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Research shows that people with these conditions account for nearly 40% of all cigarettes consumed in the U.S., despite representing a much smaller share of the population. Population-based studies, including a major Norwegian survey, have found that individuals with symptoms of anxiety and depression are significantly more likely to be current smokers compared to those without these symptoms. This association is particularly concerning because individuals with depression or anxiety often smoke more heavily and are more likely to become nicotine dependent. Additionally, the co-occurrence of both conditions has been found to strengthen the association with tobacco use, suggesting a compounding effect. The relationship between tobacco use and emotional distress is commonly explained by the self-medication hypothesis

Structured programs, which guide participants to actively follow the steps of smoking cessation, promote user engagement by imposing a consistent framework that encourages adherence and allows participants to systematically address their smoking habits 15

Delta-8 THC products have not been evaluated or approved by the FDA for safe use and may be marketed in ways that put the public health at risk

Supplementary information Additional file 1