Tobacco dependence is prevalent in patients with opioid abuse histories. Cigarette smoking rates in both intreatment and out-of-treatment samples generally range from 80 to 90%. There have been few attempts to treat opioid dependent smokers, and the extant attempts have met with limited success. The proposed study is an attempt to use an innovative motivational system, combined with extended behavioral and pharmacological treatment, to produce sustained abstinence in this population. The intervention is modeled on those used successfully in published and on-going work by our group with other complex smokers. The primary hypothesis is that the Innovative System (IS) will be more effective than the Standard Treatment Control (STC) at 12 and 18 months after entrance into the intervention. Hypotheses concerning individual differences in outcomes are also proposed, and these include both behavioral and pharmacogenetic variables. The data will also provide preliminary information about whether smoking cessation or cessation attempts are correlated with change in use of illicit drugs. Two-hundred buprenorphine treatment patients who smoke more than five cigarettes per day will be randomly assigned to either IS or to STC. Intent to quit smoking is not required as an inclusion criterion. In the STC, participants will receive a brochure on quitting, a list of local referrals, and an information sheet that tells them how to obtain cessation medication through the City of San Francisco public health care system. In the IS, participants will be counseled using a computerized counseling system at baseline and months 3, 6, and 12. The system is designed to increase motivation to quit smoking. At any time after entrance into the study up until month 12, if the participant requests smoking cessation treatment, treatment that uses both combined pharmacotherapy and behavioral counseling will be provided. Pharmacotherapy will consist of nicotine replacement treatment (NRT). If NRT fails to produce abstinence, varenicline will be provided. Treatment is available for six months after it is initiated. Assessment points are at baseline, and months 3, 6, 12, and 18. Seven-day point prevalence abstinence from cigarettes is the primary dependent variable. This study is significant in that it offers an innovative approach for a population with high smoking rates.

Public Health Relevance

This project compares an innovative intervention for tobacco dependence with standard treatment for cigarette smokers who are also being treated for opioid dependence. If successful; this intervention will improve the health of opioid addicted individuals. There is a high rate of smoking in this population; and current treatments have had limited success. Thus; it will contribute to the public health by decreasing the use of a harmful substance?tobacco?in one group of smokers.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Specialized Center (P50)
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Special Emphasis Panel (ZDA1-EXL-T)
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University of California San Francisco
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Young-Wolff, Kelly C; Karan, Lori D; Prochaska, Judith J (2015) Electronic cigarettes in jails: a panacea or public health problem? JAMA Psychiatry 72:103-4
Ramo, Danielle E; Liu, Howard; Prochaska, Judith J (2015) A mixed-methods study of young adults' receptivity to using Facebook for smoking cessation: if you build it, will they come? Am J Health Promot 29:e126-35
Ramo, Danielle E; Young-Wolff, Kelly C; Prochaska, Judith J (2015) Prevalence and correlates of electronic-cigarette use in young adults: findings from three studies over five years. Addict Behav 41:142-7
Newville, Howard; Roley, Jason; Sorensen, James L (2015) Prescription medication misuse among HIV-infected individuals taking antiretroviral therapy. J Subst Abuse Treat 48:56-61
Martínez, Cristina; Guydish, Joseph; Le, Thao et al. (2015) Predictors of quit attempts among smokers enrolled in substance abuse treatment. Addict Behav 40:6-Jan
Nelson, J Craig; Baumann, Pierre; Delucchi, Kevin et al. (2014) A systematic review and meta-analysis of lithium augmentation of tricyclic and second generation antidepressants in major depression. J Affect Disord 168:269-75
Lisha, Nadra E; Carmody, Timothy P; Humfleet, Gary L et al. (2014) Reciprocal effects of alcohol and nicotine in smoking cessation treatment studies. Addict Behav 39:637-43
Webber, Whitney L; van Erp, Brianna; Stoddard, Pamela et al. (2014) Determinants of exposure to secondhand smoke among Vietnamese adults: California Vietnamese Adult Tobacco Use Survey, 2007-2008. Prev Chronic Dis 11:E81
Cochran, Bryan N; Flentje, Annesa; Heck, Nicholas C et al. (2014) Factors predicting development of opioid use disorders among individuals who receive an initial opioid prescription: mathematical modeling using a database of commercially-insured individuals. Drug Alcohol Depend 138:202-8
Satre, Derek D; Leibowitz, Amy S; Mertens, Jennifer R et al. (2014) Advising depression patients to reduce alcohol and drug use: factors associated with provider intervention in outpatient psychiatry. Am J Addict 23:570-5

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