Smoking cessation patterns in methadone-maintained smokers

To determine predictors of smoking cessation duration in a randomized clinical trial, we assigned participants to nicotine patch ( 8-12 weeks) plus either ( a) a baseline tailored brief motivational intervention, a quit date behavioral skills counseling session, and a relapse prevention follow-up session, or ( b) brief advice using the National Cancer Institute's 4A's model. A total of 383 smokers from five methadone maintenance treatment centers in Rhode Island were enrolled, of whom 312 ( 82%) completed 6-month follow-up assessments. The primary outcome was longest period of self-reported abstinence during follow-up. Participants were on average 40.5 years of age; 51.9% were male, and 77.6% were White. In multivariate analysis controlling for demographics, nicotine dependence, depressive symptoms, and smoking-related symptoms, we found longer periods of abstinence in persons reporting at least one 24-hr quit attempt in the year prior to baseline ( OR=1.97, p=.003), in those anticipating success in cessation ( OR=1.33, p=.024), and in those with a greater percentage of nicotine patch use days ( OR=2.78, p,. 001). Past quit attempts, self-efficacy, and constant nicotine replacement were associated with duration of abstinence among methadone-maintained smokers. Attention to these domains in future intervention studies may improve treatment success.