Community Based Cannabis Cessation Program

Study Overview
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Brief Summary
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The study examined a community based cannabis cessation program in Norway (CCP). The CCP uses a combination of cognitive therapy and psychoeducation and covers the normal withdrawal period for cannabis smoking cessation (up to 8 weeks), comprising  15 individual sessions. From 2005 onwards, the CCP was implemented as a low-threshold community-based program in several Norwegian municipalities, e.g., Kristiansand, Fredrikstad and Oslo. The study had an observational one-group pre- / post test design. Outcomes was changes in cannabis use, mental distress, well-being, social network and sense of coherence (SoC) measured post-intervention (T2) and at a 3 months follow-up (T3).

Official Title
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Examining a Community Based Intervention for Cannabis Smoking Cessation in Norway - an Observational Study

Conditions
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Cannabis Use

Intervention / Treatment
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* Behavioral: Cannabis cessation Program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Severity of Dependence Scale (SDS) score ≥4 Exclusion Criteria: polydrug use where cannabis was not the predominating substance of use psychiatric comorbidity that was perceived as too severe to handle at the community-based centers

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| HAP - group<br>The target group was individuals who engaged in regular or daily cannabis use, and who were motivated to quit cannabis. The formal inclusion criteria was a Severity of Dependence Scale (SDS) score ≥4 and being ≥16 years old. Exclusion criteria was polydrug use where cannabis was not the predominating substance of use and psychiatric comorbidity that was perceived as too severe to handle at the community-based centers . | Behavioral: Cannabis cessation Program<br>* Lundqvist and Ericsson developed the 'Cannabis Cessation Program' (CCP, Nordic abbreviation: HAP) in Sweden in the 1990s. The method uses a combination of cognitive therapy and psychoeducation and covers the normal withdrawal period for cannabis smoking cessation (up to 8 weeks), comprising  15 individual sessions. It describes a medical, a psychological, and a social phase, in which the participant is helped to recognize and address typical problems related to each phase, e.g., physical and psychological withdrawal problems. The overarching aim of the program is to help cannabis users to reorganize thinking patterns that developed while they were using cannabis and increase their social and psychological coping skills in relation to quitting cannabis use. The CCP manual has been translated into eight languages, e.g., Norwegian.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cannabis use | Days with cannabis use last 30 days | Changes from baseline to post-treatment and follow-up, on average 5 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mental distress | The Hopkins Symptom Checklist (HSCL) 25-item version was used to measure mental distress. Each of the 25 items was scored on a 4-point scale (1-4). An average score was computed, indicating a global severity index of mental distress (GSI), where higher scores indicated greater distress. Clinical cut-off = 1.75 | Changes from baseline to post-treatment and follow-up, on average 5 months | 
| Well-being | The Outcome Rating Scale (ORS) was used to assess well-being. The scale has four visual analogue items on personal, interpersonal, social, and general well-being, and each item are scored from 0 = bad up to 10 = good. The items are then summed (range 0-40) and a score <25 indicated scores expected in a clinical population. | Changes from baseline to post-treatment and follow-up, on average 5 months | 
| Social network | Number of current friends with and without problematic substance use | Changes from baseline to post-treatment and follow-up, on average 5 months | 
| Sense of Coherence (SoC) | The Sense of Coherence questionnaire, 29 item version, measures the degree to which the subject feels that he or she has a sense of control over their own lives (manageability - 10 items), that life has meaning (8 items) and that their social life is understandable (comprehensibility - 11 items). Responses to items are scored on a seven-point semantic differential scale. Scores are summed (ranges from 29 - 203) and higher scores indicated a stronger SoC | Changes from baseline to post-treatment and follow-up, on average 5 months |