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A smoking cessation intervention for the methadone‐maintained
Author(s) -
Stein Michael D.,
Weinstock Marjorie C.,
Herman Debra S.,
Anderson Bradley J.,
Anthony Jennifer L.,
Niaura Raymond
Publication year - 2006
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2006.01406.x
Subject(s) - medicine , smoking cessation , methadone , methadone maintenance , randomized controlled trial , nicotine , nicotine withdrawal , physical therapy , psychiatry , pathology
Aim To test, in combination with the nicotine patch, the incremental efficacy of a maximal, tailored behavioral treatment over a minimal treatment for smoking cessation. Design Randomized clinical trial with 6‐month follow‐up. Setting Five methadone maintenance treatment centers in Rhode Island. Participants Three hundred and eighty‐three methadone‐maintained smokers. Intervention Participants were assigned randomly to nicotine patch (8–12 weeks) plus either (1) a baseline tailored brief motivational intervention, a quit date behavioral skills counseling session and a relapse prevention follow‐up session (Max) or (2) brief advice using the National Cancer Institute's 4 As model (Min). An intent‐to‐treat analysis with those lost to follow‐up assumed to smoke was used. Measurements Carbon monoxide (CO)‐confirmed 7‐day point smoking cessation prevalence at 3 and 6 months, and self‐reported numbers of cigarettes smoked per day. Findings Participants had a mean age of 40 years, were 53% male, 78% Caucasian, smoked 26.7 (± 12.2) cigarettes/day and had a mean methadone dose of 95.5 mg. At 3 months, 317 (83%) were reinterviewed; at 6 months, 312 (82%) were reinterviewed. The intent‐to‐treat, 7‐day point prevalence estimate of cessation was 5.2% in the Max group and 4.7% in the Min group ( P = 0.81) at 6 months. In logistic models with treatment condition, age, gender, race, Fagerström Test for Nicotine Dependence and cigarettes per day as covariates, males were more likely to be abstinent at 3 months (OR 4.67; P = 0.003) and 6 months (OR 4.01; P = 0.015). Conclusion A tailored behavioral intervention did not increase quit rates over patch and minimal treatment. Smoking cessation rates in methadone‐maintained smokers are low, with men having greater success.