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Achieving Smoking Abstinence is Associated with Decreased Cocaine Use in Cocaine-Dependent Patients Receiving Smoking-Cessation Treatment.

Drug and Alcohol Dependence 2014;134(1):391-395. [doi: 10.1016/j.drugalcdep.2013.09.019]

Theresa M. Winhusen, PhD, Frankie B. Kropp, MS, Jeff Theobald, Daniel F. Lewis (all from University of Cincinnati/CinARC, OV Node).

Past research suggests that a significant relationship exists between cigarette smoking and illicit-stimulant abuse. The present study, a secondary analysis of the National Drug Abuse Treatment Clinical Trials Network protocol CTN-0046 (Smoking Cessation and Stimulant Treatment (S-CAST)), evaluated the association between achieving smoking abstinence in response to smoking-cessation treatment (SCT) and illicit-stimulant abstinence in cocaine- and/or methamphetamine-dependent participants.

Two hundred and sixty-seven adults meeting DSM-IV-TR criteria for cocaine- and/or methamphetamine-dependence and interested in quitting smoking were randomized to SUD treatment-as-usual plus SCT consisting of weekly individual smoking cessation counseling, extended-release (XL) bupropion (300 mg/day), nicotine inhaler, and contingency management for smoking abstinence. Smoking abstinence was assessed via self-report and carbon monoxide levels. The analysis found a significant effect for the cocaine-dependent subsample (n=147) in which participants who stopped smoking were abstinent for illicit stimulants an average of 78.2% of the post-smoking-quit weeks (weeks 4-10) relative to 63.6% in participants who continued smoking. No significant effects were found for the sample as a whole (n=249) or for the methamphetamine-dependent subsample (n=102).

Conclusions: The present results suggest that cocaine-dependent patients achieving smoking abstinence in response to smoking-cessation treatment might evidence not only improved smoking outcomes but improved cocaine use outcomes as well. Because the prevalence of smoking in cocaine-dependent patients is 75-80%, and cigarette smoking itself is deadly, using smoking-cessation treatment to intervene with both cocaine use and cigarette smoking would impact two important public health issues. Future research to replicate this finding appears warranted. (Article (Peer-Reviewed), PDF, English, 2013)

Keywords: Cocaine | CTN platform/ancillary study | Methamphetamine | Motivational incentives | Nicotine replacement therapy | Pharmacological therapy | Smoking | Drug and Alcohol Dependence (journal)

Document No: 1025, PMID: 24128381, PMCID: PMC3889710.

Submitted by CTN Dissemination Librarians, 10/7/2013.

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