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CBD for treating tobacco addiction?

By José Carlos Bouso

José Carlos Bouso is a clinical psychologist and a doctor of pharmacology. His areas of interest are psychopharmacology and the therapeutic properties of entactogens, psychedelics and cannabis. He has conducted therapeutic research with MDMA, pharmacological research with several substances of plant and synthetic origin and has also performed studies on the long-term neuropsychological effects of substances such as cannabis, ayahuasca and cocaine. He is author of the book “Qué son las drogas de síntesis” [What are synthetic drugs?], and co-author of “¿La marihuana como medicamento? Los usos médicos y terapéuticos del cannabis y los cannabinoides” [Marihuana as medicine? The medical and therapeutic uses of cannabis and cannabinoids] and “Ayahuasca y salud” [Ayahuasca and health]. His research has been published in scientific journals. He is currently the director of scientific projects at Fundación ICEERS.

Although cannabis has long been considered as a “drug of abuse”, in recent years an increasing number of studies published in the biomedical literature indicate that either the plant itself or some of its compounds may be of use in treating addictions. For example, a recent review sets out the current evidence on the involvement of the endocannabinoid system in modulating addictive behaviour, looking at the results of research with animals on the potential role of some cannabinoids in treating psychostimulant addiction 1 . More specifically, there is evidence to indicate that pharmaceuticals that are CB2 receptor agonists may be of use in treating cocaine addiction 2 . Certain observational studies have also been published showing that cannabis may be a substitute for more dangerous drugs, including alcohol 3 . Finally, another recent review compiled current studies focusing on the possible properties of CBD (cannabidiol) as an intervention for addictive disorders 4 . This article will review the current evidence for considering cannabis in general, and CBD in particular, as a possible aid for quitting smoking.

Tobacco in figures

According to a report published in 2014 by the World Health Organisation (WHO) 5 , tobacco smoke contains more than 7,000 chemical substances, of which at least 250 are known to be harmful for health and at least 69 are known to cause cancer. According to this report, the spectrum of medical problems that can be caused by smoking include: shortness of breath, exacerbated asthma, respiratory infections, cancer (larynx, oropharynx, oesophagus, trachea, bronchus, lung, acute myeloid leukaemia, stomach, pancreas, kidney, ureter, colon, cervix, and bladder), coronary heart disease, heart attacks, stroke, chronic obstructive pulmonary disease, osteoporosis, blindness, cataracts, periodontitis, aortic aneurysm, atherosclerotic peripheral vascular disease, hip fractures, infertility and impotence.

According to another WHO study, tobacco continues to be the principal preventable cause of death in the world, killing approximately 6 million people each year and causing economic losses estimated at over half a trillion dollars 6 . The latest report of the Global Tobacco Surveillance System, which gathers data from 22 countries representing nearly 60% of the world’s population, shows that there are approximately 1,300 million smokers in those countries, of whom 205 million had made some attempt to quit smoking in the last 12 months 7 . According to the American Cancer Society, only 4-7% of people are capable of giving up smoking in any given attempt without medicines or other help while around 25% of smokers using medication manage to stay smoke-free for over 6 months. Psychological counselling and other types of emotional support can boost success rates higher than medicines alone 8 .

Nicotine addiction or tobacco habit?

Although the accepted theory on drug addiction appears to be that it is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, causing a deterioration in control of consumption despite harmful consequences to the addicted individual and to those around him or her 9 , an ever larger number of experts are beginning to challenge this view of addiction as a brain disease 10 . At least two studies have found that the percentage of people who recover from their addiction throughout their lives is, in nearly all cases, over 80% 11 . The results of these studies also indicate that tobacco addiction is the one of the forms of addiction with the lowest cessation rates.

One of these reasons may be the extent to which conventional wisdom in our society ascribes tobacco addiction to the pharmacological effects of nicotine. If attributing addiction to the substance used is a problem for understanding drug addiction in general, in the case of tobacco addiction it becomes especially paradigmatic. The problem with drug addiction in general, and tobacco addiction in particular, is, as we have explained, the problem tends to be attributed to a disorder of the brain caused by a pharmacological agent, when at the base of all addictive behaviour, what is actually introduced is a habit. And this habit is established, not so much by the effects of the substance itself, as by the behaviours involved in seeking and consuming the substance. And it is these habits, as forms of conduct, that are difficult to correct. Indeed, in the specific case of nicotine it is very difficult to train animal models to be addicted to the substance. And as we have seen, the rates of tobacco cessation by pharmacological means (including patches, gum and any other nicotine-based pharmaceutical preparation) are distressingly low 12 . Therefore, of all the reasons for which tobacco proves addictive for so many people, the fact that it contains nicotine is probably the least significant. It is precisely the fact that it is a habit, which is generally established over a long time –in most cases over several years– that makes it so difficult to correct. As humans, we establish our everyday behaviour by means of habits and the more ingrained a habit is, the more difficult it is to change. This is all the more true, insofar as the habit –as in the case of tobacco– offers such versatility for that the individual can indulge it when engaged in an animated conversation, in a state of depression or when waiting for a bus – in short, in nearly every aspect of his or her life, except sleep. This versatility and generalisation make the habit of smoking so especially difficult to correct.

Vaping cannabis as an alternative to smoking tobacco

As cannabis users increasingly become aware of the health dangers of smoking, some of them are trying to replace the smoking of cannabis (which involves combustion) with vaping (which does not). Indeed, it is well known that the risks of smoking derive precisely from the combustion of the material smoked, rather than the products smoked. Even so, surveys on preferred methods of consumption indicate that the immense majority (more than 90%) of cannabis users still prefer smoking, even though they recognise that vaping is the most effective way of reducing the harm 13 . Even in states like California, whose citizens are famous for their worship of healthy lifestyles, the preferred means of consuming cannabis in medicinal marijuana dispensaries is by smoking (86.1% of those interviewed), far ahead of vaping (used by 21.8%) 14 . These results may be somewhat skewed by the fact that so many of those surveyed started out as tobacco consumers who when they subsequently began to use cannabis, also preferred to smoke it. It is also well-known that many consumers manage to give up smoking not only “joints” but also tobacco when they start vaping cannabis. In a recent letter to the journal Addiction, Hindocha et al. set out a series of examples in which vaping cannabis is accompanied by a reduction in tobacco consumption. According to these researchers: “ there could be reason to be optimistic about the potential of vaporizers. If vaporizers can reduce cannabis and tobacco co-administration, the outcome could be a reduction of tobacco use/dependence among cannabis users and a resultant reduction in harms associated with cannabis. Indeed, if vaping cannabis becomes commonplace in the future, the next generation of cannabis users might never be exposed to nicotine or tobacco in the first place” 15 .

Use of CBD in treating the tobacco habit

CBD is in vogue. Whereas in the 1990s seed companies vied to obtain the strain with most THC, they are now competing for more narcotic varieties – in other words, those with the highest CBD content. We don’t know the reason for this change: whether cannabis consumers have grown tired of such a strong high (THC concentrations in Dutch marijuana have been falling by 0.22% per year since 2005 16 ); whether it is a result of the industry’s marketing campaigns attributing the medicinal effects of cannabis to CBD; whether it simply reflects a market in which consumers want a varied product offering different experiences depending on what they are looking for at any specific time, or whether it is combination of all of these factors, or even some other reason. One other possible reason is the fashion for CBD oils which –albeit the labels do no state as much– also contain sufficient quantities of THC to possibly cause a consumer to test positive in a roadside saliva test. Moreover, for reasons we shall not go into here, the legality of these oils is decidedly dubious.

The way CBD acts on the endocannabinoid system is not yet fully understood. Indeed, some articles discuss mechanisms of action that others ignore altogether, and vice versa. I will therefore leave it to readers to search for the mechanism of action of CBD. A recent review on the possible role of CBD as an anti-addictive pharmaceutical, quoted above 17 , after appraising this mechanism of action, concludes that “CBD has been associated with many neural circuits involved in the acquisition of addiction and subsequent drugseeking behaviors, making it an interesting pharmacological candidate to treat substance-use disorders”.

Only one study has researched the role of CBD as a treatment for addiction to tobacco smoking. In a pilot clinical study, the effectiveness of CBD was compared against a placebo in treatment of tobacco addiction. (A pilot study is one with a small number of subjects, used to test a working hypothesis before moving on to a larger, and therefore more economically costly, sample). It was double blind (neither researchers nor subjects knew who received what treatment), randomised (patients were assigned one or other treatment at random) and placebo controlled (the active pharmaceutical was compared with an inactive one). 24 subjects were recruited who smoked more than 10 cigarettes per day and given an inhaler to be used whenever they felt the urge to smoke. Twelve subjects (6 females) received an inhaler containing CBD and the other twelve (6 females) received an inhaler with a placebo. Treatment lasted one week. During this time, they recorded their cravings for tobacco and anxiety on a daily basis. A follow-up interview was conducted 21 days after treatment. Following the treatment week, cigarette consumption in the CBD group had fallen by 40%, a significant contrast with the placebo group, but these differences were not kept up after 21 days. Both groups reported the same reduction in craving and anxiety over the 7 days the treatment lasted, but, again, by day 21 they had returned to the initial conditions. The authors conclude: “the preliminary data presented here suggest that CBD may be effective in reducing cigarette use in tobacco smokers, however larger scale studies, with longer follow-up are warranted to gauge the implications of these findings. These findings add to a growing literature that highlights the importance of the endocannabinoid system in nicotine addiction” 18 .

In their article, the authors of the study offer a series of explanations, based on the effects of CBD on the Endocannabinoid system, which might explain the results. These include the action of CBD on CB1 receptors (as a weak reverse agonist), and its properties as an inhibitor of the enzyme that breaks down the anandamide (FAAH). These actions may be related to a reduction in the boosting properties of nicotine. They also offer some speculation on psychological causes, such as the possible action of CBD in reducing attention on contextual cues that may be involved in maintenance of nicotine consumption.

However, there are doubts that remain to be clarified. As explained, in this study, reported tobacco craving fell by the same amount in the CBD and placebo groups, as did anxiety levels. These scores were taken once a day, but not after the inhaler was used in response to the desire to smoke a cigarette. It is possible that in general terms the placebo is capable of reducing the desire for consumption and anxiety, since the scores had normalised by the 21-day follow-up assessment, when neither group was using the device. Perhaps the CBD, by acting as an anxiolytic 19 , might be a substitute treatment for progressively quitting tobacco, due to the fact that the subject is not as anxious. This study did not assess the possible anxiolytic effect following inhalations. Nonetheless, this pilot study provides more evidence that tobacco addiction is more a habit than a pharmacological effect of nicotine. If tobacco addiction were a matter of nicotine addiction, after a week, when the desire for consumption had already disappeared and where the number of cigarettes –and therefore the nicotine– has been considerably reduced, there would be no reason for the withdrawal symptoms to reappear, inducing subjects to start smoking tobacco again. Finally, as we saw in the previous section, many people quit smoking when they start vaping. It is therefore possible that cannabis and/or CBD inhaled by some means other than smoking might be of use for people who want to quit smoking. As Morgan and collaborators conclude, more studies are necessary in this regard. What does seem clear is that smoking, more than an addiction to a drug (nicotine), is a habit, and like all habits, its interruption causes anxiety. In this regard, replacing tobacco with vaporised cannabis and/or CBD may be a useful substitute measure, although this requires more evidence before it can be confirmed.

Although cannabis has long been considered as a “drug of abuse”, in recent years an increasing number of studies published in the biomedical literature indicate that either the plant itself or some of its compounds may be of use in treating addictions. For example, a recent review sets out the current evidence on the involvement of the endocannabinoid system in modulating

Everything You Need to Know About CBD and Quitting Smoking

Posted on August 27th, 2020

Every year, it is estimated that tobacco smoking leads to the deaths of more than eight million people across the world . This number includes both smokers and non-smokers who are affected by third party smoke. It may seem surprising that smokers continue this habit knowing its dangerous nature. However, smoking is largely addictive and can be hard to break.

Smokers who decide to quit smoking on the other hand do not have it easy. Strong and unpleasant withdrawal symptoms make it very hard for those trying to quit achieve long-lived success.

Research suggests that CBD oil may be helpful to those quitting smoking. Cannabidiol, also known as CBD, may ease the stress and symptoms of anxiety associated with the withdrawal symptoms from the cessation of smoking; great news for cigarette smokers looking to kick this habit, and lead healthier lives.

Read on below to find out more about CBD and how it may be used to help smokers quit this habit for good.

How Addictions Develop

To understand why it is so hard for smokers to quit smoking you need to first understand how a nicotine addiction develops.

In the short term, smoking produces a positive feeling in the user’s body. Every time you inhale cigarette smoke, the nicotine molecules therein travel to the brain via the bloodstream. As these molecules cross the blood-brain barrier, they interact with various receptors leading to the release of dopamine; a fairly strong neurotransmitter that is involved in the reward pathways of the brain.

Simply put, the inhalation of cigarette smoke leads to the release of mood-inducing hormones. These hormones are responsible for providing a feeling of reduced stress or pressure.

Over time, a strong habit is formed. This happens as the brain correlates smoking with the resultant release of dopamine, a neurochemical reward. The neurotransmission involved in self-control and stress shifts over time as this reward pathway is triggered over and over again when smoking.

It is worth mentioning that the body of a smoker, including the brain, is not actually addicted to nicotine. But rather, the neurochemical reward triggered by its consumption.

At this point, it is clear to see just how deeply the brain’s reward chemistry is involved in people with a tobacco addiction. This is part of the reason why some smokers find it so hard to quit smoking.

Ways of Quitting Cigarette Smoking

It is true that most smokers find it hard to successfully quit smoking. However, some have actually done it by avoiding their nicotine fix and braving through a period of cold turkey.

However, for those who struggle with shaking the habit, there are a number of ways they can use to wean themselves off tobacco. Nicotine patches, nicotine chewing gum, and even vaping are some of the main options available. These may help smokers looking to gradually reduce their overreliance on cigarette smoking through nicotine replacement therapy.

In this approach, smokers get their nicotine fix, though at a reduced level, from sources other than tobacco cigarettes. This helps them reduce their overreliance on nicotine. It also helps them avoid the act of smoking, which is considered to be carcinogenic.

While this approach does have its advantages, it also means that the brain continues to get its nicotine fix. However, the nicotine consumption is at a lower volume, for longer. This means that smokers trying to quit may find it harder to get over their addiction to nicotine further down the line.

Whenever such a person goes without their nicotine fix for longer than normal, they are likely to experience severe withdrawal symptoms. Some of these symptoms may include anxiety, irritability, depression, weight gain, headaches, and sore throat among others.

Adding to it, such individuals are more likely to succumb to their nicotine cravings whenever they engage in an activity that reminds them of smoking.

So, is there a way for smokers to quit smoking without having to brave through the negative effects of nicotine withdrawal? Well, according to research findings, CBD oil may help those trying to quit achieve their goals, without the negative effects. If you are wondering how this happens, continue reading below.

Studies Investigating CBD and Quitting Tobacco Smoking

In recent years CBD has also emerged as another product that may be used to help cigarette smokers achieve their goal of quitting. CBD is an active compound found in the cannabis plant. This compound is typically extracted from industrial hemp plants. Some of the main uses of CBD may include helping relieve inflammation, insomnia, and symptoms of anxiety, among others. This active ingredient normally produces its positive effects by interacting with the body’s endocannabinoid system.

According to research findings, CBD might also help smokers quit by interacting with the endocannabinoid system (ECS).

One study published in the journal of Addictive Behaviors found that CBD helped smokers reduce their consumption of cigarettes by a significant margin over the course of a week. It was also observed that drugs that interact with the ECS could be effective at helping smokers overcome their overreliance on nicotine.

In this study, a group of 24 smokers with the desire to quit smoking were involved in a double-blind, placebo-controlled pilot. The group was then divided into two, each with an equal number of members. Members of one group were given inhalers with a placebo while the other group was given a CBD inhaler. The instructions were for each member to use their inhaler whenever they craved a cigarette.

After a week, members of the group using the CBD inhalers reported a 40 percent decrease in cigarette consumption. Furthermore, the smokers that had used the CBD inhaler also reported that this effect was maintained, even after the conclusion of the study, during a subsequent follow-up.

Researchers conducting the study observed that CBD may hold promise when it comes to helping smokers get over their addiction to nicotine. However, these findings also demonstrated the need for further studies on the effects of CBD on cigarette smokers.

How to Use CBD

There are a number of reasons why CBD may be seen as a better option, over the existing options, when it comes to helping smokers quit this dangerous habit. For starters, CBD is generally considered safe and has little to minimal side effects on users. Furthermore, since legal CBD products have a low concentration of THC, tetrahydrocannabinol, they do not have the same psychoactive effects of marijuana upon use.

When it comes to helping smokers overcome their nicotine addiction much more effectively, CBD may show promise. However, those looking to use this product to quit smoking should first consult their physician before using CBD as it may interact with some medications.

CBD can be consumed in a variety of ways. One way is through a CBD oil tincture. Here, CBD oil is packed in a dropper bottle and can be introduced into the body sublingually by dropping a few drops under the tongue. Some may find the taste of CBD oil to be overwhelming. If that’s the case, you can look to alternative products like CBD water solubles. These can be incorporated into beverages such as juices, teas, and smoothies.

For smokers that would like to mimic the smoking action, vaping may be an option. Vaping actually feels like smoking, given the inhalation and exhalation actions involved. CBD oil e-liquids and extracts are a way to introduce this natural substance into the body through the lungs. However, there are reports of lung-related illnesses as a result of vaping, so we advise speaking with your doctor first.

CBD isolates and or extracts like CBD butter can also be added to different dishes for consumption as edibles.

Quality CBD Products

It is important that you only buy and consume quality CBD products. This ensures that you get the full effects that you are seeking. Look for high-quality products from reputable companies, like Tanasi. Our products are lab tested by a third party for quality assurance purposes. As such, you can be sure that you are getting high-quality CBD that has the full spectrum of cannabinoids with a low THC content, below 0.3 percent. While CBD is federally legal, be sure to check with state and local laws as they may vary.

Conclusion

Smoking is a dangerous habit that can result in harmful illnesses and may even lead to death. People looking to quit smoking usually have a hard time getting over this habit due to their overreliance on nicotine. While nicotine replacement therapies can help smokers reduce their consumption of cigarettes, it continues to feed nicotine to the brain. And this is what maintains the addiction to this substance.

CBD, which has little to no side effects, may help users reduce cigarette consumption. And, CBD’s interaction with the body’s endocannabinoid system might also help with a nicotine addiction.

To ensure that you get the desired results, be sure to consult your physician before you start using CBD products.

Cannabidiol, also known as CBD, may ease the stress and symptoms of anxiety associated with the withdrawal symptoms experienced when quitting smoking.