McClure, Erin A and Piper, Megan E and Crotty Alexander, Laura E and Burnham, Ellen L and Freeman, Tom P and Galiatsatos, Panagis and Lang, Adam Edward and Lee, Dustin C and Leone, Frank T and Melzer, Anne C and Mermelstein, Robin J and Montgomery, LaTrice and Rabin, Rachel A and Smith, Danielle M and St Helen, Gideon and Weinberger, Andrea H and Kathuria, Hasmeena (2025) Effects of inhaled tobacco and cannabis co-use on respiratory health and tobacco cessation. An official American Thoracic Society research statement. American Journal of Respiratory and Critical Care Medicine, Early online, https://doi.org/10.1164/rccm.202507-1792st.
External website: https://www.atsjournals.org/doi/10.1164/rccm.20250...
BACKGROUND: Tobacco and cannabis are among the most widely used substances globally, and rates of co-use are on the rise. Understanding the impact of inhaled tobacco-cannabis co-use on health outcomes and tobacco cessation is critical for guiding patients and clinicians.
OBJECTIVES: To summarize the existing evidence, identify knowledge gaps, and prioritize research questions related to effects of inhaled tobacco-cannabis co-use on tobacco cessation and lung health.
METHODS: A multidisciplinary committee was convened to review the evidence, identify knowledge gaps, and develop research questions in four priority research areas: 1) common data elements and terminology; 2) patterns and prevalence of co-use; 3) impact of co-use on tobacco cessation; and 4) effects of co-use on lung health. A modified Delphi process was conducted in three rounds to reach consensus on prioritizing research questions.
RESULTS: The evidence reviewed by the expert panel in four priority research areas yielded the following gaps in the literature with high priority to address with future research: 1) lack of consensus on terminology and recommended co-use data elements; 2) limited research on co-use and tobacco-related disparities; 3) insufficient evidence on how cannabis use affects tobacco cessation; and 4) alarming yet inconsistent findings on the effects of co-use on lung health.
CONCLUSIONS: This statement outlines and guides a research agenda on the effects of inhaled tobacco-cannabis co-use on tobacco cessation and lung health. Consensus-driven recommendations include adopting harmonized terms and minimum data elements; studying the prevalence of co-use among populations experiencing tobacco-related disparities; evaluating the impact of co-use on tobacco cessation pharmacotherapies; and assessing the effects of co-use on the development and progression of lung diseases.
B Substances > Tobacco (cigarette smoking)
E Concepts in biomedical areas > Route of administration > Smoke, vape, inhalation
G Health and disease > Respiratory / lung disease
HJ Treatment or recovery method > Substance disorder treatment method > Cessation of tobacco / nicotine use
VA Geographic area > International
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