Nicotine dependence predicts repeated use of prescribed opioids. Prospective population-based cohort study.
OBJECTIVE
The aim of this study was to evaluate prospectively smoking dependence as a predictor of repeated use of prescribed opioids in non-cancer patients.


METHODS
We conducted a prospective population-based study cohort of 12,848 men and 15,894 women 30-75 years of age in health surveys in Norway during 2000-2002 with repeated opioid prescriptions (12+, during 2004-2007) recorded in the Norwegian Prescription Database as the outcome measure. Information on history of smoking and potential confounders was obtained at baseline by self-administered questionnaires. For smoking, participants were divided into categories: never; previously heavy (stopped maximum of 5 years earlier; 10+ cigarettes daily); daily not heavy (1-9 cigarettes); dependent daily smokers (10+ cigarettes), and other (previously and/or not daily). Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by logistic regression.


RESULTS
During follow-up, 335 (1.5%) of survey participants were registered with 12+ prescriptions of opioids during the period 2004-2007. The prevalence of repeated prescription frequency of opioids was higher for men and women with a history of smoking. The adjusted OR for prescribed opioids for dependent daily smokers was 3.1 (95% CI: 2.3-4.1), for daily non-heavy smokers 1.8 (1.2-2.7), and for previous heavy smokers 1.8 (1.1-3.0), compared with never-smokers as reference.


CONCLUSIONS
Results of the study suggest that smoking dependence may predict more frequent use of opioids.
Skurtveit
Svetlana
S
Department of Pharmacoepidemiology, Norwegian Institute of Public Health, and Norwegian Centre for Addiction Research, University of Oslo, Norway. svetlana.skurtveit@fhi.no
Furu
Kari
K
Selmer
Randi
R
Handal
Marte
M
Tverdal
Aage
A
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D015986:Confounding Factors, Epidemiologic; D016208:Databases, Factual; D004363:Drug Utilization; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology; D055553:Prescription Drugs; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology*
D000701:Analgesics, Opioid; D055553:Prescription Drugs