title: A comparison of cigarette smoking profiles in opioid-dependent pregnant patients receiving methadone or buprenorphine.
abstract: BACKGROUND
  Little is known about the relationship between cigarette smoking and agonist treatment in opioid-dependent pregnant patients. The objective of this study is to examine the extent to which cigarette smoking profiles differentially changed during the course of pregnancy in opioid-dependent patients receiving either double-blind methadone or buprenorphine. Patients were participants in the international, randomized controlled Maternal Opioid Treatment: Human Experimental Research (MOTHER) study.
  
  
  METHODS
  A sample of opioid-maintained pregnant patients (18-41 years old) with available smoking data who completed a multisite, double-blind, double-dummy, randomized controlled trial of methadone (n = 67) and buprenorphine (n = 57) between 2005 and 2008. Participants were compared on smoking variables based on opioid agonist treatment condition.
  
  
  RESULTS
  Overall, 95% of the sample reported cigarette smoking at treatment entry. Participants in the two medication conditions were similar on pretreatment characteristics including smoking rates and daily cigarette amounts. Over the course of the pregnancy, no meaningful changes in cigarette smoking were observed for either medication condition. The fitted difference in change in adjusted cigarettes per day between the two conditions was small and nonsignificant (β = -0.08, SE = 0.05, p = .132).
  
  
  CONCLUSIONS
  Results support high rates of smoking with little change during pregnancy among opioid-dependent patients, regardless of the type of agonist medication received. These findings are consistent with evidence that suggests nicotine effects, and interactions may be similar for buprenorphine compared with methadone. The outcomes further highlight that aggressive efforts are needed to reduce/eliminate smoking in opioid-dependent pregnant women.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. mchisol1@jhmi.edu
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Chisolm
authors.forename: Heather
authors.initials: H
authors.lastname: Fitzsimons
authors.forename: Jeannie-Marie S
authors.initials: JM
authors.lastname: Leoutsakos
authors.forename: Shauna P
authors.initials: SP
authors.lastname: Acquavita
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Heil
authors.forename: Molly
authors.initials: M
authors.lastname: Wilson-Murphy
authors.forename: Michelle
authors.initials: M
authors.lastname: Tuten
authors.forename: Karol
authors.initials: K
authors.lastname: Kaltenbach
authors.forename: Peter R
authors.initials: PR
authors.lastname: Martin
authors.forename: Bernadette
authors.initials: B
authors.lastname: Winklbaur
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Jansson
authors.forename: Hendrée E
authors.initials: HE
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008691:Methadone / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000523:psychology; D011247:Pregnancy; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D055815:Young Adult
chemical_list: D002047:Buprenorphine; D008691:Methadone