Associations between tobacco smoking and illicit drug use among methadone-maintained opiate-dependent individuals.

Tobacco chippers are individuals who smoke regularly yet are not nicotine dependent. In the present study, the authors examined the prevalence of tobacco chipping among methadone-maintained opiate abusers. Furthermore, the authors examined associations between tobacco and illicit substance use by comparing heavy smokers, tobacco chippers, and nonsmokers. Results demonstrate that tobacco chipping occurs among methadone-maintained individuals. Illicit substance use, measured through urine toxicology, was found to increase in a stepwise fashion from nonsmokers, to chippers, to heavy smokers. Smoking status (nonsmoker, chipper, heavy smoker) proved a more powerful predictor of cocaine and opiate use than daily methadone dose. Findings lend support to existing evidence suggesting associations between tobacco and opiate and cocaine use and strongly suggest that smoking cessation should be offered to all methadone-maintained individuals.