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Grant Details

Grant Number: 5R01CA084392-05 Interpret this number
Primary Investigator: Stein, Michael
Organization: Rhode Island Hospital
Project Title: Smoking Cessation Among Methadone Maintained Patients
Fiscal Year: 2005
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Abstract

Opiate dependent persons who are successfully engaged in the treatment of their primary drug of addiction often continue to use other drugs such as nicotine. With the high prevalence of smoking in this population, treatment providers are recognizing that many of those they help recover are now dying of smoking-related illnesses, including cancer. Recent surveys indicate that persons enrolled in methadone maintenance treatment programs are interested in receiving smoking cessation treatment, particularly as treatment facilities go smoke-free through voluntary efforts or JCAHO mandates. The long-term aim of our proposal is to advance knowledge and produce interventions to help achieve optimal dissemination of stroking cessation strategies for those usually deprived of such programs with dual diagnosis of opioid dependence and nicotine dependence. Using a two-group design, we will enroll 408 methadone-maintained cigarette smokers from two methadone treatment programs in Rhode Island. The specific aims are: A.1. To test, in combination with the nicotine patch, the incremental efficacy of a maximal, tailored and sustained behavioral treatment over a minimal treatment in the setting of a methadone maintenance program. The defined population comprises low income, less educated smokers who will vary in their level of motivation to quit smoking. Patients will be randomly assigned to one of two treatments.(a) Nicotine patch prescription plus brief nurse advice and follow-up .(minimal treatment; and (b) Nicotine patch prescription, brief nurse advice and follow-up, with the addition of a tailored motivational intervention, a behavioral skills counseling session for smoking cessation, and continued telephone counseling (maximal treatment). We hypothesize that 6 month 7-day point prevalence quit rates will be 4% and 12% in each of the two treatment groups, respectively. A2. To test the effects of the treatments on intermediate variables including motivation to quit smoking, cognitive behavioral mediators of motivation and intention to quit (e.g. self-efficacy, pros and cons of smoking, perceived vulnerability to illness, and perceived ability to prevent illness by quitting smoking), frequency of patch use, and number of quit attempts. We hypothesize that these variables will improve from baseline to 6 months as a function of treatment intensity. A3. To test the effects of the treatments on methadone treatment outcomes including methadone dose changes and continued use of illicit drugs, as measured by urine toxicologies.

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Publications

Relationship of depression to smoking outcomes in a methadone-maintained population.
Authors: Stein MD, Weinstock MC, Anderson BJ, Anthony JL
Source: J Addict Dis, 2007;26(1), p. 35-40.
PMID: 17439866
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Smoking cessation patterns in methadone-maintained smokers.
Authors: Stein MD, Anderson BJ, Niaura R
Source: Nicotine Tob Res, 2007 Mar;9(3), p. 421-8.
PMID: 17365774
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Nicotine replacement therapy: patterns of use after a quit attempt among methadone-maintained smokers.
Authors: Stein MD, Anderson BJ, Niaura R
Source: J Gen Intern Med, 2006 Jul;21(7), p. 753-7.
PMID: 16808777
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A smoking cessation intervention for the methadone-maintained.
Authors: Stein MD, Weinstock MC, Herman DS, Anderson BJ, Anthony JL, Niaura R
Source: Addiction, 2006 Apr;101(4), p. 599-607.
PMID: 16548939
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Respiratory symptom relief related to reduction in cigarette use.
Authors: Stein MD, Weinstock MC, Herman DS, Anderson BJ
Source: J Gen Intern Med, 2005 Oct;20(10), p. 889-94.
PMID: 16191133
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Perceptions of health risk susceptibility in methadone maintained smokers.
Authors: Hayaki J, Anderson BJ, Stein MD
Source: J Addict Dis, 2005;24(1), p. 73-84.
PMID: 15774412
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Nicotine and drug interaction expectancies among methadone maintained cigarette smokers.
Authors: Stein MD, Anderson BJ
Source: J Subst Abuse Treat, 2003 Jun;24(4), p. 357-61.
PMID: 12867210
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