Effectiveness of a Smoking Cessation Intervention for Methadone-Maintained Women: A Comparison of Pregnant and Parenting Women

Abstract

Women in substance abuse programs have high rates of smoking. Pregnancy represents a unique opportunity for intervention, but few data exist to guide tailoring of effective interventions. In this study, 44 pregnant and 47 nonpregnant opioid-dependent women enrolled in comprehensive substance abuse treatment received a 6-week smoking cessation intervention based on the 5A's counseling model. The number of daily cigarettes decreased by 49% for pregnant patients and 32% for nonpregnant patients at the 3-month followup. Length of time in substance abuse treatment did not correlate with smoking cessation or reduction for either group. Factors predicting reduction of cigarette smoking differed for pregnant versus nonpregnant patients. For pregnant patients, lower levels of nicotine use prior to intervention and self-reported cigarette cravings predicted successful reduction in smoking. For nonpregnant patients, lower affiliative attachment to cigarettes, reliance on cigarettes for cognitive enhancement, and greater sense of control predicted more successful outcomes.

Treating Tobacco Use Disorder in Pregnant Women in Medication-Assisted Treatment for an Opioid Use Disorder: A Systematic Review

“…This finding was not statistically different from the 32% decrease reported by the non-pregnant group, suggesting comparable efficacy for this intervention in methadone maintained pregnant and non-pregnant parenting women, but overall poor efficacy in terms of cessation. Authors of this study note that its limitations include the lack of a control condition, reliance on self-reported data (subject to recall bias and responding based on social desirability) as well as the small sample size (Holbrook & Kaltenbach, 2011). …”

“…The brief behavioral interventions were promising but did not lead to abstinence (Haug et al, 2004; Holbrook & Kaltenbach, 2011). Several brief behavioral interventions have been shown to have significant but modest effects (e.g.…”

Minimum recommended physical activity, and perceived barriers and benefits of exercise in methadone maintained persons

“…Although physical activity promotion was part of a multi-faceted health promotion intervention for methadone patients, the study authors noted that interventions to increase physical activity are needed (Fareed, et al, 2010). It is possible that a brief, counselor administered physical activity or exercise intervention would provide health benefits to this population as other interventions targeting different behaviors have been successful (Darker, et al, 2012; Fareed, et al, 2010; Holbrook & Kaltenbach, 2011). The widely used 5 A’s (ask, advise, assess, assist, arrange) smoking cessation intervention (Fiore, Jaen, & Baker, 2008) could be adapted for physical activity or exercise, thereby providing a standardized framework for a clinic based brief intervention.…”

Schwangerenbetreuung bei Drogenkonsum

“…95-98 % aller Drogenabhängigen rauchen, ist die Motivation der Schwangeren zur Konsumreduktion eine wichtige ärztliche Aufgabe. Holbrook und Kaltenbach konnten durch ein Tabakentwöhnungsprogramm bei methadonsubstituierten Schwangeren eine Reduktion der täglich gerauchten Zigaretten auf knapp die Hälfte des bisherigen Konsums erreichen [ 67 ] . Die Vermutung, dass drogenkonsumierende Schwangere für eine Tabakreduktion nicht motiviert oder überfordert seien, muss somit auch von gynäkologischer Seite hinterfragt werden.…”