Cigarette smoking and short-term addiction treatment outcome

Drug Alcohol Depend. 2011 Jun 1;115(3):161-6. doi: 10.1016/j.drugalcdep.2010.08.017. Epub 2010 Dec 15.


Cigarette smoking is common among patients in cocaine and opioid dependence treatment, and may influence treatment outcome. We addressed this issue in a secondary analysis of data from an outpatient clinical trial of buprenorphine treatment for concurrent cocaine and opioid dependence (13 weeks, N=200). The association between cigarette smoking (lifetime cigarette smoking status, number of cigarettes smoked per day prior to study entry) and short-term treatment outcome (% of urine samples positive for cocaine or opioids, treatment retention) was evaluated with analysis of covariance, bivariate correlations, and multivariate linear regression. Nicotine-dependent smokers (66% of participants) had a significantly higher percentage of cocaine-positive urine samples than non-smokers (12% of participants) (76% vs. 62%), but did not differ in percentage of opioid-positive urine samples or treatment retention. Number of cigarettes smoked per day at baseline was positively associated with percentage of cocaine-positive urine samples, even after controlling for baseline sociodemographic and drug use characteristics, but was not significantly associated with percentage of opioid-positive urine samples or treatment retention. These results suggest that cigarette smoking is associated with poorer short-term outcome of outpatient treatment for cocaine dependence, but perhaps not of concurrent opioid dependence, and support the importance of offering smoking cessation treatment to cocaine-dependent patients.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Behavior, Addictive / drug therapy*
  • Behavior, Addictive / epidemiology
  • Behavior, Addictive / psychology
  • Buprenorphine / therapeutic use
  • Cocaine-Related Disorders / drug therapy
  • Cocaine-Related Disorders / epidemiology
  • Cocaine-Related Disorders / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Smoking / epidemiology*
  • Smoking / metabolism
  • Smoking / therapy
  • Substance-Related Disorders / drug therapy*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Time Factors
  • Tobacco Use Disorder / epidemiology
  • Tobacco Use Disorder / metabolism
  • Treatment Outcome


  • Analgesics, Opioid
  • Buprenorphine