Opioid treatment program patients and staff often have concerns that smoking cessation may jeopardize abstinence from illicit drug use. In this study, we evaluated whether smoking abstinence produced with a two-week contingency-management (CM) intervention was associated with relapse to illicit drug use among patients enrolled in opioid maintenance. Opioid-maintenance patients who were stable in treatment and abstinent from illicit drugs were enrolled in a 14-day smoking-cessation study. Participants were dichotomized into Abstainers (> 90% smoking-negative samples, n=12) and Smokers (< 10% smoking-negative samples, n=16). Illicit drug assays included opioids, oxycodone, propoxyphene, cannabis, amphetamines, cocaine, and benzodiazepines. There were no differences between the Abstainers and Smokers, with 99% and 96% of samples testing negative for all illicit drugs in each group, respectively. Data from this study provide no evidence that smoking cessation among stable opioid-maintained patients undermines drug abstinence and lend support for programs that encourage smoking cessation during drug abuse treatment.
CampbellB.K.WanderN.StarkM.J.HolbertT.1995Treating cigarette smoking in drug-abusing clients. Journal of Substance Abuse Treatment, 12 (2), 89–94.
5.
Center for Disease Control (CDC)2005Annual smoking-attributable mortality, years of potential life lost, and economic costs–-United States, 1997–2001. Morbidity and Mortality Weekly Report, 55, 625–628.
6.
ChaitL.D.GriffithsR.R.1984Effects of methadone on human cigarette smoking and subjective ratings. The Journal of Pharmacology and Experimental Therapeutics, 229 (3), 636–640.
7.
ClarkJ.G.SteinM.D.McGarryK.A.GogineniA.2001Interest in smoking cessation among injection drug users. The American Journal on Addictions, 10 (2), 159–166.
8.
ClemmeyP.BroonerR.ChutuapeM.A.KidorfM.StitzerM.1997Smoking habits and attitudes in a methadone maintenance treatment population. Drug and Alcohol Dependence, 44 (2–3), 123–132.
9.
Drug Abuse and Alcohol Treatment Information System (DASIS)2006Facilities operating opioid treatment programs: 2005. Rockville, MD: Office of Applied Studies, SAMHSA.
10.
DunnK.E.SigmonS.C.ThomasC.S.HeilS.H.HigginsS.T.2008Voucher-based contingent reinforcement of smoking abstinence among methadone-maintained patients: A pilot study. Journal of Applied Behavior Analysis, 41 (4), 527–538.
11.
EngstromA.AdamssonC.AllebeckP.RydbergU.1991Mortality in patients with substance abuse: A follow-up in Stockholm County, 1973–84. International Journal of Addictions, 26 (1), 91–106.
12.
Federal Register 42 CRF Part 82001Opioid drugs in maintenance and detoxification treatment of opiate addiction; Final Rule. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.
13.
FroschD.L.ShoptawS.JarvikM.E.RawsonR.A.LingW.1998Interest in smoking cessation among methadone maintained outpatients. Journal of Addictive Disorders, 17 (2), 9–19.
14.
FullerB.E.GuydishJ.TsohJ.ReidM.S.ResnickM.ZammarelliL.ZiedonisD.M.SearsC.McCartyD.2007Attitudes towards the integration of smoking cessation treatment into drug abuse clinics. Journal of Substance Abuse Treatment, 32 (1), 53–60.
15.
GourlayS.G.ForbesA.MarrinerT.PethicaD.McNeilJ.J.1994Prospective study of factors predicting outcome of transdermal nicotine treatment in smoking cessation. British Medical Journal, 309 (6958), 842–846.
16.
HeathertonT.F.KozlowskiL.T.FreckerR.C.FagerströmK.O.1991The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire. British Journal of Addiction, 86 (9), 1119–1127.
HigginsS.T.HeilS.H.DumeerA.T.ThomasC.S.SolomonL.J.BernsteinI.M.2006Smoking status in the initial weeks of quitting as a predictor of smoking-cessation outcomes in pregnant women. Drug and Alcohol Dependence, 85, 138–141.
19.
HigginsS.T.HeilS.H.SolomonL.J.LussierJ.P.AbelR.L.LynchM.E.BadgerG.J.2004A pilot study on voucher-based incentives to promote abstinence from cigarette smoking during pregnancy and postpartum. Nicotine and Tobacco Research, 6 (6), 1015–1020.
20.
HigginsS.T.SilvermanK.HeilS.H. (Eds.) 2008Contingency management in the treatment of substance use disorders: A science-based treatment innovation. New York: The Guilford Press.
21.
HoffmanA.L.KantorB.LeechT.LindbergD.Order-ConnorsB.SchreiberJ.SladeJ.1997Drug-free is nicotine-free: Addressing tobacco in the treatment and prevention of other addictions. New Brunswick, NJ: St. Peter's Medical Center.
22.
HserY.I.McCarthyW.J.AnglinM.D.1994Tobacco use as a distal predictor of mortality among long-term narcotic addicts. Preventative Medicine, 23 (1), 61–69.
23.
HurtR.D.CroghanI.T.OffordK.P.EbermanK.M.MorseR.M.1995Attitudes towards nicotine dependence among chemical dependency unit staff: Before and after a smoking cessation trial. Journal of Substance Abuse Treatment, 12 (4), 247–252.
24.
HurtR.D.EbermanK.M.CroghanI.T.OffordK.P.DavisL.J.MorseR.M.PalmenM.A.BruceB.K.1994Nicotine dependence treatment during inpatient treatment for other addictions: A prospective intervention trial. Alcoholism: Clinical and Experimental Research, 18 (4), 867–872.
25.
HurtR.D.OffordK.P.CroghanI.T.Gomez-DahlL.KottkeT.E.MorseR.M.MeltonL.J.1996Mortality following inpatient addictions treatment: Role of tobacco use in a community-based cohort. Journal of the American Medical Association, 275 (14), 1097–1103.
26.
JohnsonR.E.StrainE.C.AmassL.2003Buprenorphine: How to use it right. Drug and Alcohol Dependence, 70, S59–S77.
27.
KenfordS.L.FioreM.C.JorenbyD.E.SmithS.S.WetterD.BakerT.B.1994Predicting smoking cessation: Who will quit with and without the nicotine patch. Journal of the American Medical Association, 271 (8), 589–594.
28.
KnappJ.M.RosheimC.L.MeisterE.A.KottkeT.E.1993Managing tobacco dependence in chemical dependency treatment facilities: A survey of current attitudes and policies. Journal of Addictive Diseases, 12 (4), 89–104.
29.
KozlowskiL.T.SkinnerW.KentC.PopeM.A.1989Prospects for smoking treatment in individuals seeking treatment for alcohol and other drug problems. Addictive Behavior, 14 (3), 273–278.
30.
McCoolR.M.RichterK.ChoiW.S.2005Benefits of and barriers to providing smoking treatment in methadone clinics: Findings from a national study. The American Journal of Addictions, 14 (4), 358–366.
31.
McLellanA.T.LuborskyL.CacciolaJ.GriffithJ.EvansF.BarrH.O'BrienC.P.1985New data from the Addiction Severity Index: Reliability and validity in three centers. Journal of Nervous and Mental Disorders, 173 (7), 412–422.
32.
MelloN.K.LukasS.E.MendelsonJ.H.1985Buprenorphine effects on cigarette smoking. Psychopharmacology, 86 (4), 417–425.
33.
MillerW.R.HedrickK.E.TaylorC.A.1983Addictive behaviors and life problems before and after behavioral treatment of problem drinkers. Addictive Behaviors, 8 (4), 403–412.
34.
NahviS.RichterK.LiX.ModaliL.ArnstenJ.2006Cigarette smoking and interest in quitting in methadone maintenance patients. Addictive Behaviors, 31 (11), 2127–2134.
35.
OlsenY.AlfordD.P.HortonN.J.SaitzR.2005Addressing smoking cessation in methadone programs. Journal of Addictive Diseases, 24 (2), 33–48.
36.
ProchaskaJ.J.DelucchiK.HallS.M.2004A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. Journal of Consulting and Clinical Psychology, 72 (6), 1144–1156.
37.
ReidM.S.FallonB.SonneS.FlamminoF.NunesE.V.JiangH.KourniotisE.LimaJ.BradyR.BurgessC.ArfkenC.PihlgrenE.GiordanoL.StarostaA.RobinsonJ.RotrosenJ.2008Smoking cessation treatment in community-based substance abuse rehabilitation programs. Journal of Substance Abuse Treatment, 35 (1), 68–77.
38.
RichterK.P.2006Good and bad times for treating cigarette smoking in drug treatment. Journal of Psychoactive Drugs, 38 (3), 311–315.
39.
RichterK.P.ChoiW.S.AlfordD.P.2005Smoking policies in U.S. outpatient drug treatment facilities. Nicotine & Tobacco Research, 7 (3), 475–480.
40.
RichterK.P.GibsonC.A.AhluwaliaJ.S.SchmelzleK.H.2001Tobacco use and quit attempts among methadone maintenance clients. American Journal of Public Health, 91 (2), 296–299.
41.
RichterK.McCoolR.B.OkuyemiK.S.MayoM.S.AhluwaliaJ.S.2002Patient's views on smoking cessation and tobacco harm reduction during drug treatment. Nicotine & Tobacco Research, 4(Suppl. 2), S175–S182.
42.
RollJ.M.HigginsS.T.2000A within-subject comparison of three different schedules of reinforcement of drug abstinence using cigarette smoking as an exemplar. Drug and Alcohol Dependence, 58 (1–2), 103–109.
43.
RollJ.M.HigginsS.T.TideyJ.W.1997Cocaine use can increase cigarette smoking: Evidence from laboratory and naturalistic settings. Experimental and Clinical Psychopharmacology, 5 (3), 263–268.
44.
SeesK.L.ClarkH.W.1993When to begin smoking cessation in substance abusers. Journal of Substance Abuse Treatment, 10 (2), 189–195.
45.
SigmonS.C.LambR.J.DalleryJ.2008Contingency management for reducing tobacco use. In HigginsS.T.SilvermanK.HeilS.H. (Eds.), Contingency management in the treatment of substance use disorders: A science-based treatment innovation. (99–119) New York: The Guilford Press.
Society for Research on Nicotine and Tobacco (SRNT) Subcommittee on Biochemical Verification2002Biochemical verification of tobacco use and cessation. Nicotine and Tobacco Research, 4 (2), 149–159.
48.
Substance Abuse and Mental Health Services Administration (SAMHSA)2007Results from the 2006 National Survey on Drug Use and Health: National findings (Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA 07–4293). Rockville, MD.
49.
YudkinP.L.JonesL.LancasterT.FowlerG.H.1996Which smokers are helped to give up smoking using transdermal nicotine patches? Results from a randomized, double-blind, placebo-controlled trial. British Journal of General Practice, 46 (404), 145–148.
