Use of Smoking Cessation Methods Among Patients Receiving Office-based Buprenorphine Maintenance Treatment

Abstract

Objectives Provision of smoking cessation treatment is limited in office-based buprenorphine maintenance treatment (BMT) settings. This study describes smoking and smoking cessation behaviors among patients receiving office-based BMT. Methods Cross-sectional study of patients receiving office-based BMT at a community health center in the Bronx, NY. We interviewed patients assessing sociodemographic, substance use and tobacco use characteristics, including methods used for smoking cessation. We report simple frequencies and explored associations of BMT characteristics with smoking behaviors. Results Of 68 patients, 87.7% were current cigarette smokers, 7.9% were former smokers and 4.4% had never smoked. Of lifetime smokers, 83.1% reported at least one prior quit attempt; 78.5% had used medication (75.4% used nicotine replacement therapy, 29.2% varenicline, and 9.2% bupropion). Ten patients (15.4%) reported using electronic cigarettes to try to quit smoking. Stopping “cold turkey” (40.0%) and gradually decreasing the number of cigarettes smoked (32.3%) were non-pharmacological methods of quitting tried most often. Use of behavioral support, including stop smoking programs and counseling, was low. Higher dose and longer duration of BMT was associated with greater smoking frequency. Conclusions Patients receiving BMT have a high prevalence of cigarette smoking, though most have tried to quit, and have prior experience with pharmacotherapy for smoking cessation. Efforts to optimize smoking cessation treatments among BMT patients are needed.

Perceived risk, attitudes, and behavior of cigarette smokers and nicotine vapers receiving buprenorphine treatment for opioid use disorder during the COVID-19 pandemic

“…In line with our findings, evidence from data published prior to the pandemic suggest that most people with OUD who smoke are motivated to quit and try to quit (See Vlad et al, 2020 for a review; Shah et al, 2017 ). For example, Nahvi and colleagues (2006) conducted a cross-sectional survey study of patients in methadone treatment and reported about half (48%) of smokers were contemplating quitting smoking.…”

“…Our findings apply to patients with OUD who were stable in office-based buprenorphine treatment at the start of a COVID-19 surge and may not generalize to individuals who smoke cigarettes or vape nicotine and are in other OUD treatment programs (e.g., methadone maintenance) or to less stable samples such as those out of treatment and actively using opioids. The survey response rate may have been higher had we been able to approach patients in-person at their regular office visits as originally planned, as this has been shown to optimize response rates in other vulnerable samples ( Oga et al, 2018 ; Shah et al, 2017 ). This strategy was precluded by restrictions on research recruitment during the COVID-19 surge at our institution.…”

Pilot Tobacco Treatment Intervention for Women in Residential Treatment for Substance Use Disorder

“…Interestingly, two out of the seven participants who completed the GFAQ reported switching entirely from conventional cigarettes to electronic cigarettes at the 6-month session. This is in accordance with previous research among clients with SUDs who were engaged in medication-assisted treatment: 15% of clients who were current smokers had used electronic cigarettes as part of a smoking cessation attempt (Shah, Cunningham, Brisbane, DeLuca, & Nahvi, 2017). Oncken and colleagues (2017) reported that a history of substance abuse was associated with electronic cigarette use during pregnancy.…”

Self-Rated Physical Health and Unmet Healthcare Needs among Swedish Patients in Opioid Substitution Treatment

“…A vast majority (75%) of individuals included in our study were daily smokers, compared to an average of 9% in the general adult Swedish population [24]. International research on substance dependence shows tobacco smoking prevalence in 73-97%, with OST patients generally being at the higher end [25–33]. Apart from tobacco smoking, inhalation, smoking, or intravenous use of substances can cause a wide spectrum of diseases affecting the lungs, either direct or indirect.…”