the least frequent co-use. Participants who perceived their tobacco use as more harmful than their cannabis use were more likely to prefer quitting tobacco first. Across past and future attempts, the most cited methods for both substances were sport, cannabidiol, electronic cigarettes and nicotine replacement therapy.
DISCUSSION AND CONCLUSIONS: Simultaneous cessation appeared more acceptable to young adults with lower-risk co-use patterns. Overall, the likelihood of using recommended cessation methods was low. Further research is needed to develop effective and acceptable sequential cessation strategies for young adults who co-use these substances. [Author's abstract]