Smoking cessation in methadone maintenance

Steve Shoptaw, Erin Rotheram-Fuller, Xiaowei Yang, Dominick Frosch, Debbie Nahom, Murray E. Jarvik, Richard A. Rawson, Walter Ling

Research output: Contribution to journalArticle

190 Citations (Scopus)

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) x 2 (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.

Original languageEnglish (US)
Pages (from-to)1317-1328
Number of pages12
JournalAddiction
Volume97
Issue number10
DOIs
StatePublished - Oct 1 2002
Externally publishedYes

Fingerprint

Methadone
Smoking Cessation
Secondary Prevention
Nicotine
Opiate Alkaloids
Smoking
Therapeutics
Cocaine
Urine
Opioid-Related Disorders
Los Angeles
Narcotics
Carbon Monoxide
Random Allocation
Tobacco Products
Tobacco
Research Design

Keywords

  • Contingency management
  • Methadone maintenance
  • Relapse prevention
  • Smoking cessation

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Shoptaw, S., Rotheram-Fuller, E., Yang, X., Frosch, D., Nahom, D., Jarvik, M. E., ... Ling, W. (2002). Smoking cessation in methadone maintenance. Addiction, 97(10), 1317-1328. https://doi.org/10.1046/j.1360-0443.2002.00221.x

Smoking cessation in methadone maintenance. / Shoptaw, Steve; Rotheram-Fuller, Erin; Yang, Xiaowei; Frosch, Dominick; Nahom, Debbie; Jarvik, Murray E.; Rawson, Richard A.; Ling, Walter.

In: Addiction, Vol. 97, No. 10, 01.10.2002, p. 1317-1328.

Research output: Contribution to journalArticle

Shoptaw, S, Rotheram-Fuller, E, Yang, X, Frosch, D, Nahom, D, Jarvik, ME, Rawson, RA & Ling, W 2002, 'Smoking cessation in methadone maintenance', Addiction, vol. 97, no. 10, pp. 1317-1328. https://doi.org/10.1046/j.1360-0443.2002.00221.x
Shoptaw S, Rotheram-Fuller E, Yang X, Frosch D, Nahom D, Jarvik ME et al. Smoking cessation in methadone maintenance. Addiction. 2002 Oct 1;97(10):1317-1328. https://doi.org/10.1046/j.1360-0443.2002.00221.x
Shoptaw, Steve ; Rotheram-Fuller, Erin ; Yang, Xiaowei ; Frosch, Dominick ; Nahom, Debbie ; Jarvik, Murray E. ; Rawson, Richard A. ; Ling, Walter. / Smoking cessation in methadone maintenance. In: Addiction. 2002 ; Vol. 97, No. 10. pp. 1317-1328.
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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) x 2 (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.",
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