Clinician’s perceptions and experiences with tobacco treatment in people who use cannabis: a qualitative study

Global demand for the treatment of cannabis use disorder has increased significantly, prompting a need to understand effective strategies for addressing concurrent cannabis and tobacco use. This study focuses on clinicians' experiences and perceptions in delivering tobacco cessation services to people who use cannabis. Fifteen participants (12 females, 3 males) participated in three homogenous focus groups, including two groups with extensive experience in providing tobacco cessation among the substance use population in Catalonia, Spain, and one group of clinicians without such experience. Thematic analysis was conducted to identify key patterns and insights in their discourse, focusing on shared themes and divergences across groups. Five main themes and 17 subthemes emerged: Individual characteristics, Clinician characteristics, Models of intervention, Organizational healthcare models, and Health policies. Clinicians stressed the importance of intervention models and the active role of professionals in addressing tobacco use within routine care, as tobacco cessation could mitigate social and chronic stigma among people who use cannabis, especially those engaged in polydrug use. Recommendations included integrating tobacco cessation into all services, reducing healthcare service fragmentation, improving resource accessibility, enhancing clinical documentation, and advocating for stronger population-level tobacco control policies. The ACT-ATAC project has been successfully registered at Clinicaltrials.gov [NCT04841655]. • Concurrent cannabis and tobacco use is widespread, making it crucial to gain insights from front-line clinicians to promote the cessation of both substances. • Clinicians emphasize systemic fragmentation in tobacco interventions and the lack of coordination among several healthcare services. • Clinical professionals recommend addressing tobacco cessation as a crucial element for reducing chronicity among people who use several drugs, including cannabis. • Discussions about tobacco use should be incorporated into group activities and treatments tailored based on individual characteristics. • Collaboration among researchers, clinicians, and public health authorities is essential in developing tobacco cessation policy and treatment models based on personalized interventions.