Last updated on February 2018

Smoking Cessation & Opioid Dependence Treatment Integration

Brief description of study

The purpose of this study is to examine the effectiveness of a smoking cessation intervention for cigarette smokers enrolled in an outpatient program for opioid dependence. Treatment effects will be compared as a function of phase in the outpatient program: 0-90 days, 90 days-1 year, and more than 1 year.

Detailed Study Description

Tobacco smoking rates are substantially higher among individuals with substance use disorders (SUDs), relative to individuals in the general population (e.g., 97% vs. 19%, respectively). Yet most treatment programs for SUDs fail to address the use of tobacco among patients, and integration of smoking cessation treatment with SUD treatment may improve outcomes for both drugs. The question remains, however, whether to implement a smoking cessation component immediately or only after a patient is stabilized on their SUD pharmacotherapy. Existing research that directly addresses this factor is limited and findings are mixed. Therefore, the purpose of this study is to compare drug use outcomes among patients at three different stages of their SUD treatment: 0-90 days, 90 days-1 year, and more than 1 year of consistent abstinence from illicit drugs. Smokers currently in treatment for opioid dependence, at the WVU Comprehensive Opioid Addiction Treatment (COAT) program, will be recruited to participate in this 12-week study. A total of 20 patients will be completed from each of the three COAT treatment groups, and groups will be matched on relevant demographic and substance use characteristics (e.g., gender, number of cigarettes smoked per day, nicotine dependence score). During the 12-week intervention period, individuals will continue to attend their regular COAT clinic appointments while following a standard varenicline (Chantix) dosing regimen and responding to questions daily via text messaging (e.g., adherence to varenicline, use of tobacco, tobacco withdrawal side effects, etc.). The primary outcomes will be those relevant to feasibility: 1) recruitment and retention rates, 2) adherence to medication regimen, and 3) compliance with responding to text message-based questions. Secondary outcomes will include a comparison of groups on the 1) proportion of relapses for all substances, 2) proportion of smokers abstinent at each assessment (confirmed with expired air carbon monoxide samples), 3) days until successful cigarette quit day, and 4) substance withdrawal-related symptoms.

Clinical Study Identifier: NCT02854800

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