Smoking cessation treatment at community based substance abuse rehabilitation programs: Impact on cigarette smoking

Cigarette smoking is far more prevalent among substance abusers than in the general population. For a variety of reasons, many community based treatment programs have not taken on this health issue. In this study, we established smoking cessation treatment in conjunction with substance abuse treatment to determine if smoking cessation treatment could be effective among this population without disrupting substance abuse treatment.

A smoking cessation study was performed at community-based outpatient rehabilitation programs in the National Institute on Drug Abuse Clinical Trials Network (CTN). Drug or alcohol dependent patients, who smoked were randomly selected on a 2:1 ratio to receive smoking cessation treatment and transdermal nicotine patches as an adjunct to substance abuse treatment (SC), or substance abuse treatment as usual (TAU).. Smoking abstinence rates in the SC group reached 10% during treatment, and remained above 5% at the 13 and 26 week follow-up visits. The SC group underwent a 75% reduction in cigarettes smoked/day, a decrease in exhaled CO levels, and a drop in cigarette craving and nicotine withdrawal ratings during treatment. Smoking in the TAU group remained unchanged during treatment and abstinence rates were negligible. Compliance with smoking cessation treatment was moderate, and both counseling attendance and nicotine patch treatment adherence were positively associated with smoking abstinence rates. These findings demonstrate that smoking cessation treatment, when given concurrently with outpatient substance abuse treatment, results in significant reductions in daily smoking and modest levels of smoking abstinence.