title: Early quit days among methadone-maintained smokers in a smoking cessation trial.
abstract: BACKGROUND
  Methadone maintenance treatment (MMT) patients have an exceedingly high prevalence of tobacco use, and interventions that have been specifically developed for this vulnerable subpopulation have struggled to attain even modest rates of cessation. A significant barrier has been an inability to initiate a quit attempt early in the treatment process and adherence to treatment.
  
  
  METHODS
  This study examined the extent to which self-efficacy, medication adherence, and other demographic and smoking variables predicted an early quit day in a sample of MMT smokers (n = 315) enrolled in a smoking cessation pharmacotherapy trial. Using logistic regression, we estimated the association of having an early quit day-24hr without smoking during the first month of treatment.
  
  
  RESULTS
  Only 35.2% of participants reported a successful early quit day. The likelihood of an early quit day increased significantly (odds ratio [OR] = 1.39, 95% CI = 1.04-1.86, p < .05) with education level and if a quit attempt was made in the past year (OR = 2.27, 95% CI = 1.33-3.87, p < .01). Compared to the placebo arm, those randomized to either nicotine replacement therapy (OR = 3.25, 95% CI = 1.30-8.10, p < .01) or varenicline (OR = 3.16, 95% CI = 1.26-7.92) were significantly more likely to have an early quit day. The likelihood of an early quit day was also positively associated with adherence to the medication protocol (OR = 2.05, 95% CI = 1.52-2.76).
  
  
  CONCLUSIONS
  Difficulty in achieving an early quit attempt may help explain the very low cessation rates found in studies of MMT smokers.
authors.affiliation: Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX; made@mdanderson.org.
authors.forename: Marcel A
authors.initials: MA
authors.lastname: de Dios
authors.affiliation: Butler Hospital, Providence, RI;
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Anderson
authors.affiliation: Butler Hospital, Providence, RI;
authors.forename: Celeste M
authors.initials: CM
authors.lastname: Caviness
authors.affiliation: Butler Hospital, Providence, RI; Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI; Department of Health Services, Policy, and Practice, Warren Alpert Medical School, Brown University, Providence, RI.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Stein
mesh_terms: D000328:Adult; D001552:Benzazepines / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods / Q000523:psychology*; D011810:Quinoxalines / Q000627:therapeutic use; D020377:Self Efficacy; D012907:Smoking / Q000188:drug therapy* / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D013997:Time Factors; D000068580:Varenicline
chemical_list: D001552:Benzazepines; D011810:Quinoxalines; D008691:Methadone; D000068580:Varenicline