title: The barriers to smoking cessation in Swiss methadone and buprenorphine-maintained patients.
abstract: BACKGROUND
  Smoking rates in methadone-maintained patients are almost three times higher than in the general population and remain elevated and stable. Due to the various negative health effects of smoking, nicotine dependence contributes to the high mortality in this patient group. The purpose of the current study was to investigate Swiss methadone and buprenorphine-maintained patients' willingness to stop smoking and to clarify further smoking cessation procedures.
  
  
  METHODS
  Substance abuse history, nicotine dependence, and readiness to stop smoking were assessed in a sample of 103 opiate-dependent patients in the metropolitan area of Zurich, Switzerland. Patients were asked to document their smoking patterns and readiness to quit.
  
  
  RESULTS
  Only a small number of patients were willing to quit smoking cigarettes (10.7%) and, even though bupropione or nicotine replacement therapy was included in the fixed daily treatment care, only one patient received nicotine replacement therapy for smoking cessation. A diagnosis of depression in patients' clinical records was associated with readiness to stop smoking. No significant associations were found between readiness to quit smoking and age, methadone treatment characteristics, and presence of co-dependencies.
  
  
  CONCLUSIONS
  The current prescription level of best medicine for nicotine dependence in Swiss methadone and buprenorphine-maintained patients is far from adequate. Possible explanations and treatment-relevant implications are discussed.
authors.affiliation: Psychiatric University Hospital Zurich, Research Group on Substance Use Disorders, Selnaustrasse 9, 8002 Zurich, Switzerland. mail2victoria@bluewin.ch
authors.forename: Victoria
authors.initials: V
authors.lastname: Wapf
authors.forename: Michael
authors.initials: M
authors.lastname: Schaub
authors.forename: Beat
authors.initials: B
authors.lastname: Klaeusler
authors.forename: Lukas
authors.initials: L
authors.lastname: Boesch
authors.forename: Rudolf
authors.initials: R
authors.lastname: Stohler
authors.forename: Dominique
authors.initials: D
authors.lastname: Eich