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Smoking cessation services in U.S. methadone maintenance facilities.

Kimber P Richter1, Won S Choi, Robert M McCool

  • 1Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Mail Stop 1008, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA. krichter@kumc.edu

Psychiatric Services (Washington, D.C.)
|November 10, 2004
PubMed
Summary

Most patients in drug treatment smoke, yet few receive nicotine dependence services. Opioid treatment clinics offer limited smoking cessation support, indicating a need for comprehensive services and staff training.

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Area of Science:

  • Addiction Medicine
  • Public Health
  • Tobacco Control

Background:

  • A significant majority of patients undergoing drug treatment, particularly in methadone maintenance programs, are cigarette smokers.
  • Nicotine dependence is a prevalent comorbidity that can complicate treatment outcomes for opioid use disorder.

Purpose of the Study:

  • To determine the prevalence and types of nicotine dependence services offered in U.S. methadone and other opioid treatment clinics.
  • To identify factors associated with the provision of these services.

Main Methods:

  • A cross-sectional survey was administered to leadership at outpatient methadone maintenance clinics nationwide.
  • Data were collected via phone, fax, or mail, with a response rate of 59% (408 of 697 clinics).

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Main Results:

  • Only 18% of clinics offered smoking cessation counseling and 12% prescribed nicotine replacement therapy, reaching very few patients.
  • Clinics with written smoking cessation guidelines were more likely to provide services.
  • Private for-profit clinics were less likely to offer nicotine dependence treatment compared to public or nonprofit clinics.

Conclusions:

  • Despite high smoking rates among patients, comprehensive nicotine dependence services are underutilized in opioid treatment settings.
  • Implementing mandatory services and providing staff training are crucial for increasing treatment adoption.
  • The presence of staff "champions" and interest in training suggest potential for service expansion.