Open AccessAchieving Smoking Cessation Among Persons with Opioid Use Disorder
Author(s) -
Cynthia Vlad,
Julia H. Arnsten,
Shadi Nahvi
Publication year - 2020
Publication title -
cns drugs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.565
H-Index - 108
eISSN - 1179-1934
pISSN - 1172-7047
DOI - 10.1007/s40263-020-00701-z
Subject(s) - varenicline , medicine , smoking cessation , opioid use disorder , bupropion , nicotine replacement therapy , contingency management , pharmacotherapy , nicotine , population , psychiatry , opiate substitution treatment , nicotine patch , opioid , intervention (counseling) , buprenorphine , environmental health , placebo , alternative medicine , receptor , pathology
While prevalence of tobacco use in the US general population is declining, prevalence among those with opioid use disorder (OUD) remains high and results in excessive tobacco-related disease and premature mortality. Among smokers with OUD, tobacco cessation rates are negligible without treatment. However, both low-intensity behavioral interventions and more intensive motivational interventions yield negligible cessation rates. While contingency management has potent short-term cessation effects, effects are not maintained at post-intervention follow-up. Evidence-based smoking cessation pharmacotherapies, such as nicotine replacement therapy, bupropion, and varenicline, result in very modest cessation rates among smokers with OUD. Intensification of pharmacotherapy, such as high-dose and combination nicotine replacement therapy or extended medication treatment, has failed to improve cessation outcomes compared with standard treatment regimens. Targeting the unique challenges faced by smokers with OUD, including nicotine-opioid interactions and poor medication adherence, has potential to improve cessation outcomes, but further research is needed to optimize intervention efficacy among smokers with OUD.