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Research Summary

Effectiveness of a Smoking Cessation Intervention in Substance Abuse Treatment Programs

Patients in treatment for substance use disorders have a high prevalence of smoking. Treating nicotine dependence in substance abuse treatment (SAT) settings, however, is uncommon. Researchers conducted a randomized trial to evaluate the effectiveness of a smoking cessation intervention in SAT programs. The intervention consisted of nicotine replacement therapy plus 9 weekly cognitive-behavioral group counseling sessions and was compared with treatment-as-usual (TAU). Participants included 225 smokers (≥10 cigarettes per day) from 5 methadone maintenance programs and 2 drug- and alcohol-dependence treatment programs. Counseling attendance was highest in the first 3 weeks (40–60%).

  • In addition to significantly better smoking abstinence rates during treatment (see table, below) participants in the intervention arm had significantly greater reductions in cigarettes smoked per day, exhaled carbon monoxide levels, cigarette craving, and nicotine withdrawal.
Smoking Abstinence Rates (%)
   Intervention
arm
TAU
arm
Weeks 2–7 (treatment period)
10–11
<1
Week 13 follow-up
5.5
0
Week 26 follow-up
5.7
5.2

  • There was no difference between groups on rates of SAT retention, abstinence from primary substance of abuse, or craving for primary substance of abuse.

Comments:

Combining nicotine replacement therapy and counseling is modestly effective in reducing smoking, with more significant impacts on number of cigarettes smoked and craving for cigarettes. These results indicate that SAT programs may offer a unique means of integrating nicotine dependence treatment with treatment for substance abuse.

Julia H. Arnsten, MD, MPH

Reference:

Reid MS, Fallon B, Sonne S, et al. Smoking cessation treatment in community-based substance abuse rehabilitation programs. J Subst Abuse Treat. 2008;35(1):68–77.


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