A Systematic Review of Smoking Cessation Interventions for Adults in Substance Abuse Treatment ...
Thursday, July 9, 2015
Posted by: Natalia Gromov
Thurgood SL, McNeill A., Clark-Carter D. and Brose LS.
A Systematic Review of Smoking Cessation Interventions for Adults in Substance Abuse Treatment or Recovery.
Nicotine Tob Res (2015)doi: 10.1093/ntr/ntv127
The aim was to evaluate the effectiveness of smoking cessation interventions for patients with substance use disorders. The secondary aim was to evaluate impact on substance use treatment outcomes. Randomised controlled trials involving adult smokers, recently or currently receiving inpatient or outpatient treatment for substance use disorders were reviewed. Databases, grey literature, reference lists and journals were searched for relevant studies between 1990 and August 2014. Two authors extracted data and assessed quality. The primary outcome was biochemically verified continuous abstinence from smoking at 6 or 12 months, secondary outcomes were biochemically verified seven-day point prevalence smoking abstinence (ppa) at 6 or 12 months and substance use outcomes. Heterogeneity between studies precluded pooled analyses of the data.
Seventeen of 847 publications were included. Five studies reported significant effects on smoking cessation: 1) Nicotine patches improved continuous abstinence at six months. 2) Nicotine gum improved continuous abstinence at 12 months. 3) Counselling, contingency management and relapse prevention improved continuous abstinence at six and 12 months. 4) Cognitive behavioural therapy, plus nicotine replacement therapy, improved ppa at six months. 5) A combination of bupropion, nicotine replacement therapy, counselling and contingency management improved ppa at six months. Two studies showed some evidence of improved substance use outcomes with the remaining eight studies measuring substance use outcomes showing no difference. Nicotine replacement therapy, behavioural support and combination approaches appear to increase smoking abstinence in those treated for substance use disorders. Higher quality studies are required to strengthen the evidence base.