TREATING CIGARETTE-SMOKING IN DRUG-ABUSING CLIENTS

Clients in substance abuse treatment are at high risk for smoking-related illness due to higher rates and heavier smoking than the general population. Three myths widely held by both treatment staff and substance abusers in treatment-people in treatment do not want to quit smoking, people in treatment will relapse to other drug use if they attempt to quit smoking, and people in treatment are unable to quit smoking - make if difficult to broach the matter of smoking cessation. A 16-week, cognitive-behavioral group program with nicotine patches was conducted at Oregon's largest, private, nonprofit substance abuse treatment agency. Of 490 clients, approximately 85% of whom smoke, 106 (25% of the smokers) were interested enough in quitting to attend an orientation. Approximately 40% of these were methadone maintenance clients. The others were distributed among two residential and two outpatient drug-free treatment services. Of 90 assigned, 68 began voluntary treatment, and 21 were assigned to delayed treatment. Of the 66 smokers who began, 74% succeeded in quitting smoking for at least 1 day, and 23% were abstinent for at least 4 continuous weeks. At the end of the 16-week treatment, 7 subjects (11%) were abstinent. No control subjects quit smoking on their own. The article discusses issues of institutionalizing smoking cessation services in drug treatment agencies.