title: Cognitive behavioral therapy and the nicotine transdermal patch for dual nicotine and cannabis dependence: a pilot study.
abstract: OBJECTIVE
  We assessed the feasibility of a new cognitive behavioral therapy (CBT) manual, plus transdermal patch nicotine replacement therapy (NRT), to treat co-occurring nicotine and cannabis dependence.
  
  
  METHODS
  Seven of 12 (58.3%) adults with DSM-IV diagnoses of both nicotine and cannabis dependence completed 10 weeks of individual CBT and NRT.
  
  
  RESULTS
  Participants smoked 12.6 ± 4.9 tobacco cigarettes per day at baseline, which was reduced to 2.1 ± 4.2 at the end of treatment (F[5]  = 23.5, p < .0001). The reduction in cannabis use from 10.0 ± 5.3 inhalations per day at baseline to 8.0 ± 5.3 inhalations per day at 10 weeks was not significant (F[5]  = 1.12, p = .37). There was a significant decrease from the mean baseline Fagerstrom Test for Nicotine Dependence scores at weeks 4, 6, 8, and 10 of treatment (F[4]  = 19.8, p < .001) and mean Client Satisfaction Questionnaire scores were uniformly high (30.6 ± 1.9).
  
  
  CONCLUSIONS
  A CBT plus NRT treatment program significantly reduced tobacco smoking but did not significantly reduce cannabis use in individuals with co-occurring nicotine and cannabis dependence. There was no compensatory increase in cannabis use following the reduction in tobacco smoking, suggesting that clinicians can safely pursue simultaneous treatment of co-occurring nicotine and cannabis dependence. The intervention was well-liked by the 7 of the 12 enrollees who completed the study.
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, Massachusetts, USA. khill@mclean.harvard.edu
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Hill
authors.forename: Lindsay H
authors.initials: LH
authors.lastname: Toto
authors.forename: Scott E
authors.initials: SE
authors.lastname: Lukas
authors.forename: Roger D
authors.initials: RD
authors.lastname: Weiss
authors.forename: George H
authors.initials: GH
authors.lastname: Trksak
authors.forename: John M
authors.initials: JM
authors.lastname: Rodolico
authors.forename: Shelly F
authors.initials: SF
authors.lastname: Greenfield
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000704:Analysis of Variance; D002248:Carbon Monoxide / Q000032:analysis; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003367:Cotinine / Q000032:analysis; D013759:Dronabinol / Q000652:urine; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000188:drug therapy* / Q000628:therapy; D009538:Nicotine / Q000627:therapeutic use*; D010865:Pilot Projects; D016540:Smoking Cessation / Q000379:methods*; D011795:Surveys and Questionnaires; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000188:drug therapy* / Q000628:therapy
chemical_list: D009538:Nicotine; D013759:Dronabinol; D002248:Carbon Monoxide; D003367:Cotinine