title: Cigarette smoking and short-term addiction treatment outcome.
abstract: Cigarette smoking is common among patients in cocaine and opioid dependence treatment, and may influence treatment outcome. We addressed this issue in a secondary analysis of data from an outpatient clinical trial of buprenorphine treatment for concurrent cocaine and opioid dependence (13 weeks, N=200). The association between cigarette smoking (lifetime cigarette smoking status, number of cigarettes smoked per day prior to study entry) and short-term treatment outcome (% of urine samples positive for cocaine or opioids, treatment retention) was evaluated with analysis of covariance, bivariate correlations, and multivariate linear regression. Nicotine-dependent smokers (66% of participants) had a significantly higher percentage of cocaine-positive urine samples than non-smokers (12% of participants) (76% vs. 62%), but did not differ in percentage of opioid-positive urine samples or treatment retention. Number of cigarettes smoked per day at baseline was positively associated with percentage of cocaine-positive urine samples, even after controlling for baseline sociodemographic and drug use characteristics, but was not significantly associated with percentage of opioid-positive urine samples or treatment retention. These results suggest that cigarette smoking is associated with poorer short-term outcome of outpatient treatment for cocaine dependence, but perhaps not of concurrent opioid dependence, and support the importance of offering smoking cessation treatment to cocaine-dependent patients.
authors.affiliation: Intramural Research Program, National Institute on Drug Abuse/NIH, Baltimore, MD 21224, USA.
authors.forename: P T
authors.initials: PT
authors.lastname: Harrell
authors.forename: I D
authors.initials: ID
authors.lastname: Montoya
authors.forename: K L
authors.initials: KL
authors.lastname: Preston
authors.forename: L M
authors.initials: LM
authors.lastname: Juliano
authors.forename: D A
authors.initials: DA
authors.lastname: Gorelick
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D016739:Behavior, Addictive / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D002047:Buprenorphine / Q000627:therapeutic use; D019970:Cocaine-Related Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology* / Q000378:metabolism / Q000628:therapy; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine