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| Malcolm Reid , Ph.D.
Lead Investigator
Department of Psychiatry
New York University School of Medicine
423 East 23rd St., VET-17W
New York, NY 10010
malcolm.reid@med.va.gov |
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The prevalence of cigarette smoking among substance abusers is high,
and substance abusers who smoke have more health problems, higher death
rates, and more severe drug and alcohol addiction than those who don't.
In the past decade, studies have demonstrated that smoking cessation
programs and smoke-free policies can be successful in drug and alcohol
rehabilitation clinics. Patients stay in treatment longer, they stop
smoking for a time, and they do not use more drugs or alcohol than other
patients. This study looks at how feasible it is to incorporate a state-of-the-art
smoking cessation treatment program into community substance abuse treatment
programs and to see if adding such a program will help people quit smoking
and stay off of drugs and alcohol better than substance abuse treatment
alone. The treatment for quitting smoking consists of group counseling
in combination with the nicotine skin patch (NicoDerm CQ). Cigarette smokers from five methadone-maintenance programs and two drug and alcohol dependence treatment programs were randomly assigned to receive either smoking cessation treatment with the transdermal nicotine patch replacement (SC) as an adjunct to usual care, or treatment-as-usual (TAU).
Primary Findings: Smoking abstinence rates in the SC group were greater during treatment and at the 13- and 26-week follow-up visits, compared to the usual care group. Also, the SC group exhibited greater reductions in cigarettes smoked per day, cigarette craving, nicotine withdrawal, and exhaled carbon monoxide levels, compared to the usual care group. SC did not differ from TAU on abstinence from the primary substance of abuse, rates of retention in substance abuse treatment, and craving for primary substance of abuse. Compliance with SC was moderate at best, and was positively associated with rates of smoking abstinence. Smoking cessation treatment improved smoking abstinence and reduced daily smoking without having an adverse effect on substance abuse rehabilitation when given at the same time as outpatient substance abuse treatment. Substance abuse treatment programs should not be hesitant to implement SC for patients seeking treatment for substance use disorders.
Primary Outcomes Paper: Reid M, et al. Smoking cessation treatment in community-based substance abuse rehabilitation programs. Journal of Substance Abuse Treatment 2008;35(1):68-77. [more. . .]
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