- Smoking cessation interventions provided to people engaged in addiction treatment has been associated with a 25% greater likelihood of long-term abstinence. In addition, cessation in conjunction with other mental health or addictions treatment does not negatively affect abstinence from other substances.1
- Providing smoking treatment concurrently with treatment for other drugs improves smoking outcomes in the short- term and does not appear to harm drug treatment outcomes. Relapse to smoking is common among people who smoke but are attempting to quit, including adults with SUDs. Few studies have tested effective smoking treatments for adults with SUDs but there are promising preliminary results with pharmacotherapies for nicotine dependence.2
- Due to mixed findings regarding the efficacy of NRT for patients in opioid dependence treatment, unless contraindicated or unavailable, bupropion (which acts on dopaminergic neurons) or varenicline (which is a partial agonist of the alpha-4 beta-2 nicotinic acetylcholine receptor) will be better first-line options. This is particularly the case if providers can address general low adherence to taking medication capsules. Clinician training is necessary to ensure that cessation medications are prescribed in combination and at therapeutic dosages meeting individual dependence levels.3
- A 2015 study suggested that receiving tobacco dependence treatment from addiction treatment clinicians was strongly and positively associated with past year quit attempts.4
- Integrating tobacco use dependency treatment into substance use disorder treatment plans, including routinely screening for, and documenting, tobacco use. Evidence-based treatments for people with tobacco dependence, including FDA-approved medication and counseling, can be utilized concurrently with treatment for other substance use disorders. Additionally, connecting clients with evidence-based cessation resources to provide continuity of care and ongoing support can enhance intervention. Substance use disorder treatment programs that implement tobacco dependence interventions, including NRT and individual and group therapy, have been found to achieve higher overall treatment completion rates.5,6
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Prochaska, Delucchi, and Hall, “A Meta-Analysis of Smoking Cessation Interventions With Individuals in Substance Abuse Treatment or Recovery” Journal of Consulting and Clinical Psychology (2004), Vol. 72, No. 6, 1144–1156 https://dbhids.org/wp-content/uploads/2017/03/A-meta-analysis-of-smoking-cessation-interventions-with-individuals-in-substance-abuse-treatment-or-recovery.pdf
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Andrea H. Weinberger et al., “Cigarette Smoking Is Associated with Increased Risk of Substance Use Disorder Relapse: A Nationally Representative, Prospective Longitudinal Investigation,” The Journal of Clinical Psychiatry 78, no. 2 (February 2017): e152–60. https://doi.org/10.4088/JCP.15m10062.
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Chad D. Morris and Christine E. Garver-Apgar, “Nicotine and Opioids: A Call for Co-Treatment as the Standard of Care,” The Journal of Behavioral Health Services & Research, June 3, 2020, 1–13. https://doi.org/10.1007/s11414-020-
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Martinez, C., Guydish, J., Le, T., Tajima, B., Passalacqua, E. (2015, January 1), Predictors of quit attempts among smokers enrolled in substance abuse treatment. Addictive Behaviors. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250286/pdf/nihms-624510.pdf
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Sharp, J.R., Schwartz, S., Nightingale, T., Novak, S. (2003, August). Targeting Nicotine Addiction in a Substance Abuse Program. Science & Practice Perspectives. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851041/pdf/spp-02-1-33.pdf
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Pakhale, S., Kaur, T., Charron, C., et al. (2018, January 25). Management and Point-of-Care for Tobacco Dependence (PROMPT): a feasibility mixed methods community-based participatory action research project in Ottowa, Canada. BMJ Open. Retrieved from http://bmjopen.bmj.com/content/ bmjopen/8/1/e018416.full.pdf
Page last updated: October 27, 2022
