Biological and self-report measures of tobacco use/dependence in pregnant women with opiate dependence

National data suggests that 4% of the pregnant population uses illicit drugs, and that most of these women smoke (NSDUH, 2006). Prenatal smoking is associated with adverse infant outcomes including low birth weight and prematurity. Interestingly, the association between prenatal smoking and adverse infant outcomes is more robust than those found for cocaine, marijuana or opiates. Despite such findings, prenatal smoking generally receives little attention from clinicians who focus on abstinence from illicit drugs. Similarly, research on prenatal smoking in women with other substance use disorders (SUDs) is limited. For example, there are no psychometric studies to-date of the Fagerström Tolerance Questionnaire (FTQ) in pregnant women with other SUDs. The present study compared FTQ scores, urinary cotinine, and self-report measures of smoking in 49 opiate dependent pregnant women. Once participants provided informed consent on admission to residential treatment, they completed the FTQ, estimated number of cigarettes smoked per day and provided urine samples to assess for cotinine levels. Participants reported smoking 15.6 cigarettes daily (SD=8.4) with mean cotinine levels of 1338.3 ng/mL (SD= 643.6). The mean FTQ score was 4.9 (SD=1.7), suggesting a moderate level of nicotine dependence. No relationship was found between urinary cotinine levels and FTQ scores. However, number of cigarettes/day was positively correlated with FTQ scores (r=0.64, p < .001). Findings confirm previous research, with FTQ scores associated with self-report measures of smoking but not with biological (urinary cotinine) levels. Data affirm the need for more research focused on the high-risk population of pregnant drug dependent women.