Briefly, alternative approaches to treating co-use of tobacco and cannabis must first determine whether to intervene on both substances simultaneously or sequentially, i.e., target one substance then the other. This issue in relation to treatment of other non-cannabis substances and tobacco has been somewhat controversial because of concern that intervening on tobacco will interfere with treatment for the other substance. However most studies suggest that simultaneous tobacco treatment does not jeopardize outcomes for treating addiction to alcohol or other illicit drugs (126). Further, as many cannabis users smoke a mixture of cannabis and tobacco or chase cannabis use with tobacco, and as conditioned cues associated with smoking both substances may trigger use of either substance, a simultaneous cessation approach with cannabis and tobacco may be most beneficial.
