Extended Tobacco Dependence Intervention in Buprenorphine Treatment

有阿片类药物滥用史的患者普遍存在烟草依赖。两种治疗中的吸烟率 而治疗外样本一般在80 - 90%之间。很少有人试图 治疗阿片类药物依赖的吸烟者，现有的尝试取得了有限的成功。拟议 这项研究试图使用一种创新的激励系统，结合扩展的行为和 药物治疗，以在该人群中产生持续的禁欲。干预是模拟的 我们的研究小组在已发表的和正在进行的研究中成功地使用了那些与其他复杂的吸烟者。的 主要假设是创新系统（IS）将比标准治疗更有效 对照组（STC）在进入干预后12个月和18个月。关于个人的假设 结果的差异也被提出，这些差异包括行为和药物遗传学 变量这些数据还将提供有关戒烟或戒烟 企图与非法药物使用的变化有关。200名接受丁丙诺啡治疗的患者 每天吸烟超过五支的人将被随机分配到IS或STC。打算退出 吸烟并不是入选标准。在STC，参与者将收到一本关于戒烟的小册子， 一份当地转诊名单，以及一份信息表，告诉他们如何通过以下途径获得戒烟药物： 旧金山弗朗西斯科市的公共卫生保健系统。在IS中，将使用 在基线和第3、6和12个月时使用计算机化咨询系统。该系统旨在增加 戒烟的动机。入组研究后直至第12个月的任何时间，如果受试者 要求戒烟治疗，即同时使用药物疗法和行为疗法的治疗 将提供咨询。药物治疗将包括尼古丁替代治疗（NRT）。如果NRT 不能产生禁欲，将提供伐尼克兰。治疗可持续六个月后，它是 启动。评估点为基线和第3、6、12和18个月。七天的时点戒烟率 戒烟是主要的因变量。这项研究的意义在于它提供了一个 为吸烟率高的人群提供创新方法。

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.