Marcel A de Dios1, Bradley J Anderson2, Celeste M Caviness2, Michael D Stein3. 1. Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX; made@mdanderson.org. 2. Butler Hospital, Providence, RI; 3. Butler Hospital, Providence, RI; Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI; Department of Health Services, Policy, and Practice, Warren Alpert Medical School, Brown University, Providence, RI.
Abstract
INTRODUCTION:Methadone maintenance treatment (MMT) patients have an exceedingly high prevalence of tobacco use, and interventions that have been specifically developed for this vulnerable subpopulation have struggled to attain even modest rates of cessation. A significant barrier has been an inability to initiate a quit attempt early in the treatment process and adherence to treatment. METHODS: This study examined the extent to which self-efficacy, medication adherence, and other demographic and smoking variables predicted an early quit day in a sample of MMT smokers (n = 315) enrolled in a smoking cessation pharmacotherapy trial. Using logistic regression, we estimated the association of having an early quit day-24hr without smoking during the first month of treatment. RESULTS: Only 35.2% of participants reported a successful early quit day. The likelihood of an early quit day increased significantly (odds ratio [OR] = 1.39, 95% CI = 1.04-1.86, p < .05) with education level and if a quit attempt was made in the past year (OR = 2.27, 95% CI = 1.33-3.87, p < .01). Compared to the placebo arm, those randomized to either nicotine replacement therapy (OR = 3.25, 95% CI = 1.30-8.10, p < .01) or varenicline (OR = 3.16, 95% CI = 1.26-7.92) were significantly more likely to have an early quit day. The likelihood of an early quit day was also positively associated with adherence to the medication protocol (OR = 2.05, 95% CI = 1.52-2.76). CONCLUSIONS: Difficulty in achieving an early quit attempt may help explain the very low cessation rates found in studies of MMT smokers.
RCT Entities:
INTRODUCTION:Methadone maintenance treatment (MMT) patients have an exceedingly high prevalence of tobacco use, and interventions that have been specifically developed for this vulnerable subpopulation have struggled to attain even modest rates of cessation. A significant barrier has been an inability to initiate a quit attempt early in the treatment process and adherence to treatment. METHODS: This study examined the extent to which self-efficacy, medication adherence, and other demographic and smoking variables predicted an early quit day in a sample of MMT smokers (n = 315) enrolled in a smoking cessation pharmacotherapy trial. Using logistic regression, we estimated the association of having an early quit day-24hr without smoking during the first month of treatment. RESULTS: Only 35.2% of participants reported a successful early quit day. The likelihood of an early quit day increased significantly (odds ratio [OR] = 1.39, 95% CI = 1.04-1.86, p < .05) with education level and if a quit attempt was made in the past year (OR = 2.27, 95% CI = 1.33-3.87, p < .01). Compared to the placebo arm, those randomized to either nicotine replacement therapy (OR = 3.25, 95% CI = 1.30-8.10, p < .01) or varenicline (OR = 3.16, 95% CI = 1.26-7.92) were significantly more likely to have an early quit day. The likelihood of an early quit day was also positively associated with adherence to the medication protocol (OR = 2.05, 95% CI = 1.52-2.76). CONCLUSIONS: Difficulty in achieving an early quit attempt may help explain the very low cessation rates found in studies of MMT smokers.
Authors: Sheryl L Catz; Lisa M Jack; Jennifer B McClure; Harold S Javitz; Mona Deprey; Susan M Zbikowski; Tim McAfee; Julie Richards; Gary E Swan Journal: Nicotine Tob Res Date: 2011-02-24 Impact factor: 4.244
Authors: Kelly E Dunn; Stacey C Sigmon; Edward F Reimann; Gary J Badger; Sarah H Heil; Stephen T Higgins Journal: Exp Clin Psychopharmacol Date: 2010-02 Impact factor: 3.157
Authors: Megan E Piper; Stevens S Smith; Tanya R Schlam; Michael C Fiore; Douglas E Jorenby; David Fraser; Timothy B Baker Journal: Arch Gen Psychiatry Date: 2009-11