TY - JOUR
T1 - Achieving Smoking Cessation Among Persons with Opioid Use Disorder
AU - Vlad, Cynthia
AU - Arnsten, Julia H.
AU - Nahvi, Shadi
N1 - Funding Information:
This work was supported by the Office of Medical Student Research at Albert Einstein College of Medicine and National Institute on Drug Abuse R01 DA042813.
Funding Information:
Dr Arnsten and Dr Nahvi have received investigator-initiated grant funding from Pfizer. Pfizer had no role in the drafting or publication of this manuscript. Author Cynthia Vlad declares that she has no conflicts of interest.
Funding Information:
We thank Racheline Habousha and Remi Donnelly for their assistance in the preparation of this manuscript and the Einstein Division of General Internal Medicine Substance Use Research Affinity Group and Meghan Peterson for their feedback.
Publisher Copyright:
© 2020, Springer Nature Switzerland AG.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - While prevalence of tobacco use in the US general population is declining, prevalence among those with opioid use disorder (OUD) remains high and results in excessive tobacco-related disease and premature mortality. Among smokers with OUD, tobacco cessation rates are negligible without treatment. However, both low-intensity behavioral interventions and more intensive motivational interventions yield negligible cessation rates. While contingency management has potent short-term cessation effects, effects are not maintained at post-intervention follow-up. Evidence-based smoking cessation pharmacotherapies, such as nicotine replacement therapy, bupropion, and varenicline, result in very modest cessation rates among smokers with OUD. Intensification of pharmacotherapy, such as high-dose and combination nicotine replacement therapy or extended medication treatment, has failed to improve cessation outcomes compared with standard treatment regimens. Targeting the unique challenges faced by smokers with OUD, including nicotine–opioid interactions and poor medication adherence, has potential to improve cessation outcomes, but further research is needed to optimize intervention efficacy among smokers with OUD.
AB - While prevalence of tobacco use in the US general population is declining, prevalence among those with opioid use disorder (OUD) remains high and results in excessive tobacco-related disease and premature mortality. Among smokers with OUD, tobacco cessation rates are negligible without treatment. However, both low-intensity behavioral interventions and more intensive motivational interventions yield negligible cessation rates. While contingency management has potent short-term cessation effects, effects are not maintained at post-intervention follow-up. Evidence-based smoking cessation pharmacotherapies, such as nicotine replacement therapy, bupropion, and varenicline, result in very modest cessation rates among smokers with OUD. Intensification of pharmacotherapy, such as high-dose and combination nicotine replacement therapy or extended medication treatment, has failed to improve cessation outcomes compared with standard treatment regimens. Targeting the unique challenges faced by smokers with OUD, including nicotine–opioid interactions and poor medication adherence, has potential to improve cessation outcomes, but further research is needed to optimize intervention efficacy among smokers with OUD.
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U2 - 10.1007/s40263-020-00701-z
DO - 10.1007/s40263-020-00701-z
M3 - Review article
C2 - 32107731
AN - SCOPUS:85080959819
SN - 1172-7047
VL - 34
SP - 367
EP - 387
JO - CNS Drugs
JF - CNS Drugs
IS - 4
ER -
