Extended Tobacco Dependence Intervention in Buprenorphine Treatment

烟草依赖在有阿片类药物滥用史的患者中很普遍。两种治疗中的吸烟率都不同 而未处理的样本一般在80%到90%之间。几乎没有人试图 治疗阿片类药物依赖吸烟者，现有的尝试取得的成功有限。建议数 学习是一种尝试，使用创新的激励系统，结合扩展的行为和 药物治疗，在这一人群中产生持续的禁欲。干预是模型化的 在我们小组与其他复杂吸烟者的已发表和正在进行的工作中成功使用的那些。这个 基本假设是创新系统(IS)将比标准治疗更有效 干预后12个月和18个月作为对照(STC)。关于个体的假设 结果的差异也被提出，其中包括行为和药物遗传。 变量。数据还将提供关于戒烟或戒烟的初步信息 尝试与非法药物使用的变化有关。丁丙诺啡治疗患者200例 每天吸烟超过五支的人将被随机分配到IS或STC。打算戒烟 吸烟不是必须的纳入标准。在STC，参与者将收到一本关于戒烟的小册子， 一份当地转介的名单，以及一份告诉他们如何通过 旧金山市的公共医疗保健系统。在IS中，参与者将使用 计算机咨询系统在基线和3个月、6个月和12个月。该系统旨在增加 戒烟的动力。在进入研究之后的任何时间，直到12个月，如果参与者 要求戒烟治疗，同时使用药物治疗和行为治疗 我们将提供咨询服务。药物治疗将包括尼古丁替代治疗(NRT)。如果NRT 如果不能产生戒断，将提供varenicline。治疗后六个月内有效。 已启动。评估点处于基线，3个月、6个月、12个月和18个月。 戒烟是主要的因变量。这项研究具有重要意义，因为它提供了一个 针对吸烟率高的人群的创新方法。

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.