Smoking in Pregnant Women Screened for an Opioid Agonist Medication Study Compared to Related Pregnant and Non-Pregnant Patient Samples

Abstract

Background-Little is known about the prevalence and severity of smoking in pregnant opioid dependent patients.

Illicit Drug Use Among Pregnant Women Enrolled in Treatment for Cigarette Smoking Cessation

“…It should be noted that our measurements of drug use likely underestimate illicit use in pregnant smokers, as those who were receiving opioidmaintenance therapy (buprenorphine or methadone) were excluded from the current trials as opioids are known to alter smoking rates (e.g., Mello, Mendelson, Sellers, & Kuehnle, 1980). As opioid-maintained pregnant smokers have relatively high rates of illicit drug use (Choo, Huestis, Schroeder, Shin, & Jones, 2004;Haug, Stitzer, & Svikis, 2001;Jones et al, 2009), any trial that excludes them will likely underestimate illicit drug use in pregnant smokers.…”

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

“…Alarmingly high rates of smoking (88-95%) occur in pregnant women concurrently treated with buprenorphine or methadone for an opioid use disorder (Chisolm et al, 2013; Jones et al, 2009). Medication-assisted treatment is recommended to help lessen illicit opioid use and improve pregnancy outcomes in women with an opioid use disorder (Center for Substance Abuse Treatment, 2005; National Consensus Development Panel on Effective Medical Treatment of Opiate Addiction, 1998).…”

“…In the general pregnant population, 20-45% of women spontaneously quit smoking upon becoming pregnant (Quinn, Mullen, & Ershoff, 1991; Solomon & Quinn, 2004; Woodby, Windsor, Snyder, Kohler, & Diclemente, 1999), while almost no pregnant women in medication-assisted treatment for an opioid use disorder quit spontaneously (Chisolm et al, 2013; Jones et al, 2009). The American College of Obstetricians and Gynecologists (ACOG) and the U.S. Department of Health and Human Services recommend that obstetrical providers ask all pregnant women about tobacco use and provide pregnancy-tailored counseling based on the “5 A's” counseling model (Albrecht, Phelan, & Melvin, 2011; Fiore et al, 2008).…”

“…Although rates of spontaneous smoking cessation in pregnant women on medication-assisted treatment are extremely low (Chisolm et al, 2013; Jones et al, 2009), those engaged in substance abuse treatment may be interested in smoking cessation, (Clemmey, Brooner, Chutuape, Kidorf, & Stitzer, 1997; Haug, Stitzer, & Svikis, 2001) and pregnancy can be a time when women are particularly motivated to stop smoking (Lumley et al, 2009). Pregnant women on methadone or buprenorphine are also a reachable population with regular contact with substance treatment providers.…”

“…Given the current rise in illicit opioid use during pregnancy (Patrick et al, 2012), concurrent cigarette smoking during pregnancy is becoming a growing problem with great public health significance (Haug et al, 2001; Jones et al, 2009; Tong, Jones, Dietz, D'Angelo, & Bombard, 2009). Effective treatments are needed.…”