When Tobacco and Cannabis Use Motives Interact: Implications for Dependence and Quitting.

Barré T.; Cazorla G.; Leroy V.; Maradan G.; Couderc C.; de Ternay J.; Magnani C.; Carrieri P.; Protopopescu C. · Substance use & misuse · 2026

**Background & Methods** A cross-sectional survey was conducted among 357 French young adults (ages 18-30; 54.9% male) who reported concurrent tobacco and cannabis use. Participants endorsed their agreement with 21 use motives (10 tobacco-specific, 11 cannabis-specific, 7 shared motives), followed by hierarchical clustering analysis to identify distinct motivational profiles and associations with dependence severity and cessation readiness. **Key Findings** • Three distinct motivational profiles were identified: (1) high tobacco/moderate cannabis motive endorsement (n=188) with high nicotine dependence; (2) low overall motive endorsement except for pleasure-seeking (n=39) with low dependence levels; and (3) high endorsement of both tobacco and cannabis motives (n=130) with high dependence levels across both substances. • Within-substance motives and all cross-substance shared motives showed significant correlations, indicating substantial overlap in reasons for co-use. Notably, the number of endorsed tobacco motives demonstrated a paradoxical relationship with cessation intentions: negative association with readiness to quit tobacco but positive association with readiness to quit cannabis. • Motivational patterns significantly predicted both dependence severity and quit-readiness, suggesting that understanding individual motivation profiles is critical for predicting substance use trajectories and treatment outcomes in dual-users. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. **Evidence Quality** This cross-sectional study provides moderate evidence with inherent limitations. The study design cannot establish causality or temporal relationships between motives, dependence, and quit intentions. The sample is limited to French young adults, potentially restricting generalizability to other populations or age groups. The Yes/No binary response format for motive endorsement may oversimplify the complexity of motivation and limit nuance in capturing motive intensity. Self-reported data on motives and dependence are subject to recall bias and social desirability bias. The study lacks objective biomarkers for substance use confirmation. However, the study's strengths include a reasonably large sample size, examination of interactive effects between tobacco and cannabis motives, and practical implications for intervention design. The findings underscore the heterogeneity of co-users and suggest that one-size-fits-all cessation approaches may be ineffective.

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