Abstract: About 25% of Veterans prescribed opioid analgesics report smoking tobacco. There are reciprocal relationships between tobacco use, chronic pain, and opioid use, including increased smoking and difficulty quitting among those with chronic pain and opioid use disorders, increased prevalence of chronic pain among those who smoke, and nicotine/opioid interactions on pain perception and reward pathways. Recent data suggest cannabis use disorder has increased in Veterans with chronic pain. Cannabis use has been associated with greater nicotine dependence and may impact smoking cessation, but there are open questions about whether cannabis use hinders smoking cessation for Veterans prescribed opioid analgesics. Using Veterans Health Administration (VHA) data, we examined initiation of smoking cessation medication or smoking abstinence among Veterans prescribed opioid analgesics and estimated associations between cannabis use and each smoking-related outcome.