Opioids and Smoking Cessation

• Status: Not yet recruiting
• Trial end date: 2023-01-01
• Target enrollment: 0
• Participant gender: All

Summary

The selection hypothesis of smoking prevalence posits that smokers who are not able to quit successfully are "burdened" by specific characteristics that make it more challenging to quit1. For example, those less successful in quitting smoking may be more nicotine dependent or more likely to suffer from substance use, psychiatric, or medical conditions. In line with this perspective, smoking prevalence has stabilized in the US, presumably because the remaining population has become increasingly representative of those "at-risk smokers" who are unable to quit2. Emerging evidence suggests that persons who suffer from opioid misuse, defined as opioid use without a prescription, at a dose or frequency higher than prescribed, or for a non-medical purpose (e.g., getting high),3 may constitute such a high-risk group. Opioid misuse affects greater than 16% adults who use opioids4 and up to 29% of those with chronic pain.5 The prevalence of tobacco smoking in this group may exceed twice that observed in the general population, and smokers misusing opioids are almost twice as likely to be dependent on nicotine6,7. Yet, the role of opioid misuse in periods of early abstinence and smoking cessation has yet to be explored. The main objective of the present proposal is to fill existing gaps in knowledge by examining the extent to which opioid misuse is associated with decreased success during early smoking abstinence and over the course of an attempt to quit smoking, and to identify mediators and moderators of opioid-smoking relations in this context. This contribution is clinically-significant from a public health standpoint because it will directly guide the development of novel psychosocial/behavioral smoking cessation interventions to help this high-risk population of smokers quit by targeting unique vulnerability processes that result in poor cessation outcomes.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of Houston
• Treatments: Nicotine

Criteria

Inclusion Criteria:

• 1. 18-65 years of age. 2. Daily smoker (≥ 10 cigarettes per day for at least one year), biochemically confirmed via Carbon Monoxide [CO] analysis at least 8 ppm.

3. Motivation to quit smoking (≥ 5 on a 0-10 scale) 4. Interested in making a serious quit attempt in the next month 5. Not have decreased number of cigarettes by more than half in the past 6 months 6. Own a smartphone (for EMA) 7. Report of current (past 30-day) opioid use (opioid misuse group) 8. Verification of opioid use by positive urine toxicology screen & Positive Aberrant Drug Behavior Index (opioid misuse group)

• PDUQ > 11, +POTQ, +urine toxicology screen

Exclusion Criteria:

• 1. Current use of psychotropic medication. 2. Current use of nicotine replacement therapy, Zyban, or Chantix (or intention to use).

3. Use of other tobacco products, including e-cigarettes. 4. Current treatment for opioid misuse, including methadone, buprenorphine, or naltrexone.

5. Current diagnosis of Opioid Use Disorder. 6. Pregnancy (by self-report) 7. Limited mental capacity or inability to provide informed consent 8. Current suicidality (by structured clinical interview) 9. Lifetime or current psychosis