Smoking cessation in methadone maintenance

Abstract

Contingency management optimized outcomes using nicotine replacement therapy for reducing cigarette smoking during treatment for opiate dependence, although long-term effects are not generally maintained. Findings document strong associations between reductions in cigarette smoking and reductions in illicit substance use during treatment.

Early Quit Days Among Methadone-Maintained Smokers in a Smoking Cessation Trial

“…Quit initiation is an area that has not been well studied among MMT smokers. As noted previously, the existing RCTs of smoking cessation among MMT populations report on longer term follow-up outcomes and do not emphasize the early stages of the quitting in their analyses (Haug et al, 2004;Shoptaw et al, 2002;Stein et al, 2006Stein et al, , 2013, which will be examined in the current investigation.…”

“…In Shoptaw et al (2002), four-group trial testing NRT, relapse prevention plus NRT, contingency management plus NRT, and all three treatments combined, 12-month carbon monoxide (CO)-confirmed abstinence rates were below 10% in all four groups and there were no significant treatment group differences found. In the trial by Stein et al (2006) comparing Motivational Interviewing (MI) plus NRT to brief advice and patch, the intent-to-treat CO-confirmed 7-day point prevalence estimate of cessation were 5.2% in the MI group and 4.7% in the brief advice group at 6 months.…”

“…Yet, all of the smoking cessation pharmacotherapies that have been tested in opioiddependent persons have far lower quit rates (Mooney et al, 2008;Okoli et al, 2010;Reid et al, 2008;Shoptaw et al, 2002;Stein et al, 2006) than those reported in trials of nondrug users (Hurt et al, 1994;Mooney et al, 2008;Okoli et al, 2010;Reid et al, 2008;Shoptaw et al, 2002;Stead et al, 2008;Stein et al, 2006). Over the last two decades, there have been four fully powered randomized clinical trials (RCTs) involving smoking cessation interventions specifically with MMT smokers (Haug, Advance Access publication June 20, 2014 nicotine & tobacco research, volume 16, number 11 (november 2014) 1463-1469 early quit days among methadone-maintained smokers Svikis, & Diclemente, 2004;Shoptaw et al, 2002;Stein et al, 2006Stein et al, , 2013Story & Stark, 1991).…”

Cigarette smoking cessation services in outpatient substance abuse treatment programs in the United States

“…12 A recent nonrandom survey of U.S. outpatient methadone facilities found that 18% had offered individual or group quit smoking counseling, and 12% had prescribed or had facilitated access to nicotine replacement therapy, to at least one patient in the past month. 13 These studies, however, provide an incomplete picture of smoking cessation treatment in substance abuse treatment because they collected minimal data on tobacco treatment services and little data on program characteristics. Furthermore, all focused on study populations that do not generalize to the entire U.S. substance abuse treatment system.…”

“…On any given day, approximately 1 million Americans are in treatment for alcohol and other drug problems. 11 Research in this new field suggests that many substance abuse treatment patients are highly interested in quitting smoking, [12][13][14][15][16][17][18][19][20] that evidence-based treatment achieves long-term quit rates of 5-14%, 13,[21][22][23][24] and that quitting smoking does not threaten abstinence from other drugs of abuse, but might actually promote it. [6][7][8][9] Some substance abuse treatment facilities are beginning to do so.…”