Smoking Cessation Therapy Does Not Interfere with Simultaneous Stimulant Addiction Treatment

A study conducted by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH), concluded that smokers who are also addicted to cocaine and/or methamphetamine can successfully quit smoking without interfering with simultaneous stimulant addiction treatment. The study was published online in The Journal of Clinical Psychiatry. According to a pamphlet released in 2008 by the Substance Abuse and Mental Health Services Administration (SAMHSA), “smoking tobacco causes more deaths among clients in substance abuse treatment than the alcohol or drug use that brings them into treatment.”

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According to the study, smoking-cessation treatment does not interfere with stimulant-dependent patients also undergoing substance use treatment. It showed that outpatient substance use disorder treatment will not worsen, and may even enhance, abstinence from nonnicotine substance use.

"Substance abuse treatment programs have historically been hesitant to incorporate concurrent smoking cessation therapies with standard drug addiction treatment because of the concern that patients would drop out of treatment entirely," NIDA Director Nora D. Volkow, M.D., said in a press release. "However, treating their tobacco addiction may not only reduce the negative health consequences associated with smoking, but could also potentially improve substance use disorder treatment outcomes."

The researchers wanted to evaluate the impact of simultaneous treatment for substance abuse and smoking. Their study was a 10-week trial with a follow up at three and six months after the patients’ smoking quit date and was conducted between February 2010 and July 2012. Adults meeting DSM-IV-TR criteria for cocaine and/or methamphetamine dependence who were also interested in quitting smoking were randomized into two groups: substance treatment, or substance treatment with smoking-cessation treatment. Each adult received normal substance use treatment throughout the study. Patients in the smoking-cessation group additionally received counseling and extended-release bupropion (300 mg/d) for all 10 weeks. During weeks 4-10, the “post-quit” treatment, they also received a nicotine inhaler and contingency management for smoking abstinence. Results were collected using urine drug screenings, carbon monoxide testing, and using self-reports.