Smoking cessation in methadone maintenance
Smoking cessation in methadone maintenance
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DOI：
10.1046/j.1360-0443.2002.00221.x
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发表时间：
2002-10-01
期刊：
影响因子：
6
通讯作者：
Ling, W
中科院分区：
文献类型：
--
作者：
Shoptaw, S;Rotheram-Fuller, E;Ling, W
目的评价复发预防（预防复发）和应急管理（应急管理），以优化戒烟结果使用尼古丁替代疗法的美沙酮维持烟草吸烟者。（预防复发）x 2（应急管理）重复测量设计，使用尼古丁替代治疗平台，具有2周基线期，随后随机分配至12周治疗，以及6个月和12个月的随访。设置三个麻醉治疗中心在洛杉矶。参与者175名参与者谁满足所有纳入和不排除标准。干预参与者接受12周的尼古丁替代疗法和分配到四个条件之一：仅贴剂，复发预防+贴剂，应急管理+贴片和复发预防+应急管理+贴片。测量每周三次呼吸样本（分析一氧化碳）和尿液（分析阿片类药物和可卡因的代谢产物）和每周自我报告的吸烟数量。在治疗期间，被分配接受应急管理的患者的戒烟率在统计学上高于未被分配接受应急管理的患者（F-3.4680 = 6.3，P = 0.0003），但未观察到类似的预防复发效果。在后续评估中。条件之间没有显著差异。参与者在符合戒烟标准的几周内提供的不含阿片类药物和可卡因的尿液比不符合这些标准的几周内提供的要多（F-1.2054 = 14.38，P = 0.0002; F-1，F-2419 = 16.52，结论：在阿片类药物依赖治疗期间，使用尼古丁替代疗法减少吸烟的应急管理优化了结局，尽管长期效果通常不能维持。研究结果表明，治疗期间吸烟减少与非法药物使用减少之间存在密切联系。
Aims To evaluate relapse prevention (relapse prevention) and contingency management (contingency management) for optimizing smoking cessation outcomes using nicotine replacement therapy for methadone-maintained tobacco smokers.Design Experimental, 2 (relapse prevention) x 2 (contingency management) repeated measures design using a platform of nicotine replacement therapy featuring a 2-week baseline period, followed by randomization to 12 weeks of treatment, and 6- and 12-month follow-up visits.Setting Three narcotic treatment centers in Los Angeles.Participants One hundred and seventy-five participants who met all inclusion and no exclusion criteria.Intervention Participants received 12 weeks of nicotine replacement therapy and assignment to one of four conditions: patch-only, relapse prevention + patch, contingency management + patch and relapse prevention + contingency management + patch.Measurements Thrice weekly samples of breath (analyzed for carbon monoxide) and urine (analyzed for metabolites of opiates and cocaine) and weekly self-reported numbers of cigarettes smoked.Findings Participants (73.1'%) completed 12 weeks of treatment. During treatment, those assigned to receive contingency management showed statistically higher rates of smoking abstinence than those not assigned to receive contingencies (F-3.4680 = 6.3, P = 0.0003), with no similar effect observed for relapse prevention. At follow-up evaluations. there were no significant differences between conditions. Participants provided more opiate and cocaine-free urines during weeks when they met criteria for smoking abstinence than during weeks when they did not meet these criteria (F-1.2054 = 14.38, P = 0.0002; F-1,F-2419 = 16.52, P < 0.0001).Conclusions Contingency management optimized outcomes using nicotine replacement therapy for reducing cigarette smoking during treatment for opiate dependence, although long-term effects are not generally maintained. Findings document strong associations between reductions in cigarette smoking and reductions in illicit substance use during treatment.