TY - JOUR
T1 - Smoking cessation in methadone maintenance
AU - Shoptaw, Steve
AU - Rotheram-Fuller, Erin
AU - Yang, Xiaowei
AU - Frosch, Dominick
AU - Nahom, Debbie
AU - Jarvik, Murray E.
AU - Rawson, Richard A.
AU - Ling, Walter
PY - 2002/10/1
Y1 - 2002/10/1
N2 - Aims: To evaluate relapse prevention (relapse prevention) and contingency management (contingency management) for optimizing smoking cessation outcomes using nicotine replacement therapy for methadone-maintained tobacco smokers. Design: Experimental. 2 (relapse prevention) x 2 (contingency management) repeated measures design using a platform of nicotine replacement therapy featuring a 2-week baseline period, followed by randomization to 12 weeks of treatment, and 6- and 12-month follow-up visits. Setting: Three narcotic treatment centers in Los Angeles. Participants: One hundred and seventy-five participants who met all inclusion and no exclusion criteria. Intervention: Participants received 12 weeks of nicotine replacement therapy and assignment to one of four conditions: patch-only, relapse prevention + patch, contingency management + patch and relapse prevention + contingency management + patch. Measurements: Thrice weekly samples of breath (analyzed for carbon monoxide) and urine (analyzed for metabolites of opiates and cocaine) and weekly self-reported numbers of cigarettes smoked. Findings: Participants (73.1%) completed 12 weeks of treatment. During treatment, those assigned to receive contingency management showed statistically higher rates of smoking abstinence than those not assigned to receive contingencies (F3.4680=6.3, P=0.0003), with no similar effect observed for relapse prevention. At follow-up evaluations, there were no significant differences between conditions. Participants provided more opiate and cocaine-free urines during weeks when they met criteria for smoking abstinence than during weeks when they did not meet these criteria (F1.2054=14.38, P=0.0002; F1.2419=16.52, P<0.0001). Conclusions: Contingency management optimized outcomes using nicotine replacement therapy for reducing cigarette smoking during treatment for opiate dependence, although long-term effects are not generally maintained. Findings document strong associations between reductions in cigarette smoking and reductions in illicit substance use during treatment.
AB - Aims: To evaluate relapse prevention (relapse prevention) and contingency management (contingency management) for optimizing smoking cessation outcomes using nicotine replacement therapy for methadone-maintained tobacco smokers. Design: Experimental. 2 (relapse prevention) x 2 (contingency management) repeated measures design using a platform of nicotine replacement therapy featuring a 2-week baseline period, followed by randomization to 12 weeks of treatment, and 6- and 12-month follow-up visits. Setting: Three narcotic treatment centers in Los Angeles. Participants: One hundred and seventy-five participants who met all inclusion and no exclusion criteria. Intervention: Participants received 12 weeks of nicotine replacement therapy and assignment to one of four conditions: patch-only, relapse prevention + patch, contingency management + patch and relapse prevention + contingency management + patch. Measurements: Thrice weekly samples of breath (analyzed for carbon monoxide) and urine (analyzed for metabolites of opiates and cocaine) and weekly self-reported numbers of cigarettes smoked. Findings: Participants (73.1%) completed 12 weeks of treatment. During treatment, those assigned to receive contingency management showed statistically higher rates of smoking abstinence than those not assigned to receive contingencies (F3.4680=6.3, P=0.0003), with no similar effect observed for relapse prevention. At follow-up evaluations, there were no significant differences between conditions. Participants provided more opiate and cocaine-free urines during weeks when they met criteria for smoking abstinence than during weeks when they did not meet these criteria (F1.2054=14.38, P=0.0002; F1.2419=16.52, P<0.0001). Conclusions: Contingency management optimized outcomes using nicotine replacement therapy for reducing cigarette smoking during treatment for opiate dependence, although long-term effects are not generally maintained. Findings document strong associations between reductions in cigarette smoking and reductions in illicit substance use during treatment.
KW - Contingency management
KW - Methadone maintenance
KW - Relapse prevention
KW - Smoking cessation
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UR - http://www.scopus.com/inward/citedby.url?scp=0036791731&partnerID=8YFLogxK
U2 - 10.1046/j.1360-0443.2002.00221.x
DO - 10.1046/j.1360-0443.2002.00221.x
M3 - Article
C2 - 12359036
AN - SCOPUS:0036791731
VL - 97
SP - 1317
EP - 1328
JO - Addiction
JF - Addiction
SN - 0965-2140
IS - 10
ER -