Decreases in smoking during treatment for methamphetamine-use disorders: preliminary evidence

Abstract

Despite high rates of smoking (70-90%) and the severely negative impact of smoking on physical and mental health, only 12% of individuals receiving stimulant-use disorder treatment also receive smoking-cessation treatment. The aim of this investigation was to examine the effect of a contingency management (CM) intervention targeting methamphetamine (MA) use on cigarette smoking. Sixty-one adults with MA-use disorders who were smokers were assigned to CM or standard psychosocial treatment. Rates of smoking-negative breath samples (carbon monoxide <3 ppm) were compared between the two groups while controlling for baseline carbon monoxide level, marijuana use, MA use, and time. This subgroup of mostly male (59%) participants included 44 participants in the CM group and 17 participants in the standard psychosocial treatment. Tobacco smoking participants who received CM targeting MA use were 140% (odds ratio: 2.395; 95% confidence interval: 1.073-5.346) more likely to submit a smoking-negative breath sample relative to standard psychosocial treatment during the treatment period, holding constant several other prespecified covariates. This study provides evidence that a behavioral treatment for MA use results in reductions in cigarette smoking in adults with MA-use disorder.

A review of contingency management for the treatment of substance-use disorders: adaptation for underserved populations, use of experimental technologies, and personalized optimization strategies

“…Lastly, and in line with some of the observations among patients with co-occurring addictions or MI, there is another line of developing inquiry focused on examining the “off-target” effects of CM on co-occurring addiction behavior in an effort to leverage such observed crossover effects. In published examples of this effect, CM exhibited an apparent off-target effect on smoking among smokers who were undergoing methamphetamine-use-disorder treatment 64 and a population of smokers who were also patients with SMI undergoing treatment for psychostimulant use 56 and alcohol-use disorder. 6 It has also been demonstrated that CM indirectly reinforces treatment attendance when attendance is mandatory in order to provide the required urine sample.…”

Parallel growth modeling to better understand smoking with stimulant use outcomes during an integrated treatment trial.

“…Importantly, research has also demonstrated that implementing smoking cessation treatment does not negatively affect substance use outcomes, including treatments delivered for stimulant use disorder (SUD; Budney et al, 1993; Patkar et al, 2006; Radzius et al, 1998). Given the strong relationship between cigarette smoking and stimulant use, it’s plausible that by introducing a combination of smoking cessation treatments, stimulant use may be indirectly treated as well (McDonell et al, 2014; McPherson et al, 2018). To formally test this idea, the most powerful methodological approach should be considered to determine whether the influence of one medication or behavioral therapy can provide relief for not only the target disorder, but also other related disorders.…”

The rewarding recovery study: a randomized controlled trial of incentives for alcohol and drug abstinence with a rural American Indian community

“…We used a one-tailed alpha error rate of 0.05 as the threshold for statistical significance. We replicated GEE models using multiple imputation to handle the missing values in a sensitivity analysis, assuming data were missing at random, and in a manner consistent with previous CM studies and best-practice handling of missing data in clinical trials [21,22,[36][37][38][39][40][41][42]. All analyses were performed using Stata version 14 software.…”