title: Cigarette Smoking During Substance Use Disorder Treatment: Secondary Outcomes from a National Drug Abuse Treatment Clinical Trials Network study.
abstract: BACKGROUND
  The majority of patients enrolled in treatment for substance use disorders (SUDs) also use tobacco. Many will continue to use tobacco even during abstinence from other drugs and alcohol, often leading to smoking-related illnesses. Despite this, little research has been conducted to assess the influence of being a smoker on SUD treatment outcomes and changes in smoking during a treatment episode.
  
  
  METHODS
  In this secondary analysis, cigarette smoking was evaluated in participants completing outpatient SUD treatment as part of a multi-site study conducted by the National Drug Abuse Treatment Clinical Trials Network. Analyses included the assessment of changes in smoking and nicotine dependence via the Fagerström Test for Nicotine Dependence during the 12-week study among all smokers (aim #1), specifically among those in the experimental treatment group (aim #2), and the moderating effect of being a smoker on treatment outcomes (aim #3).
  
  
  RESULTS
  Participants generally did not reduce or quit smoking throughout the course of the study. Among a sub-set of participants with higher baseline nicotine dependence scores randomized to the control arm, scores at the end of treatment were lower compared to the experimental arm, though measures of smoking quantity did not appear to decrease. Further, being a smoker was associated with poorer treatment outcomes compared to non-smokers enrolled in the trial.
  
  
  CONCLUSIONS
  This study provides evidence that patients enrolled in community-based SUD treatment continue to smoke, even when abstaining from drugs and alcohol. These results add to the growing literature encouraging the implementation of targeted, evidence-based interventions to promote abstinence from tobacco among SUD treatment patients.
authors.affiliation: Medical University of South Carolina School of Medicine, 67 President St., Charleston, SC, 29425, United States. Electronic address: mccluree@musc.edu.
authors.forename: Erin A
authors.initials: EA
authors.lastname: McClure
authors.affiliation: Columbia University Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States; Mount Sinai St. Luke's Hospital, Department of Psychiatry and Behavioral Health, 1111 Amsterdam Avenue, New York, NY 10025, United States.
authors.forename: Aimee N C
authors.initials: AN
authors.lastname: Campbell
authors.affiliation: Department of Biostatistics, Mailman School of Public Health, CUMC, Columbia University, 722W. 168th street, New York, NY 10032, United States.
authors.forename: Martina
authors.initials: M
authors.lastname: Pavlicova
authors.affiliation: Columbia University Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States.
authors.forename: Meichen
authors.initials: M
authors.lastname: Hu
authors.affiliation: Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, United States.
authors.forename: Theresa
authors.initials: T
authors.lastname: Winhusen
authors.affiliation: Johns Hopkins University, School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, United States.
authors.forename: Ryan G
authors.initials: RG
authors.lastname: Vandrey
authors.affiliation: The City College of New York, CUNY, 160 Convent Avenue, New York, NY 10031, United States.
authors.forename: Lesia M
authors.initials: LM
authors.lastname: Ruglass
authors.affiliation: Columbia University Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States.
authors.forename: Lirio S
authors.initials: LS
authors.lastname: Covey
authors.affiliation: Johns Hopkins University, School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, United States.
authors.forename: Maxine L
authors.initials: ML
authors.lastname: Stitzer
authors.affiliation: Aspire Health Partners, 5151 Adanson St., Orlando, FL 32804, United States.
authors.forename: Tiffany L
authors.initials: TL
authors.lastname: Kyle
authors.affiliation: Columbia University Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States.
authors.forename: Edward V
authors.initials: EV
authors.lastname: Nunes
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D016540:Smoking Cessation; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D014029:Tobacco Use Disorder / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D014481:United States / Q000453:epidemiology
keywords: Cessation; Internet-delivered treatment; Smoking; Substance use disorders; Therapeutic education system; Tobacco