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Addiction. 2002 Oct;97(10):1317-28; discussion 1325.

Smoking cessation in methadone maintenance.

Author information

1
Friends Research Institute, Los Angeles, CA, UCLA, Department of Psychiatry, Los Angeles, CA 90025, USA. shoptaw@friendsresearch.org

Abstract

AIMS:

To evaluate relapse prevention (relapse prevention) and contingency management (contingency management) for optimizing smoking cessation outcomes using nicotine replacement therapy for methadone-maintained tobacco smokers.

DESIGN:

Experimental, 2 (relapse prevention)x2 (contingency management) repeated measures design using a platform of nicotine replacement therapy featuring a 2-week baseline period, followed by randomization to 12 weeks of treatment, and 6- and 12-month follow-up visits.

SETTING:

Three narcotic treatment centers in Los Angeles.

PARTICIPANTS:

One hundred and seventy-five participants who met all inclusion and no exclusion criteria.

INTERVENTION:

Participants received 12 weeks of nicotine replacement therapy and assignment to one of four conditions: patch-only, relapse prevention + patch, contingency management + patch and relapse prevention + contingency management + patch.

MEASUREMENTS:

Thrice weekly samples of breath (analyzed for carbon monoxide) and urine (analyzed for metabolites of opiates and cocaine) and weekly self-reported numbers of cigarettes smoked.

FINDINGS:

Participants (73.1%) completed 12 weeks of treatment. During treatment, those assigned to receive contingency management showed statistically higher rates of smoking abstinence than those not assigned to receive contingencies (F3,4680=6.3, P=0.0003), with no similar effect observed for relapse prevention. At follow-up evaluations, there were no significant differences between conditions. Participants provided more opiate and cocaine-free urines during weeks when they met criteria for smoking abstinence than during weeks when they did not meet these criteria (F1,2054=14.38, P=0.0002; F1,2419=16.52, P<0.0001).

CONCLUSIONS:

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.

PMID:
12359036
[Indexed for MEDLINE]
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