Differences in cigarette smoking behaviors among heroin inhalers versus heroin injectors

The high prevalence of cigarette smoking among heroin users has triggered many studies to explore possible interactions between cigarette smoking and heroin addiction; however, little is known about the relationship between cigarette smoking behaviors and routes of heroin administration. The present study provided the first examination of cigarette smoking status, motivation, and cigarette smoking cue reactivity among injecting or inhaling heroin users.

Forty-six heroin-dependent patients were recruited in the present study. A battery of self-report questionnaires was used to assess cigarette smoking status and the reasons for smoking. In the clinical laboratory study, participants completed a cue-reactivity procedure that involved collecting psychophysical and motivational data in response to cigarette smoking slides.

The average number of cigarette per day among heroin inhalers was higher than that among heroin injectors. Most heroin inhalers reported that the primary reason for smoking was "maintaining drug pleasure," whereas heroin injectors reported that the primary smoking reason was "nicotine pleasure." Compared with heroin injectors, heroin inhalers provided increased ratings of heroin craving and desire to heroin use when exposed to cigarette smoking cues. Number of cigarettes per day was significantly correlated with cue-induced overall mean motivation in heroin inhalers but not in heroin injectors.

Cigarette smoking behaviors were different among heroin inhalers from among heroin injectors. These results emphasize the stronger association between cigarette smoking and heroin inhaling.