Brief article Smoking cessation interventions among individuals in methadone maintenance: A brief review Chizimuzo T.C. Okoli, (Ph.D., M.P.H.) a, ⁎ , Milan Khara, (M.D., M.B.Ch.B. C.C.F.P. A.B.A.M.) b , Ric M. Procyshyn, (B.Sc. (Pharm.), M.Sc., Pharm.D., Ph.D.) c , Joy L. Johnson, (Ph.D., R.N., F.C.A.H.S.) d , Alasdair M. Barr, (Ph.D.) e , Lorraine Greaves, (Ph.D.) a a British Columbia Centre of Excellence for Women's Health, Box 48, Vancouver, British Columbia, Canada V6H 3N1 b Tobacco Dependence Clinic 3rd Floor, Pacific Spirit Community Health Centre, Vancouver, British Columbia, Canada V6M 2E1 c BC Mental Health & Addictions Research Institute, Vancouver, British Columbia, Canada V5Z 4H4 d School of Nursing, NEXUS, University of British Columbia, Vancouver, British Columbia, Canada V6T 1Z3 e Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada Received 22 May 2009; received in revised form 22 September 2009; accepted 15 October 2009 Abstract Background: Individuals in methadone maintenance treatment are motivated to quit smoking and are interested in smoking cessation treatment. However, few studies have assessed the efficacy of smoking cessation treatment for individuals undergoing methadone maintenance. The purpose of this article is to review interventions for tobacco use cessation among individuals in methadone maintenance with a particular emphasis on the components of such interventions and their effect on smoking cessation/reduction and drug use. Methods: A comprehensive search of six databases in June 2008 retrieved 584 research studies, which addressed smoking cessation interventions among individuals in substance use treatment. Of the retrieved articles, eight studies addressed smoking cessation among individuals undergoing methadone maintenance treatment. These studies were examined for effect of intervention on smoking cessation/reduction, gender differences in treatment outcomes, and the effect of the smoking cessation intervention on substance use behaviors. Results: Few studies demonstrated successful smoking abstinence among individuals in methadone maintenance treatment. Most interventions were associated with significant smoking reduction from baseline. Few studies assessed differences between men and women in smoking cessation treatment outcome. Smoking cessation treatment was not associated with increased substance use. Conclusions: To date, interventions among individuals in methadone treatment have been largely unsuccessful in achieving sustained smoking abstinence. However, smoking cessation treatment does not worsen substance use. Future studies are necessary to determine intervention designs and components that can enhance smoking cessation among individuals in methadone maintenance. © 2010 Elsevier Inc. All rights reserved. Keywords: Methadone maintenance; Smoking cessation; Smoking reduction; Smoking and substance use 1. Introduction Although North America has seen a decline in smoking prevalence during the past five decades, this overall reduction of smoking in the general population masks the high smoking rates among several subgroups, such as individuals with mental illness and substance use disorders. Studies have estimated that up to 90% of individuals undergoing substance use treatment concurrently use tobacco (Best et al., 1998; Burling & Ziff, 1988; Clarke, Stein, McGarry, & Gogineni, 2001). Moreover, in Canada, the morbidity and mortality associated with tobacco-related disease are greater than that associated with other substance Journal of Substance Abuse Treatment 38 (2010) 191 – 199 ⁎ Corresponding author. British Columbia Centre of Excellence for Women's Health, E311 - 4500 Oak Street, Box 48, Vancouver, BC, Canada V6H 3N1. Tel.: +1 604 875 3793; fax: +1 604 875 3716. E-mail address: cokoli@cw.bc.ca (C.T.C. Okoli). 0740-5472/09/$ – see front matter © 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.jsat.2009.10.001