Concurrent cessation of tobacco and cannabis and the associated withdrawal syndrome is typically expected to be a challenging experience. In the only experimental study we know of, Vandrey and colleagues (110) found that simultaneous cessation of cannabis and tobacco, compared with withdrawal from either drug alone, was associated with greater aggression, anger and irritability, but only during day 2 of abstinence. Interestingly, comparable numbers of participants rated withdrawal associated with dual abstinence as less severe than withdrawal from either drug alone. Revisiting the role of route of administration, the authors suggest that absence of smoking cues when abstaining from both substances may reduce withdrawal severity in some individuals.
