Electronic cigarette and tobacco use in individuals entering methadone or buprenorphine treatment

Abstract

Background: Although smoking is prevalent among populations with opioid use disorder (OUD), few studies have examined electronic cigarette (EC) use in individuals seeking opioid agonist therapy (OAT). The aim of this study was to evaluate the prevalence and correlates of EC use among individuals seeking OAT. Methods: 782 patients seeking OAT for OUD completed surveys assessing current and past EC use, reasons for use, current and past cigarette smoking, nicotine dependence, psychiatric distress, trauma, and pain. Bivariate and multivariate models evaluated correlates of daily EC use, past-30day EC use, and current cigarette smoking. Results: 6% of patients reported daily EC use, 18% reported past-30-day use, 62% reported EC use history, and 85% reported current cigarette smoking. 46% reported using ECs to quit or cut down smoking. In multivariate analyses, daily EC use was associated with higher odds of being a former smoker (OR 21; CI 1.7-273) and lower odds of ever smoking more than 100 cigarettes *

Effect of brief nicotine corrective messaging on nicotine beliefs in persons who use opioids.

“…This study represents a first step toward examining the role of such education in promoting smoking cessation and a novel strategy to increase the use of NRT, which has been shown to be effective for smoking cessation in persons receiving treatment for OUD (Yee et al, 2018). It could also be leveraged to increase the use of e-cigarettes in smoking cessation in this population, as suggested by earlier studies (Baldassarri et al, 2019; Stein et al, 2016). Given the disproportionate impact of smoking-related consequences (e.g., Goodwin et al, 2014) on the health of persons who use opioids, new approaches to reduce cigarette use in this population are urgently needed.…”

“…Promising evidence on smoking cessation in those receiving medication for OUD support the efficacy of financial incentives for smoking cessation (Dunn et al, 2008), highlighting that smoking cessation does not undermine opioid abstinence in this population (Dunn et al, 2009); however, these effects are not sustained postintervention (Vlad et al, 2020). Nicotine-replacement therapy (NRT) has been proven to be effective for cessation among persons in methadone-maintenance treatment for OUD (Yee et al, 2018) and early data suggest that e-cigarettes may reduce cigarette smoking in this population as well (Baldassarri et al, 2019; Stein et al, 2016).…”

“…Nicotine misperceptions have been identified as a barrier to NRT use among smokers to aid in quitting smoking (Bansal et al, 2004). Whether misperceptions have reduced e-cigarette use for cessation is unknown, but population-level data suggest that e-cigarettes have been widely used by people to quit smoking cigarettes (Farsalinos & Niaura, 2020; Giovenco & Delnevo, 2018), with high uptake of e-cigarettes among opioid-dependent smokers (Baldassarri et al, 2019; Stein et al, 2015).…”

An empirical perspective on cigarette use in substance use recovery

“…Additional challenges exist toward implementation of tobacco cessation services in SUD treatment facilities desiring them, including inadequate cessation resources, high prevalence of smoking among facility staff, and organizational cultures that do not prioritize cessation (Guydish et al, 2007;Knudsen, 2017). Compounding these issues is the proliferation of non-cigarette tobacco products and widespread increase in their use, the increase in polytobacco product use, which is 2302 Editorial associated with lower odds of quitting (Guydish et al, 2016;Wang-Schweig, Jason, Stevens, & Chaparro, 2019), and the increase in use of products that are often used to co-administer tobacco and cannabis (Baldassarri et al, 2019;Dixit, Herbst, & Das, 2021;Guydish et al, 2016;Wang-Schweig et al, 2019). E-cigarettes, for example, are often permitted in SUD treatment facilities where combustible tobacco use is prohibited (Wang-Schweig et al, 2019).…”

Reductions in tobacco use in naltrexone, relative to buprenorphine-maintained individuals with opioid use disorder: Secondary analysis from the National Drug Abuse Treatment Clinical Trials Network

“…Approximately 83-98% of adults in opioid use disorder (OUD) treatment report current cigarette smoking (Baldassarri et al, 2019;Chisolm et al, 2013;Do et al, 2017;Guydish et al, 2016). Among opioid users, the mortality rate of cigarette smokers is four times greater than that of nonsmokers (Hser, McCarthy, & Anglin, 1994).…”