Ever wonder if CBD Cigarettes might help you quit tobacco? Hemp cigarettes are a new phenomenon that have been hitting the US by storm. You can find them in your local smoke shops, and they might be a key to helping people overcome nicotine addiction. New studies reveal CBD’s potential in treating addiction and withdrawals. Does CBD oil help to quit smoking cigarettes? Can you smoke hemp CBD flowers as a substitute for tobacco? Here’s what you need to know about CBD oil and addiction to cigarettes. Although cannabis has long been considered as a “drug of abuse”, in recent years an increasing number of studies published in the biomedical literature indicate that either the plant itself or some of its compounds may be of use in treating addictions. For example, a recent review sets out the current evidence on the involvement of the endocannabinoid system in modulating
CBD Cigarettes & Nicotine | How CBD Cigarettes May Help People Quit Tobacco
We receive a lot of questions about whether or not hemp cigarettes might help someone quit smoking (tobacco). Every year, tobacco addiction claims more than 8 million lives worldwide. This includes not only long-term active smokers but also occasional smokers.
Those affected by second-hand smoke are just as much at risk. While most people understand that tobacco use is detrimental to their health, tobacco continues to dominate sales in smoke shops across the country due to high rates of nicotine addiction.
Quit smoking with CBD cigarettes
The good news is that according to national surveys, the rates of tobacco usage in adults is gradually decreasing. Smokers are interested in quitting, and Cannabidiol, commonly known as CBD, may be helpful to those who are looking to fight their addiction.
Studies suggest that CBD may help with managing unpleasant withdrawal symptoms from smoking cessation.This is great news for nicotine smokers who’re looking to break free from the life-threatening addictive behaviors and to lead a healthy life.
Want to find out how CBD cigarettes might be able to help people stop smoking tobacco? Read on to learn more about how hemp cigarettes might assist those who need to break free from nicotine once and for all.
CBD Uses in the U.S.
You might have noticed CBD products popping up in your local grocery stores and health shops. With more research surfacing each year surrounding CBD and its purported health benefits, people are becoming increasingly optimistic about the positive effects it may carry.
Some proponents of CBD claim that it may help people deal with diseases such as arthritis, anxiety, schizophrenia, cancer, and addiction. To date, the FDA has only approved CBD for as a medical treatment for epilepsy to reduce seizures in certain individuals.
In the U.S. market, the most sought-after (and off-label) benefits of CBD cigarettes include lowered anxiety and enhanced well-being. Additionally, some studies have shown the effectiveness of CBD for nicotine withdrawal, so we’ve put together a guide to assist you.
Where Does CBD Come From?
CBD is one of the two most common cannabinoids found in the cannabis plant. In the United States, hemp is defined as the Cannabis sativa L. plant containing no more than 0.3% THC, the chemical that makes you high. CBD on the other hand, is the non-psychoactive ingredient of the plant. In other words, you won’t get high from smoking or ingesting it.
Nowadays, you can find CBD in various forms such as tinctures, vaporized liquids, edibles, capsules, hemp cigarettes and pre-rolls.
CBD cigarettes for tobacco smokers and smoking cessation
Similar to many hard drugs circulating our world today, nicotine is extremely addictive. After a sudden reduction of nicotine intake, most people begin to experience nicotine withdrawal symptoms within a few hours.
These unpleasant withdrawal symptoms can cause headaches, irritability, anxiety, sleep disturbances, high blood pressure, flu-like symptoms, and depression. It’s no wonder that so many who attempt to quit often fail.
Can CBD cigarettes help you quit smoking?
Some research indicates that CBD may interact with certain receptors that help to regulate sleep cycles, improve mood, and decrease anxiety and pain. By combining nicotine cessation tools and strategies along with CBD, cigarette smokers may find some relief when experiencing nicotine withdrawal symptoms during the quitting process.
It seems that the general consensus is a likely yes, that Cannabidiol reduces cigarette consumption. Read further to take a look at some studies surrounding recent research on this topic.
CBD and Relaxation
In a 2015 study, CBD was found to have potential anxiolytic properties, meaning that it may help to reduce anxiety in patients. Sometimes compared to diazepam, a common sedative drug, CBD may have properties that promote a feeling of relaxation.
Some people suffering from post-traumatic stress disorder (PTSD) use CBD for managing stress hormones and promoting a sense of calm. Although most of these claims are anecdotal, many users claim that CBD has changed their lives for the better.
Double blind placebo study in 2015
A 2015 double blind placebo study of 24 smokers gave people a glimpse into the potential role that CBD may play in tobacco cessation. The study instructed patients in a CBD group to use a CBD inhaler when they felt the urge to smoke. Over the one-week period, the researches found that those treated with CBD inhalers smoked ~40% fewer cigarettes.
Statistically speaking, this was a surprisingly significant reduction from their normal intake. Meanwhile, the placebo group showed no differences in number of cigarettes smoked.
The writers of the article explain that this preliminary data, when combined with the strong preclinical rational for the use of CBD, suggests that CBD would be a potential candidate for tobacco addiction treatment that warrants further exploration.
UK Study on CBD and attentional bias to cigarettes
In 2018, a study performed in the UK indicated that CBD reverses attentional bias to cigarette cues to tobacco withdrawal symptoms. It was a randomized, double-blind cross-over study using a human experimental model, designed where patients would abstain from using tobacco over two nights under observation.
They found that CBD reduced the salience and pleasantness of cigarette cues, when compared with placebo. However, CBD did not influence tobacco craving, nicotine withdrawal symptoms or any subjectively rated side effects in this experiment.
The researchers responsible for these studies observed that CBD may yet prove to be a promising tool when it comes to smoking cessation. The preliminary findings have demonstrated the need for further, in-depth studies on the effects of CBD in tobacco smokers.
CBD Side Effects
CBD seems to be well tolerated, though it may cause some side effects, such as reduced appetite, drowsiness or fatigue, dry mouth, or diarrhea. Also, CBD may interact with some medications, so it’s always necessary to consult with your doctor prior to using any form of CBD.
Is CBD addictive?
Our readers often ask us this question. Is CBD addictive? Studies strongly suggest that CBD is not addictive in its many forms. In fact, CBD seems to be able to help with treating drug addiction.
Some Other Forms of CBD
CBD can be consumed in many different ways. One of the most common ways is in the form of oils. CBD oil can be introduced into the body in sublingual drops that are placed under the tongue before swallowing.
Due to the naturally pungent aroma of the cannabis plant, many find the taste of CBD oil to be overwhelming. Several companies have found ways around this by incorporating it into beverages, edibles, topicals, or in our case here, hemp cigarettes.
For smokers who would like to imitate the action of smoking, hemp can be a solid option. Again, you should consult your healthcare professional before using any form of CBD.
Certificates of Analysis (COAs)
Before you purchase a CBD product to quit cigarette smoking, it’s important to conduct your own research, and consume only high-quality CBD that has been tested by a third-party lab. Always opt for reliable companies and retailers who show COAs (Certificate of Analysis), that show pesticides, heavy metals, potencies, and other impurities that may affect your body.
When reviewing a COA, you’ll usually find a range of acceptable limits for each line item. Just because a CBD company publishes their COA does not mean that they have met all of the recommended limits of each tested item.
You’ll often run into COAs where the product clearly did not meet industry standards, but the unknowing layperson will assume that a published COA means that the product passed with flying colors.
Now that you’re equipped with some knowledge about COAs, we’re going to dive in to some specific products that may help you on your journey.
Which CBD products to buy for nicotine addiction?
While CBD comes in many forms, you may find that inhalable CBD may be more suitable for quitting cigarette smoking than products such as gummies and oils. This is mainly due to a smoker’s habit of inhaling tobacco or nicotine.
By replacing your tobacco cigarette with a similar and familiar alternative, you’re able to transition your smoking habit with a less drastic change in lifestyle. You probably already noticed this, but the act of smoking itself is one part of many addictive behaviors that you’ve acquired as a long-time smoker.
Our favorite is CRÈME Vanilla CBD cigarettes, since it’s enjoyable and also smooth. This can be paired with nicotine cessation tools such as nicotine gum or a nicotine patch.
We encourage you to try different products to see which works best for you. Everyone is different, and must take their own path to breaking free from addiction.
Quit Date & Quit Plan
Start with the decision by setting a quit date, and stick with it by executing a quit plan. If you have a rough day and give in to your cravings, don’t let it discourage you. it’s normal. Keep trying, and don’t ever give up.
Like everything else in life, if you educate yourself, set a plan and execute, you’re bound to succeed.
Quitting cigarettes has proven to be a notoriously difficult. But if you’re one who’s looking to kick the habit, here’s a bit of advice. Combine different types of cessation tools, such as gum, breathing exercises, and perhaps CBD, which can help with withdrawal symptoms, and ultimately help you quit smoking.
Tools like gum or patches will help you slowly reduce nicotine intake, while hemp cigarettes can introduce smoking CBD as a potential mechanism to reduce nicotine cue, and also mimic the act of smoking with an actual cigarette without the nicotine.
It’s exciting to see in actual studies that Cannabidiol reverses attentional bias. While more studies are warranted, our customers have found success in quitting smoking already. We wish you luck on your journey!
How Can CBD Oil Help You to Quit Smoking Cigarettes?
Although tobacco addiction isn’t contagious, it causes millions of deaths worldwide. It’s also one of the most addictive substances on Earth. Each year, more than 7 million people die from tobacco-related diseases.
In the United States, over 40 million adults struggle with nicotine addiction. Worse yet, conventional treatments seem to fail to help those people quit smoking cigarettes.
Fortunately, many promising “novel” therapies, such as cognitive-behavioral therapy, can be enhanced with natural remedies that can mitigate withdrawal symptoms. Recently, CBD (cannabidiol) has been making big headlines in research journals for its ability to help with tobacco addiction.
Does using CBD gummies to quit smoking cigarettes make sense?
Continue reading to find out.
Can You Use CBD Oil to Quit Smoking Cigarettes?
Understanding how nicotine addiction works is paramount if you want to find an effective solution. Aside from the obvious physical addiction, smoking cigarettes is habit-forming and thus can trigger behavioral addiction.
With a physical addiction, all you need to do is endure the time your body needs to flush nicotine out of your system and bring your body back to normal functioning.
Behavioral addictions are more complex because the brain of an addicted person is wired to certain processes that often lead to the pleasurable sensation associated with inhaling cigarette smoke.
That’s why nicotine replacement therapies such as nicotine gums or patches demonstrate low cessation success rates.
Imagine engaging in a particular activity 20 to 40 times a day for 10 to 20 years; won’t it be hard to quit that habit regardless of the activity?
The surge of dopamine combined with an effortless way to experience it — as is the case with smoking cigarettes — further reinforces the habit, making it more difficult to go cold turkey.
Below we explain how CBD may help you curb cigarette cravings, dampen withdrawal symptoms, and rewire your brain so that it no longer associates smoking cigarettes with a priority.
How CBD Oil May Help You Quit Smoking Cigarettes
CBD has a versatile therapeutic profile. People use it to relieve a wide range of conditions and symptoms, including pain , muscle spasms , tremors , seizures , sleeplessness , autoimmune conditions , neurodegeneration and dementia , and more.
Recently, CBD has garnered the attention of psychiatrists and addiction experts for its potential in dealing with tobacco addiction.
Here we explain how using CBD oil can help you quit smoking cigarettes.
1. CBD Alleviates Withdrawal Symptoms After Quitting Cigarettes
Nicotine is strongly addictive, similar to hard drugs like cocaine, hence quitting smoking cigarettes. At some points, most users face a barrier of withdrawal symptoms that is almost impossible to overcome.
Physical addiction to tobacco reaches far beyond the urge for another cigarette. Withdrawal symptoms develop within a few days and involve irritability, anxiety, difficulty falling asleep, high blood pressure, headaches, and depression.
They may linger for up to several weeks. If the period of withdrawal were easy to overcome, smoking addiction wouldn’t become a global health problem.
CBD interacts with the human endocannabinoid system (ECS), which maintains homeostasis throughout the body. The ECS controls essential bodily functions, including sleep cycles, stress response, blood pressure, body temperature, mood, memory, pain perception, and more.
CBD is a potent inhibitor of FAAH — an enzyme that breaks down the body’s natural endocannabinoids. These endocannabinoids bind to cannabinoid receptors in the brain (CB1) that can influence mood, pain, sleep, and reward regions in your brain . Supplementing CBD oil helps you maintain a sufficient level of your own cannabinoids and thus reduces the dysfunction of the aforementioned processes.
2. CBD Curbs Tobacco Cravings
A 2018 study that came out of the UK in May 2018 investigated the potential benefits of CBD on smoking-related behavior. This double-blind, randomized study included a sample of 30 addicted smokers. Each of the participants was taking 800 mg of CBD orally or an equivalent dose of a placebo .
Then the subjects were shown “pictorial tobacco cues” such as drinking, parties, other people smoking, etc., and were analyzed for heart rate, cravings, blood pressure, and withdrawal symptoms.
The authors concluded that a single 800 mg dose of CBD could help to reduce the “pleasantness” of images associated with smoking cigarettes compared to the placebo group, especially for the participants who only went through one day of cessation for the study.
3. CBD Eases Anxiety After Quitting Cigarettes
On top of regulating the ECS, CBD uses over 60 molecular targets to interact with the body, which explains its therapeutic versatility.
One of these targets involves the modulation of the GABA receptor to balance the levels of two neurotransmitters: glutamate (excitatory) and gamma-aminobutyric acid (inhibitory). High levels of glutamate and low levels of GABA are associated with the hyperactivity of the brain and increased feelings of anxiety. By modulating the GABA receptor, CBD helps to maintain equilibrium in your nervous system, preventing bouts of anxiety, improving stress response, and enhancing focus.
CBD also acts on the serotonin receptor. Serotonin is the neurotransmitter responsible for mood and emotions, whose low levels are linked to anxiety and depression. In contrast, excess serotonin levels in the brain can induce muscle spasms, overactive reflexes, shivering, clumsiness, and tremor.
Although CBD doesn’t directly boost your serotonin levels, it blocks its reuptake by interacting with the 5-1HTA serotonin receptor so that your brain can use it more effectively. This, in turn, translates into the proper functioning of brain cells and thus helps to relieve tremors, muscle spasms, and even lowers the incidence of anxiety and depression.
4. CBD Reduces Cigarette Consumption
One study examined smokers who wanted to quit smoking cigarettes. Each smoker was taking an inhaler with either CBD or a placebo vaping cartridge. The participants were asked to use the inhalers every time they felt the urge to smoke. At the end of this week-long study, the CBD group showed a 40% reduction in cigarette consumption while the placebo group didn’t report a significant difference in the number of cigarettes smoked .
The study authors concluded that this effect could be attributed to CBD’s indirect interactions with CB1 receptors. Not only does CBD increase the natural level of anandamide — one of the two major endocannabinoids known as “the bliss molecule,” but it can also mitigate the boosting properties of nicotine.
In a research paper posted in the journal Addiction , Hindocha et al. went on a series of experiments in which vaping cannabis was associated with reduced tobacco consumption. The research team hypothesized that :
“ There could be a reason to be optimistic about the potential of vaporizers. If vaporizers can reduce cannabis and tobacco co-administration, the outcome could be reducing tobacco use/dependence among cannabis users and a resultant reduction in harms associated with cannabis/tobacco. Indeed, if vaping cannabis becomes commonplace in the future, the next generation of cannabis users might never be exposed to nicotine or tobacco in the first place.”
Benefits of Smoking CBD Instead of Cigarettes
For some people, the problem of quitting cigarettes is more about habitual use rather than the actual physical addiction.
You pull out a cigarette, light it up, and take a steady draw — day after day, month after month, year after year.
Imagine stopping this in the blink of an eye — leaving away a part of your identity takes strong will and determination.
By smoking CBD instead of regular cigarettes, you can maintain your habit of smoking a cigarette without physically addictive content. Of course, smoking a CBD joint still delivers tar and other harmful substances to your system, but it can help you get off the nicotine and then gradually transition to vaping CBD — either as flowers or in the form of vape liquid.
How to Use CBD to Stop Smoking
As you can see, CBD can do a lot to help you quit smoking cigarettes. But how do you take CBD to get the best results for your nicotine addiction? Here are a few tips that can make it easier:
Buy High-Quality Products
The source of your CBD oil can make or break your experience with using CBD to quit smoking cigarettes. There’s a universal rule for buying CBD oil in an unregulated market like the one we have in the USA — purchase only from reputable brands.
For this, make sure the brand you’re looking at ticks off the following points:
- The hemp source: prioritize brands with in-house organic hemp fields in the US and Western Europe. Avoid products sourced from mass-produced hemp imported from overseas, as this kind of hemp is often contaminated with pesticides, heavy metals, and synthetic fertilizers.
- The THC content: the concentration of THC in your CBD oil must be less than 0.3% to be considered legal on a federal level. Any product with a higher THC content is treated by federal law as marijuana and thus prohibited unless your state has legalized marijuana for recreational use.
- Lab reports: it’s always better to choose a company that provides certificates of analysis (COAs) for their products. These certificates give you insight into the product’s phytochemical profile, including the THC content and purity levels.
Start with a Low Dose
If you’re looking for a straight answer, we don’t have good news for you. Since CBD hasn’t been yet clinically tested for tobacco addiction, there are no established dosage guidelines on this subject; you can get a quick point of reference by looking at the studies that have examined the efficacy of different doses of CBD for quitting cigarettes.
Another reason why dosing CBD in humans isn’t that obvious is the number of individual factors at play. The list includes an individual’s weight, metabolism, unique body chemistry, the severity of addiction and withdrawal symptoms, and the potency of your CBD product.
Consulting a medical practitioner experienced in using CBD for addiction should help you establish the optimal starting dosage. We recommend starting with a low dose, like 10-15 mg per day to see how your body responds to cannabidiol. If this works for you, you can begin taking more to assess what amount reduces the salience of tobacco stimuli.
To learn more about the general dosage guideline, read our post here.
Opt for Full-spectrum CBD Oil
Full-spectrum CBD oil contains all beneficial compounds that naturally occur in hemp plants, including CBD, adjunctive cannabinoids, terpenes, and trace amounts of THC. These ingredients work together to amplify each other’s health benefits while mitigating potentially unwanted reactions (e.g., in a way, CBD counteracts the psychotropic effects of THC).
This phenomenon is known as the entourage effect — the reason why full-spectrum CBD products are the most desired type of CBD. Several studies have found that full-spectrum CBD oils overcome the bell-shaped dose-response when people take pure cannabidiol — meaning that dosing is more predictable with such products.
If you’re concerned about the trace amounts of THC, you can choose a broad-spectrum extract , which only contains CBD, terpenes, and adjunctive cannabinoids — but without the intoxicating compound.
Is CBD Addictive?
While smoking marijuana can be habit-forming and thus carries a risk of developing behavioral addiction, CBD isn’t addictive in any way . Cannabidiol belongs to non-intoxicating ingredients, meaning it doesn’t change the way your brain functions. The WHO has acknowledged that the abuse potential of CBD is similar to placebo. In addition, case studies are indicating that CBD can help reduce cravings associated with a behavioral addiction.
Nicotine Addiction And Its Toll on Society
Tobacco use is the number one preventable cause of death and one of the hardest addictions for consumers to quit. As reported by the Center for Disease Control (CDC), an estimated 14% of people over the age of 18 smoke cigarettes. This makes for a whopping 34.3 million people who use tobacco regularly. Over 8 million uses smokeless forms, such as nicotine E-liquids.
Smoking can lead to heart disease, compromised lung function, cancer, and an array of comorbid conditions. Once again, smoking is THE MOST PREVENTABLE cause of death in the United States. People know all the risks; it’s all conveyed in social campaigns and written on the labels of cigarettes (oh, irony). That being said, quitting smoking cigarettes is a challenging thing to accomplish.
Especially when you consider its withdrawal symptoms.
Common Withdrawal Symptoms After Quitting Cigarettes
The withdrawal symptoms of quitting cigarettes vary depending on the severity of your addiction and your body’s dependence on nicotine. Some of the more common withdrawals include:
- Thinking problems
- Depressive mood
- Nausea and abdominal cramping
- Slowed heart rate
The physical withdrawal symptoms can be accompanied by psychological, such as:
- A strong desire to light up
- Feelings of frustration
- Difficulty concentrating
- Low mood
- Poor response to stress
- Mood swings
Managing these withdrawal symptoms is one of the most important elements of quitting smoking cigarettes — and CBD seems to fit here like a glove.
Unfortunately, using CBD oil to quit smoking cigarettes isn’t the first-choice treatment among doctors.
How Is Nicotine Addiction Usually Treated?
Pharmaceutical corporations have responded with nicotine gums and patches as a means of fighting tobacco addiction. However, these cessation devices are actually more of a tool for damage control rather than an effective solution to the problem.
The above protocols cut off the smoking part because they aim to deliver nicotine in concentrations high enough to stop cigarette cravings. However, what these protocols ignore is the behavioral aspect of addiction. Some people just want to partake in their rituals and don’t care about nicotine, which explains why substituting nicotine vapes with tobacco vapes successfully reduced nicotine use among those addicted to smoking.
While nicotine isn’t the primary cause of tobacco-related diseases, it is incredibly addictive and may cause severe withdrawal symptoms upon abrupt cessation.
If you’re looking for an effective way to quit smoking cigarettes, consult a behavioral therapist and ask them about using cognitive behavioral therapy in conjunction with CBD oil as a way to manage withdrawal symptoms and rewire your brain so that it becomes resistant to tobacco cues.
Summarizing the Benefits of Using CBD Oil Once You Quit Smoking Cigarettes
Cigarette quitters can use CBD oil as a viable solution for kicking the habit. First, cannabidiol can control tobacco withdrawal symptoms like headaches, anxiety, insomnia, and difficulty concentrating. Second, it helps you ignore cigarette cravings by making you less susceptible to cigarette cues. Last but not least, you can smoke CBD joints or vape CBD liquid as a temporary alternative to cigarettes on your way to overcoming addiction.
Just make sure your CBD oil comes from a trustworthy source that uses organic hemp, makes full-spectrum products, and tests them in an independent laboratory for their CBD content and the presence of potential contaminants.
Stay strong on your way to smoking cessation!
- Leweke, F. M., Piomelli, D., Pahlisch, F., Muhl, D., Gerth, C. W., Hoyer, C., Klosterkötter, J., Hellmich, M., & Koethe, D. (2012). Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Translational psychiatry , 2 (3), e94.
- Hindocha, C., Freeman, T. P., Grabski, M., Stroud, J. B., Crudgington, H., Davies, A. C., Das, R. K., Lawn, W., Morgan, C., & Curran, H. V. (2018). Cannabidiol reverses attentional bias to cigarette cues in a human experimental model of tobacco withdrawal. Addiction (Abingdon, England) , 113 (9), 1696–1705. Advance online publication. 
- Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics , 12 (4), 825–836. 
- Morgan, C. J., Das, R. K., Joye, A., Curran, H. V., & Kamboj, S. K. (2013). Cannabidiol reduces cigarette consumption in tobacco smokers: preliminary findings. Addictive behaviors , 38 (9), 2433–2436. 
- Schlag, A. K., Hindocha, C., Zafar, R., Nutt, D. J., & Curran, H. V. (2021). Cannabis-based medicines and cannabis dependence: A critical review of issues and evidence. Journal of psychopharmacology (Oxford, England) , 35 (7), 773–785. 
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
CBD for treating tobacco addiction?
José Carlos Bouso is a clinical psychologist and a doctor of pharmacology. His areas of interest are psychopharmacology and the therapeutic properties of entactogens, psychedelics and cannabis. He has conducted therapeutic research with MDMA, pharmacological research with several substances of plant and synthetic origin and has also performed studies on the long-term neuropsychological effects of substances such as cannabis, ayahuasca and cocaine. He is author of the book “Qué son las drogas de síntesis” [What are synthetic drugs?], and co-author of “¿La marihuana como medicamento? Los usos médicos y terapéuticos del cannabis y los cannabinoides” [Marihuana as medicine? The medical and therapeutic uses of cannabis and cannabinoids] and “Ayahuasca y salud” [Ayahuasca and health]. His research has been published in scientific journals. He is currently the director of scientific projects at Fundación ICEERS.
Although cannabis has long been considered as a “drug of abuse”, in recent years an increasing number of studies published in the biomedical literature indicate that either the plant itself or some of its compounds may be of use in treating addictions. For example, a recent review sets out the current evidence on the involvement of the endocannabinoid system in modulating addictive behaviour, looking at the results of research with animals on the potential role of some cannabinoids in treating psychostimulant addiction 1 . More specifically, there is evidence to indicate that pharmaceuticals that are CB2 receptor agonists may be of use in treating cocaine addiction 2 . Certain observational studies have also been published showing that cannabis may be a substitute for more dangerous drugs, including alcohol 3 . Finally, another recent review compiled current studies focusing on the possible properties of CBD (cannabidiol) as an intervention for addictive disorders 4 . This article will review the current evidence for considering cannabis in general, and CBD in particular, as a possible aid for quitting smoking.
Tobacco in figures
According to a report published in 2014 by the World Health Organisation (WHO) 5 , tobacco smoke contains more than 7,000 chemical substances, of which at least 250 are known to be harmful for health and at least 69 are known to cause cancer. According to this report, the spectrum of medical problems that can be caused by smoking include: shortness of breath, exacerbated asthma, respiratory infections, cancer (larynx, oropharynx, oesophagus, trachea, bronchus, lung, acute myeloid leukaemia, stomach, pancreas, kidney, ureter, colon, cervix, and bladder), coronary heart disease, heart attacks, stroke, chronic obstructive pulmonary disease, osteoporosis, blindness, cataracts, periodontitis, aortic aneurysm, atherosclerotic peripheral vascular disease, hip fractures, infertility and impotence.
According to another WHO study, tobacco continues to be the principal preventable cause of death in the world, killing approximately 6 million people each year and causing economic losses estimated at over half a trillion dollars 6 . The latest report of the Global Tobacco Surveillance System, which gathers data from 22 countries representing nearly 60% of the world’s population, shows that there are approximately 1,300 million smokers in those countries, of whom 205 million had made some attempt to quit smoking in the last 12 months 7 . According to the American Cancer Society, only 4-7% of people are capable of giving up smoking in any given attempt without medicines or other help while around 25% of smokers using medication manage to stay smoke-free for over 6 months. Psychological counselling and other types of emotional support can boost success rates higher than medicines alone 8 .
Nicotine addiction or tobacco habit?
Although the accepted theory on drug addiction appears to be that it is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, causing a deterioration in control of consumption despite harmful consequences to the addicted individual and to those around him or her 9 , an ever larger number of experts are beginning to challenge this view of addiction as a brain disease 10 . At least two studies have found that the percentage of people who recover from their addiction throughout their lives is, in nearly all cases, over 80% 11 . The results of these studies also indicate that tobacco addiction is the one of the forms of addiction with the lowest cessation rates.
One of these reasons may be the extent to which conventional wisdom in our society ascribes tobacco addiction to the pharmacological effects of nicotine. If attributing addiction to the substance used is a problem for understanding drug addiction in general, in the case of tobacco addiction it becomes especially paradigmatic. The problem with drug addiction in general, and tobacco addiction in particular, is, as we have explained, the problem tends to be attributed to a disorder of the brain caused by a pharmacological agent, when at the base of all addictive behaviour, what is actually introduced is a habit. And this habit is established, not so much by the effects of the substance itself, as by the behaviours involved in seeking and consuming the substance. And it is these habits, as forms of conduct, that are difficult to correct. Indeed, in the specific case of nicotine it is very difficult to train animal models to be addicted to the substance. And as we have seen, the rates of tobacco cessation by pharmacological means (including patches, gum and any other nicotine-based pharmaceutical preparation) are distressingly low 12 . Therefore, of all the reasons for which tobacco proves addictive for so many people, the fact that it contains nicotine is probably the least significant. It is precisely the fact that it is a habit, which is generally established over a long time –in most cases over several years– that makes it so difficult to correct. As humans, we establish our everyday behaviour by means of habits and the more ingrained a habit is, the more difficult it is to change. This is all the more true, insofar as the habit –as in the case of tobacco– offers such versatility for that the individual can indulge it when engaged in an animated conversation, in a state of depression or when waiting for a bus – in short, in nearly every aspect of his or her life, except sleep. This versatility and generalisation make the habit of smoking so especially difficult to correct.
Vaping cannabis as an alternative to smoking tobacco
As cannabis users increasingly become aware of the health dangers of smoking, some of them are trying to replace the smoking of cannabis (which involves combustion) with vaping (which does not). Indeed, it is well known that the risks of smoking derive precisely from the combustion of the material smoked, rather than the products smoked. Even so, surveys on preferred methods of consumption indicate that the immense majority (more than 90%) of cannabis users still prefer smoking, even though they recognise that vaping is the most effective way of reducing the harm 13 . Even in states like California, whose citizens are famous for their worship of healthy lifestyles, the preferred means of consuming cannabis in medicinal marijuana dispensaries is by smoking (86.1% of those interviewed), far ahead of vaping (used by 21.8%) 14 . These results may be somewhat skewed by the fact that so many of those surveyed started out as tobacco consumers who when they subsequently began to use cannabis, also preferred to smoke it. It is also well-known that many consumers manage to give up smoking not only “joints” but also tobacco when they start vaping cannabis. In a recent letter to the journal Addiction, Hindocha et al. set out a series of examples in which vaping cannabis is accompanied by a reduction in tobacco consumption. According to these researchers: “ there could be reason to be optimistic about the potential of vaporizers. If vaporizers can reduce cannabis and tobacco co-administration, the outcome could be a reduction of tobacco use/dependence among cannabis users and a resultant reduction in harms associated with cannabis. Indeed, if vaping cannabis becomes commonplace in the future, the next generation of cannabis users might never be exposed to nicotine or tobacco in the first place” 15 .
Use of CBD in treating the tobacco habit
CBD is in vogue. Whereas in the 1990s seed companies vied to obtain the strain with most THC, they are now competing for more narcotic varieties – in other words, those with the highest CBD content. We don’t know the reason for this change: whether cannabis consumers have grown tired of such a strong high (THC concentrations in Dutch marijuana have been falling by 0.22% per year since 2005 16 ); whether it is a result of the industry’s marketing campaigns attributing the medicinal effects of cannabis to CBD; whether it simply reflects a market in which consumers want a varied product offering different experiences depending on what they are looking for at any specific time, or whether it is combination of all of these factors, or even some other reason. One other possible reason is the fashion for CBD oils which –albeit the labels do no state as much– also contain sufficient quantities of THC to possibly cause a consumer to test positive in a roadside saliva test. Moreover, for reasons we shall not go into here, the legality of these oils is decidedly dubious.
The way CBD acts on the endocannabinoid system is not yet fully understood. Indeed, some articles discuss mechanisms of action that others ignore altogether, and vice versa. I will therefore leave it to readers to search for the mechanism of action of CBD. A recent review on the possible role of CBD as an anti-addictive pharmaceutical, quoted above 17 , after appraising this mechanism of action, concludes that “CBD has been associated with many neural circuits involved in the acquisition of addiction and subsequent drugseeking behaviors, making it an interesting pharmacological candidate to treat substance-use disorders”.
Only one study has researched the role of CBD as a treatment for addiction to tobacco smoking. In a pilot clinical study, the effectiveness of CBD was compared against a placebo in treatment of tobacco addiction. (A pilot study is one with a small number of subjects, used to test a working hypothesis before moving on to a larger, and therefore more economically costly, sample). It was double blind (neither researchers nor subjects knew who received what treatment), randomised (patients were assigned one or other treatment at random) and placebo controlled (the active pharmaceutical was compared with an inactive one). 24 subjects were recruited who smoked more than 10 cigarettes per day and given an inhaler to be used whenever they felt the urge to smoke. Twelve subjects (6 females) received an inhaler containing CBD and the other twelve (6 females) received an inhaler with a placebo. Treatment lasted one week. During this time, they recorded their cravings for tobacco and anxiety on a daily basis. A follow-up interview was conducted 21 days after treatment. Following the treatment week, cigarette consumption in the CBD group had fallen by 40%, a significant contrast with the placebo group, but these differences were not kept up after 21 days. Both groups reported the same reduction in craving and anxiety over the 7 days the treatment lasted, but, again, by day 21 they had returned to the initial conditions. The authors conclude: “the preliminary data presented here suggest that CBD may be effective in reducing cigarette use in tobacco smokers, however larger scale studies, with longer follow-up are warranted to gauge the implications of these findings. These findings add to a growing literature that highlights the importance of the endocannabinoid system in nicotine addiction” 18 .
In their article, the authors of the study offer a series of explanations, based on the effects of CBD on the Endocannabinoid system, which might explain the results. These include the action of CBD on CB1 receptors (as a weak reverse agonist), and its properties as an inhibitor of the enzyme that breaks down the anandamide (FAAH). These actions may be related to a reduction in the boosting properties of nicotine. They also offer some speculation on psychological causes, such as the possible action of CBD in reducing attention on contextual cues that may be involved in maintenance of nicotine consumption.
However, there are doubts that remain to be clarified. As explained, in this study, reported tobacco craving fell by the same amount in the CBD and placebo groups, as did anxiety levels. These scores were taken once a day, but not after the inhaler was used in response to the desire to smoke a cigarette. It is possible that in general terms the placebo is capable of reducing the desire for consumption and anxiety, since the scores had normalised by the 21-day follow-up assessment, when neither group was using the device. Perhaps the CBD, by acting as an anxiolytic 19 , might be a substitute treatment for progressively quitting tobacco, due to the fact that the subject is not as anxious. This study did not assess the possible anxiolytic effect following inhalations. Nonetheless, this pilot study provides more evidence that tobacco addiction is more a habit than a pharmacological effect of nicotine. If tobacco addiction were a matter of nicotine addiction, after a week, when the desire for consumption had already disappeared and where the number of cigarettes –and therefore the nicotine– has been considerably reduced, there would be no reason for the withdrawal symptoms to reappear, inducing subjects to start smoking tobacco again. Finally, as we saw in the previous section, many people quit smoking when they start vaping. It is therefore possible that cannabis and/or CBD inhaled by some means other than smoking might be of use for people who want to quit smoking. As Morgan and collaborators conclude, more studies are necessary in this regard. What does seem clear is that smoking, more than an addiction to a drug (nicotine), is a habit, and like all habits, its interruption causes anxiety. In this regard, replacing tobacco with vaporised cannabis and/or CBD may be a useful substitute measure, although this requires more evidence before it can be confirmed.