With all of the health risks involved with cigarette smoking, doctors will almost always advise patients to get help quitting as soon as they possibly can. However, there has been concern among some treatment professionals that patients who try to quit smoking while in treatment for a co-morbid drug addiction will jeopardize their recovery from that drug addiction. A new study published online in the Journal of Clinical Psychiatry suggests that this may not be the case. The study, conducted by the University of Cincinnati School of Medicine, found two positive indications for successful co-treatment. They found that the addition of smoking cessation therapy to a program of stimulant addiction recovery was successful at reducing smoking rates and did not affect continued participation in the stimulant treatment program. The study involved 10-week trials conducted at 12 substance abuse treatment facilities between February 2010 and July 2012. The 532 patients who participated were seeking treatment for cocaine or methamphetamine addiction, and met the DSM-IV criteria for substance dependence. In addition, each of the 532 participants had been regular smokers for at least three months, smoked at least seven cigarettes per day, and had carbon monoxide levels equal to or greater than eight parts per million. All participants received treatment as usual for stimulant addiction, while 267 of those patients also received smoking cessation therapy. The smoking cessation therapy involved counseling, extended release bupropion, a nicotine inhaler and prizes to encourage success. The researchers evaluated the outcomes of the study based on drug testing, carbon monoxide testing, and completion of the initial 10-week treatment program followed by participation in a three-month follow-up session and a six-month follow-up session.
Smoking Cessation Does Not Affect Treatment Outcomes
The study showed similar results across each of the factors used to evaluate the trial outcomes. Both the treatment-as-usual group and the smoking cessation group had approximately 89 percent of participants complete the initial 10-week trial, 85 percent complete the three-month follow-up and nearly 80 percent complete the final six-month follow-up. The results also showed a less than 1 percent difference in the number of stimulant-absent weeks that each group was able to achieve. The study even found that the group that received smoking cessation therapy in addition to the usual treatment for stimulant dependence was able to record a higher average number of total stimulant-free days during the first 10 weeks of the trial. In addition, the researchers found that concurrent smoking cessation therapy is effective at helping patients quit smoking. Only 2 percent of the regular smokers who participated in the trial were able to quit smoking during the initial trial, but over 25 percent of the smokers who received smoking cessation therapy had quit smoking at the time of the initial trial’s conclusion.
Researchers Hoped for More
These results are encouraging for those treatment professionals who were hesitant to address nicotine addiction and drug addiction at the same time. However, the researchers who participated in this study had hypothesized that the inclusion of smoking cessation therapy would actually improve the stimulant use outcomes. Previous studies that looked at concurrent treatment of alcohol dependence and nicotine dependence have shown that smoking cessation therapy improves a patient’s ability to abstain from alcohol. The University of Cincinnati team suspected, and hoped, that smoking cessation therapy could yield similar positive results for patients recovering from stimulant addiction. However, the actual results from the study are still positive overall, particularly when it comes to the success of the smoking cessation therapy. Smoking may be viewed as a secondary risk compared to cocaine or methamphetamine dependence, but it is still a serious and potentially life-threatening health problem. The more that smoking cessation therapy can be incorporated into or added to standard substance dependence treatment when applicable, the better the overall short-term and long-term health of people with substance use problems is likely to be.