Cannabidiol (CBD) may help people reduce cigarette consumption and manage nicotine withdrawal, according to a new systematic review and meta-analysis of 52 studies led by researchers at Yale University.
The review, published October 12 in Neuroscience & Biobehavioral Reviews, examined research involving marijuana use, nicotine dependence and the therapeutic potential of compounds that interact with the body’s endocannabinoid system.
Researchers identified 52 qualifying studies from 4,869 records, including 18 observational studies, 15 preclinical investigations and 19 human experimental studies.
Among the findings was evidence that CBD may reduce cigarette consumption, lessen withdrawal symptoms and influence how people respond to smoking-related cues.
One of the most notable findings came from a previously published randomized, placebo-controlled trial involving 24 cigarette smokers who wanted to quit. Participants received either a CBD inhaler or a placebo inhaler for one week and were instructed to use it whenever they experienced the urge to smoke.
Those assigned to CBD reduced their cigarette consumption by approximately 40% during treatment, while the placebo group experienced no significant change. Some of the reduction was maintained at a two-week follow-up.
That trial, originally published in 2013, was relatively small, but its results were among several findings supporting further investigation of CBD as a potential treatment for tobacco dependence.
Another human study involving 30 cigarette smokers found that a single 800-milligram dose of CBD reduced attentional bias toward smoking-related cues following overnight nicotine abstinence. This suggests CBD may influence how strongly smokers respond to environmental reminders associated with cigarette use.
Preclinical research provided additional evidence. In animal experiments, CBD reduced nicotine self-administration and alleviated certain physical symptoms of nicotine withdrawal without interfering with food-related reward behavior.
The review also examined compounds targeting cannabinoid type 1 receptors, which play a role in nicotine reinforcement and addiction. Although several demonstrated beneficial effects in preclinical experiments, clinical development of certain receptor-blocking medications was unsuccessful because of psychiatric side effects or insufficient effectiveness.
The findings distinguish the potential therapeutic effects of isolated CBD from the effects of marijuana consumption more broadly.
In a separate analysis of 18 observational studies involving 229,034 participants, the researchers found that marijuana consumers had approximately 25% lower odds of successfully quitting tobacco than nonconsumers. The association did not establish that marijuana use caused poorer cessation outcomes.
Researchers suggested that the differences between conventional marijuana consumption and targeted CBD treatment may reflect the distinct effects of individual cannabinoids on the brain’s reward and withdrawal systems.
The review was led by Gabriel Costa and João De Aquino of Yale University School of Medicine, alongside researchers from other institutions.
Although the evidence supporting CBD is promising, the authors emphasized that larger clinical trials are needed to establish whether CBD can reliably improve long-term smoking cessation outcomes.
