Smoking is a serious public health issue in France, with one quarter of the population
who smokes on a daily base. Tobacco use represents the first avoidable death cause.
Cannabis, often use with tobacco, is the most frequent drug use, worldwide and with a
prevalence of 3.2% of regular users in France, including 2.1% of daily users. Both
substances are associated with sleep disorders; for instance, nicotine has several side
effects, such as a negative impact on sleep quality and structure. During cessation
therapy, sleep disorders were identified as a risk factor of relapse and one of the main
lasting symptoms. Therefore, relation between addiction and sleep disorders seem to be
bidirectional, potentially increasing the impact of each other. Screening and managing
sleep disorders as a preventive measure to avoid relapse represents an improvement during
smoking or cannabis use cessation treatment.
The main objective of the study is to evaluate the impact of a specific intervention
targeting sleep disorders during tobacco or cannabis cessation therapy. We will conduct a
randomised pilot study among patients presenting at two participating addiction
prevention and care centres, for smoking or cannabis use cessation treatment. Patients
who are eligible and agree to participate will be randomised in either control group, and
will benefit of the usual care, or intervention group, and will benefit in addition of a
systematic and standardised screening of sleep disorders, and specific care at the
Chronos centre, if any disorder is diagnosed.
Patients will be followed over a 6-month period, with two visits at 1 and 3 months, to
monitor indicators related to substance consumption and sleep. The impact of the targeted
intervention will be evaluate based on the abstinence duration over the 6 months,
calculated on the total number of days without tobacco / cannabis use. We will also
collect other information that can be associated with the success or failure of cessation
therapy, such as depressive symptoms, anxiety disorders, the use of other psychoactive
substances (alcohol for instance), other psychiatric disorder, etc.
Questions on sleep will be asked to patients in the control group, to assess
comparability of both groups throughout the study. This pilot trial will allow us to
determine the feasibility and efficacy of a targeted intervention on sleep disorders
during smoking or cannabis use cessation therapy, in order to generalise such care in the
usual practice.
