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Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability

Julia Becker1*, Ines Hungerbuehler2, Oliver Berg3, Maciej Szamrovicz4, Andreas Haubensack4, Adrian Kormann3 and Michael P Schaub1

Author Affiliations

1 Swiss Research Institute for Public Health and Addiction ISGF, University of Zurich, Konradstrasse 32, P. O. Box, 8031, Zurich, Switzerland

2 Department and Institute of Psychiatry, School of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, CEP 05403-903, Brazil

3 Arud Centres for Addiction Medicine, Konradstrasse 32, Zurich, 8005, Switzerland

4 Integrierte Suchthilfe Winterthur ISW, Tösstalstrasse 19, Winterthur, 8402, Switzerland

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Substance Abuse Treatment, Prevention, and Policy 2013, 8:33  doi:10.1186/1747-597X-8-33

Published: 12 September 2013



Tobacco and cannabis use are strongly interrelated, but current national and international cessation programs typically focus on one substance, and address the other substance either only marginally or not at all. This study aimed to identify the demand for, and describe the development and content of, the first integrative group cessation program for co-smokers of cigarettes and cannabis.


First, a preliminary study using expert interviews, user focus groups with (ex-)smokers, and an online survey was conducted to investigate the demand for, and potential content of, an integrative smoking cessation program (ISCP) for tobacco and cannabis co-smokers. This study revealed that both experts and co-smokers considered an ISCP to be useful but expected only modest levels of readiness for participation.

Based on the findings of the preliminary study, an interdisciplinary expert team developed a course concept and a recruitment strategy. The developed group cessation program is based on current treatment techniques (such as motivational interviewing, cognitive behavioural therapy, and self-control training) and structured into six course sessions.

The program was evaluated regarding its acceptability among participants and course instructors.


Both the participants and course instructors evaluated the course positively. Participants and instructors especially appreciated the group discussions and the modules that were aimed at developing personal strategies that could be applied during simultaneous cessation of tobacco and cannabis, such as dealing with craving, withdrawal, and high-risk situations.


There is a clear demand for a double cessation program for co-users of cigarettes and cannabis, and the first group cessation program tailored for these users has been developed and evaluated for acceptability. In the near future, the feasibility of the program will be evaluated.

Trial registration

Current Controlled Trials ISRCTN15248397

Tobacco; Cannabis; Cessation; Integrative smoking cessation program; Cognitive behavioural therapy; Motivational interviewing; Program development; Acceptability; Co-smoking