Patterns of Tobacco Use, Dependence, and Motivation to Quit Among Individuals Seeking Treatment for Alcohol and Cannabis Consumption in Catalonia (Spain).

Abstract

Understanding smoking behaviors in vulnerable groups is essential for effective cessation services. This study characterizes tobacco consumption and identifies factors associated with nicotine dependence and motivation to quit among individuals entering alcohol and cannabis treatment programs. A multi-center cross-sectional study was conducted in ten centers in Barcelona province. Participants' sociodemographics and tobacco use were assessed, including cigarette consumption and nicotine dependence (Fagerström test). Self-efficacy and motivation to quit were measured on a 0-10 Likert scale. A decision-tree analysis identified factors linked to moderate-to-high nicotine dependence (Fagerström ≥ 5) and high cessation motivation (≥7). Most participants (96.1%) use tobacco daily, with 57.0% using manufactured and 42.2% roll-your-own (RYO) cigarettes. Mean cigarette consumption was 15.2/day (SD = 8.7), with nicotine dependence (4.4, SD = 2.3). Cannabis users started smoking tobacco earlier than those who used alcohol. Over the past year, two-thirds attempted quitting and 60% had high cessation motivation. Self-efficacy for quitting was moderate (mean = 5.1; SD = 3.3). RYO use, age over 45, and alcohol use were associated with moderate-to-high nicotine dependence (probabilities = 0.52, 0.62, and 0.71, respectively). Having a non-tobacco social network was linked to a high motivation to quit (probability = 0.72). Participants had moderate nicotine dependence, low self-efficacy, and high motivation to quit tobacco. Dependence was higher among RYO users, ≥45 years/old, and people with alcohol use disorder. High motivation was more frequent among those with a non-tobacco social network. Integrating cessation support into substance treatment, focusing on RYO and young users, and promoting self-efficacy and tobacco-free socialization may enhance cessation success.