Achieving smoking abstinence is associated with decreased cocaine use in cocaine-dependent patients receiving smoking-cessation treatment.
Past research suggests that a significant relationship exists between cigarette smoking and illicit-stimulant abuse. The present study, a secondary analysis of the National Drug Abuse Treatment Clinical Trials Network protocol CTN-0046 (Smoking Cessation and Stimulant Treatment (S-CAST)), evaluated the association between achieving smoking abstinence in response to smoking-cessation treatment (SCT) and illicit-stimulant abstinence in cocaine- and/or methamphetamine-dependent participants.
Two hundred and sixty-seven adults meeting DSM-IV-TR criteria for cocaine- and/or methamphetamine-dependence and interested in quitting smoking were randomized to SUD treatment-as-usual plus SCT consisting of weekly individual smoking cessation counseling, extended-release (XL) bupropion (300 mg/day), nicotine inhaler, and contingency management for smoking abstinence. Smoking abstinence was assessed via self-report and carbon monoxide levels. The analysis found a significant effect for the cocaine-dependent subsample (n=147) in which participants who stopped smoking were abstinent for illicit stimulants an average of 78.2% of the post-smoking-quit weeks (weeks 4-10) relative to 63.6% in participants who continued smoking. No significant effects were found for the sample as a whole (n=249) or for the methamphetamine-dependent subsample (n=102).
Conclusions: The present results suggest that cocaine-dependent patients achieving smoking abstinence in response to smoking-cessation treatment might evidence not only improved smoking outcomes but improved cocaine use outcomes as well. Because the prevalence of smoking in cocaine-dependent patients is 75-80%, and cigarette smoking itself is deadly, using smoking-cessation treatment to intervene with both cocaine use and cigarette smoking would impact two important public health issues. Future research to replicate this finding appears warranted.
Related protocols: CTN-0046