Over 75% of drug abusers receiving methadone maintenance treatment are tobacco smokers. Methadone patients disproportionately suffer from the physical consequences of smoking, including increased mortality, compared to the general population. Yet, smokers receiving methadone treatment are interested in quitting and receiving tobacco cessation treatment, and drug abusing smokers who quit smoking are less likely to use drugs. The few studies of smoking cessation interventions in methadone patients have shown significant reductions in tobacco use during and immediately after treatment;however, the percentages of individuals who quit smoking were small and nearly all those who quit quickly returned to smoking. In addition, the interventions studied were simple and modeled after guidelines for the general population that may not have accounted for the complex needs of drug abusers. To better help methadone maintained smokers quit smoking and maintain tobacco abstinence, we propose a study with the following aims: (1) to determine the structure and elements of smoking cessation treatment that will help methadone maintained smokers quit smoking and maintain long-term tobacco abstinence;(2) to develop a manual for a tailored, intensive smoking cessation intervention for methadone maintained smokers;and (3) to pilot and evaluate in a small randomized controlled trial the immediate and long-term effects of a tailored, intensive smoking cessation intervention for methadone maintained smokers. This study will consist of two projects. Project One will address Aim 1 and involve collecting qualitative data through focus groups with methadone clinic clinical staff and current and previous smokers receiving methadone maintenance treatment. The data collected from Project One will inform Project Two, to develop and pilot in a small randomized controlled clinical trial a tailored, intensive smoking cessation intervention for methadone maintained smokers (Aims 2 and 3). My goal is to become an independent clinical investigator with expertise in smoking cessation, qualitative and quantitative research methods, and behavioral intervention development. The Career Development Plan I have proposed includes mentorship and structured coursework in: (1) qualitative research methods and data analyses;(2) behavioral intervention development and methods for smoking cessation;(3) methodology and logistics of conducting randomized clinical trials;(4) epidemiology of tobacco use;(5) advanced quantitative statistical methods;and (6) responsible conduct of research. In addition, I will participate in local seminars and national scientific meetings.

Public Health Relevance

Reducing tobacco use and increasing smoking cessation attempts among adults are objectives of Healthy People 2010, and determining the effectiveness of interventions targeting persons with co- occurring risk behaviors was identified as a priority in the National Institutes of Health State-of-the- Science Conference Statement on Tobacco Use. We hope to help methadone maintained smokers quit smoking and maintain tobacco abstinence by developing and evaluating and new smoking cessation intervention.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Mentored Patient-Oriented Research Career Development Award (K23)
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Human Development Research Subcommittee (NIDA)
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Subramaniam, Geetha A
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Albert Einstein College of Medicine
Schools of Medicine
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Cooperman, Nina A; Lu, Shou-En; Richter, Kimber P et al. (2018) Pilot Study of a Tailored Smoking Cessation Intervention for Individuals in Treatment for Opioid Dependence. Nicotine Tob Res 20:1152-1156
Cooperman, Nina A; Lu, Shou-En; Richter, Kimber P et al. (2016) Influence of Psychiatric and Personality Disorders on Smoking Cessation Among Individuals in Opiate Dependence Treatment. J Dual Diagn 12:118-28
Cooperman, Nina A; Richter, Kimber P; Bernstein, Steven L et al. (2015) Determining Smoking Cessation Related Information, Motivation, and Behavioral Skills among Opiate Dependent Smokers in Methadone Treatment. Subst Use Misuse 50:566-81
Cooperman, Nina A; Shastri, Jayanthi S; Shastri, Aditi et al. (2014) HIV prevalence, risk behavior, knowledge, and beliefs among women seeking care at a sexually transmitted infection clinic in Mumbai, India. Health Care Women Int 35:1133-47
Bernstein, Steven L; Bijur, Polly; Cooperman, Nina et al. (2013) Efficacy of an emergency department-based multicomponent intervention for smokers with substance use disorders. J Subst Abuse Treat 44:139-42
Williams, Jill M; Steinberg, Marc L; Griffiths, Kim Gesell et al. (2013) Smokers with behavioral health comorbidity should be designated a tobacco use disparity group. Am J Public Health 103:1549-55
Cooperman, Nina A; Heo, Moonseong; Berg, Karina M et al. (2012) Impact of adherence counseling dose on antiretroviral adherence and HIV viral load among HIV-infected methadone maintained drug users. AIDS Care 24:828-35
Bernstein, Steven L; Cooperman, Nina; Jearld, Saba et al. (2012) Predictors of in-person follow-up among subjects in an ED-based smoking cessation trial. Am J Emerg Med 30:2067-9
Cunningham, Chinazo O; Sohler, Nancy L; Cooperman, Nina A et al. (2011) Strategies to improve access to and utilization of health care services and adherence to antiretroviral therapy among HIV-infected drug users. Subst Use Misuse 46:218-32