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Age Sex Baseline drug use Duration of recent continuous use (yrs) Baseline cann SDS3 Want to quit cann Self-reports : quantities of substance used/ enjoyment of using while taking  varenicline Reasons stopped  Tx Notes (drug use outcomes following treatment; duration of   varenicline treatment; duration of follow up)
1CUDIT score 2ASSIST score Tob Cann
1 49 F 17 Tob=15 Cann= 9 Al=3 Op= 6  27 10 3 No Enjoyed tobacco less, but used the same amount.  No effect on the enjoyment or amount of cannabis used. Migraine  headache and vomiting Erratic compliance due to bouts of nausea which forced the client to delay setting her quit date many times. Her general practitioner prescribed anti-nausea medication, but this did little to help. No change in SDS scores. Lost to follow up after 6 weeks in study. (2 weeksa; 6 weeksb)
2 31 M 16 Tob=26 Cann=12 Al=31 16 13 5 Yes Rating (2.5/5) Reduction in the amounts of tobacco and cannabis used (reported nil use at second follow-up, i.e. 2 weeks). Reduction in the enjoyment of using both drugs. Feeling flat Reported taking vareniclinefor 4 weeks as prescribed.  SDS dropped to zero soon after starting varenicline, but returned to baseline level once ceased. Following the cessation of  vareniclinethe amount of tobacco and cannabis used returned to similar levels as baseline, but the client continued to report less enjoyment from using  both substances (4 weeksa; 12 weeksb)
3 39 F 19 Tob=24 Cann=15 3 23 3 No Reported reduction in the enjoyment obtained from using both substances, but no change in the amounts used. Family stressors Reported taking vareniclinefor 5 weeks. SDS dropped to zero during this time.  The client reported that the reduction in the enjoyment obtained from using both tobacco and cannabis persisted even after ceasing varenicline.  Lost to follow up 2 weeks after ceasing   varenicline (5 weeksa;7 weeksb)
4 37 M 25 Tob=24 Cann=15 Al=3 ATS=3 Op= 8 3 29 9 No Reported a reduction in the amounts used and the enjoyment from using both substances. Nausea and vomiting/ family stressors Reported taking vareniclinefor 6 weeks and missing a few doses due to nausea and vomiting. The reduction in the amount and the enjoyment obtained from using both substances persisted after the client stopped taking varenicline. SDS dropped to 1 (from 9) soon after starting vareniclineand remained at this level at each subsequent assessment point. Lost to follow-up the week after the client ceased taking varenicline. (6 weeksa; 7 weeksb)
5 35 M 16 Tob=21 Cann=19 Al=32 ATS=30 Op= 20 2 2 3 No Reported a slight reduction in the  amounts used and the enjoyment from using both substances Anger and short temper Nausea complicated initiation onto varenicline.  Erratic compliance thereafter.  Attributed anger/short temper to  varenicline or stopping smoking – resumed smoking tobacco  Lost to follow-up 4 weeks into study (2 weeksa; 4 weeksb)
Notes: 1CUDIT = Cannabis Use Disorders Involvement Test – Revised. Score of ≥12 indicative of problematic cannabis use disorder [19]: 2ASSIST= Alcohol, Smoking and Substance Involvement Screening Test [21]. Scores are for current (3 month) drug use. Scores are indicative of low risk (0-10 for alcohol and 0-3 for other drugs), moderate risk ( 11-26 alcohol; 4-26 other drugs) or high risk (27+ all drugs): 3SDS=Substance Dependence Scale [22, 23]: Tob = Tobacco: Cann = Cannabis: AL = Alcohol; ATS=Amphetamine-type stimulants; Op=opioids; Tx = treatment; aself-reported time taking varenicline. bduration of study followed up
Table 1: Summary of Cases.