Nicotine replacement therapy: patterns of use after a quit attempt among methadone-maintained smokers.
OBJECTIVE
To determine the association between daily smoking and use of nicotine replacement therapy (NRT), and to determine predictors of greater NRT use among methadone-maintained smokers.


METHODS
Assignment to free nicotine patch (8 to 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 NCI's 4 A's model (min).


METHODS
Five methadone maintenance treatment centers.


METHODS
Of the 383 methadone-maintained smokers enrolled, 309 (80.6%) set a specific quit date (received NRT) and were located for assessments. Participants were 51.8% male, 78.6% Caucasian, and smoked 26.6 (SD=12.2) cigarettes/day.


RESULTS
Use of NRT and smoking behaviors during the 180-day follow-up period assessed by the Timeline follow-back method.


RESULTS
On the day following their quit day, 86.4% of participants used NRT. The percentage of participants using NRT was 52.3%, 27.1%, and 10.4% on day 30, day 60, and day 90, respectively. Participants used NRT on 44.1% of the days through the 90 days of the treatment protocol. The estimated odds of smoking abstinence was 7.1 (P<.001) times higher on days when NRT was used than on days when NRT was not used, and cigarettes/day was also significantly lower on NRT days (14.93 vs 4.65; P<.001).


CONCLUSIONS
Nicotine replacement therapy use was inconsistent following an initial quit attempt among methadone-maintained smokers. On days when NRT was used, individuals were likely to smoke at reduced levels or not at all.
Stein
Michael D
MD
Department of Medicine, Brown Medical School, Providence, RI, USA. mstein@life-span.org
Anderson
Bradley J
BJ
Niaura
Raymond
R
D000287:Administration, Topical; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012907:Smoking; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome
D009538:Nicotine; D008691:Methadone