Binge drinking and marijuana use among menthol and non-menthol adolescent smokers: Findings from the Youth Smoking Survey

Introduction

Research has shown that smoking menthol cigarettes induces smoking initiation and hinders cessation efforts especially among youth. The objective of this paper is to examine the association between menthol cigarette smoking and substance use among adolescent students in Canada.

Methods

A nationally representative cross-sectional sample of 4466 Canadian students in grades 7 to 12 from the 2010–2011 Youth Smoking Survey is analyzed. A bivariate probit model is used jointly to examine the association of menthol smoking status with binge drinking and marijuana use.

Results

32% of the current smokers in grades 7 to 12 smoke mentholated cigarettes, 73% are binge drinkers and 79% use marijuana. Results of the bivariate probit regression analysis, controlling for other covariates, show statistically significant differences in the likelihood of binge drinking and marijuana use between menthol and non-menthol smokers. Menthol cigarette smokers are 6% (ME = 0.06, 95% CI = 0.03–0.09) more likely to binge drink and 7% (ME = 0.07, 95% CI = 0.05–0.10) more likely to use marijuana.

Conclusion

Smoking menthol cigarettes is associated with a higher likelihood of binge drinking and marijuana use among Canadian adolescents. Banning menthol in cigarettes may be beneficial to public health.     

Individualized smoking cessation treatment in an outpatient setting: Predictors of outcome in a sample with psychiatric and addictions co-morbidity

Objective

Patients with psychiatric disorders have higher rates of smoking and greater difficulty quitting smoking. However, few studies have compared patients with schizophrenia or schizoaffective disorders to patients with other psychiatric diagnoses without psychosis, addressing ability to quit and differences in treatment characteristics.

Method

A retrospective chart review was conducted on a sample of 165 cigarette smokers admitted to an outpatient smoking cessation clinic located in a large inner-city psychiatric hospital. Patients with schizophrenia and schizoaffective disorder (n = 55) were matched for age and sex at a ratio of 1:2 with a comparison group without psychosis (n = 110) from the same clinic. Primary outcomes of interest were quit status (7-day point prevalence) and significant reduction in cigarettes per day (≥ 50% but not quit) at final treatment session.

Results

There were no significant differences between groups for end-of-treatment quit rate or significant reduction (≥ 50%) in cigarettes per day. Patients with schizophrenia made significantly more visits to the clinic and were in treatment for a longer period of time. A greater number of individual treatment sessions and being male were the most significant predictors of cessation.

Conclusion

Patients with schizophrenia were as likely to quit smoking as a comparison group of patients with a high rate of other psychiatric comorbidities without psychosis. Findings suggest treatment success in this population requires an extended number of clinic visits, group therapy, and possibly higher doses of nicotine replacement.     

At high risk and want to quit: Marijuana use among adults with depression or serious psychological distress

Objectives

This study compared marijuana use characteristics and quit behaviors between adults with and without depression or serious psychological distress (SPD).

Methods

Drawing data for 39,133 non-institutionalized adults from the 2011 National Survey on Drug Use and Health, we assessed marijuana use status, frequent use, dependence or abuse, and quit behaviors in association with lifetime clinician-identified depression, lifetime and recent major depressive episode (MDE), and recent SPD.

Results

Adults with depression or SPD were at a significantly higher risk of being lifetime ever users (OR = 1.60–2.08), past year users (OR = 1.67–1.86), frequent users (OR = 1.40–1.62), and dependent or abusing users (OR = 2.32–3.05) compared with adults without these symptoms. Adults with depression or SPD had a lower quit ratio overall, but were equally or even more likely to make quit or self-regulation attempts. Further analysis suggested that adults with recent MDE had the greatest level of quit attempts or self-regulation attempts compared with adults without MDE or with past MDE.

Conclusions

These findings highlight the need for tailored cessation programs to sustain quit attempts and promote successful quitting among adults with depression or SPD, especially those with recent symptoms.     

Behavioral cessation treatment of waterpipe smoking: The first pilot randomized controlled trial

Background

Waterpipe use has increased dramatically in the Middle East and other parts of the world. Many users exhibit signs of dependence, including withdrawal and difficulty quitting, but there is no evidence base to guide cessation efforts.

Methods

We developed a behavioral cessation program for willing-to-quit waterpipe users, and evaluated its feasibility and efficacy in a pilot, two arm, parallel group, randomized, open label trial in Aleppo, Syria. Fifty adults who smoked waterpipe ≥ 3 times per week in the last year, did not smoke cigarettes, and were interested in quitting were randomized to receive either brief (1 in-person session and 3 phone calls) or intensive (3 in-person sessions and 5 phone calls) behavioral cessation treatment delivered by a trained physician in a clinical setting. The primary efficacy end point of the developed interventions was prolonged abstinence at three months post-quit day, assessed by self-report and exhaled carbon monoxide levels of < 10 ppm. Secondary end points were 7 day point-prevalent abstinence and adherence to treatment.

Results

Thirty percent of participants were fully adherent to treatment, which did not vary by treatment group. The proportions of participants in the brief and intensive interventions with prolonged abstinence at the 3-month assessment were 30.4% and 44.4%, respectively. Previous success in quitting (OR = 3.57; 95% CI = 1.03–12.43) predicted cessation. Higher baseline readiness to quit, more confidence in quitting, and being unemployed predicted a better adherence to treatment (all p-values < 0.05).

Conclusions

Brief behavioral cessation treatment for waterpipe users appears to be feasible and effective.     

The association between probable personality disorders and smoking cessation and maintenance

Introduction

Although it has been suggested that persons with psychopathological disorders experience greater difficulty in quitting smoking, the few studies that have analyzed personality disorders in smokers have failed to produce conclusive results. The aim of this study was to examine whether the presence of probable personality disorders was associated with the achievement of abstinence at the end of a smoking cessation treatment, as well as the maintenance of abstinence at 6 and 12 months of follow-up.

Methods

The sample comprised 290 smokers (41% men and 59% women) who participated in a psychological smoking cessation treatment and who were followed for a year. Abstinence was tested by measuring carbon monoxide in exhaled air.

Results

Participants with a probable borderline, antisocial or avoidant personality disorder were less likely to quit smoking at the end of the treatment, whereas probable schizoid personality disorder predicted better maintenance of abstinence at 6 and 12 months. In addition, smoking 25 or more cigarettes before starting the treatment decreased the likelihood of maintaining abstinence at 6 and 12 months of follow-up.

Conclusions

This study revealed differential (and opposing) relationships between specific personality disorders and smoking cessation outcomes, illustrating the need to consider Axis II disorders separately when predicting treatment outcomes.     

Risk perception and intention to quit among a tri-ethnic sample of nondaily,light daily,and moderate/heavy daily smokers

Introduction

Although the relationship between risk perceptions and quit intentions has been established, few studies explore the potential impact of smoking level on these associations, and none have done so among diversely-aged samples of multiple ethnicities.

Methods

Participants, ranging in age from 25 to 81, were 1133 nondaily smokers (smoked ≥ 1 cigarette on 4 to 24 days in the past 30 days), 556 light daily smokers (≤ 10 cigarettes per day), and 585 moderate to heavy daily smokers (> 10 cigarettes per day). Each smoking level comprised approximately equal numbers of African Americans, Latinos, and Whites. A logistic regression analysis, adjusted for sociodemographics, self-rated health, time to the first cigarette of the day and smoking level, was used to examine the association between risk perception (perceived risk of acquiring lung cancer, lung disease, and heart disease) and intention to quit (≤ 6 months versus > 6 months/never). A second adjusted model tested moderation by smoking level with an interaction term.

Results

Greater risk perception was associated with a higher odds of planning to quit within 6 months (AOR = 1.34, CI_.95 = 1.24, 1.45). Smoking level did not moderate this association (p = .85).

Conclusions

Results suggest that educating all smokers, irrespective of their smoking level, about increased risk of developing smoking-related diseases might be a helpful strategy to enhance their intention to make a smoking quit attempt.     

Longitudinal study of cognition among adolescent marijuana users over three weeks of abstinence

Background

Cognitive deficits that persist up to a month have been detected among adult marijuana users, but decrements and their pattern of recovery are less known in adolescent users. Previously, we reported cognitive deficits among adolescent marijuana users after one month of abstinence (Medina, Hanson, Schweinsburg, Cohen-Zion, Nagel, & Tapert, 2007). In this longitudinal study, we characterized neurocognitive changes among marijuana-using adolescents across the first three weeks of abstinence.

Method

Participants were adolescent marijuana users with limited alcohol and other drug use (n = 19) and demographically similar non-using controls (n = 21) ages 15–19. Participants completed a brief neuropsychological battery on three occasions, after 3 days, 2 weeks, and 3 weeks of stopping substance use. Abstinence was ascertained by decreasing tetrahydrocannabinol metabolite values on serial urine drug screens. Verbal learning, verbal working memory, attention and vigilance, and time estimation were evaluated.

Results

Marijuana users demonstrated poorer verbal learning (p < .01), verbal working memory (p < .05), and attention accuracy (p < .01) compared to controls. Improvements in users were seen on word list learning after 2 weeks of abstinence and on verbal working memory after 3 weeks. While attention processing speed was similar between groups, attention accuracy remained deficient in users throughout the 3-week abstinence period.

Conclusions

This preliminary study detected poorer verbal learning and verbal working memory among adolescent marijuana users that improved during three weeks of abstinence, while attention deficits persisted. These results implicate possible hippocampal, subcortical, and prefrontal cortex abnormalities.     

First cigarette on waking and time of day as predictors of puffing behaviour in UK adult smokers

Background

There is known inter- and intra-individual variation in how cigarettes are smoked. The aim of this study was to explore the influence of diurnal factors, particularly the first cigarette of the day, on puffing behaviour in a sample of adult smokers.

Methods

We recruited 130 adults aged 18–60 years who were smoking one of seven cigarette brands popular in the UK. Puffing behaviour was measured using a portable smoking device (CReSSmicro) through which participants smoked their cigarettes over a 24 h study period. The primary outcome was total smoke volume per cigarette (obtained by summing the puff volumes for each cigarette). Secondary outcome measures were puffing frequency, average puff volume, average puff flow, average puff duration and inter-puff interval.

Results

Total smoke volume was found to be significantly associated with the time the cigarette was smoked (P < 0.001), with cigarettes smoked between 2 and 10 a.m. being smoked less intensively than other cigarettes. After adjusting for time of cigarette, the first cigarette on waking was smoked slightly less intensively than other cigarettes and significantly so if smoked within 5 min of waking (P = 0.004).

Conclusions

This study suggests that cigarettes smoked during the night and early morning, including the first cigarette of the day, are puffed less intensively. This is a potentially important finding that merits more research given the importance of the first cigarette of the day and diurnal smoking patterns for determining dependence, cessation and relapse.     

Nondaily smoking patterns in young adulthood

Purpose

Many young adult smokers routinely smoke less than daily. Prospective, longitudinal data are needed to describe and predict the influences on smoking patterns among nondaily young adult smokers.

Methods

Latent class growth analysis was used to examine developmental trajectories and predictors of nondaily cigarette smoking among young adults aged 18 to 21 in the Upper Midwestern United States.

Results

There were three distinct groups of nondaily smokers during young adulthood (n = 519). College status, previous quit attempts, attitudes toward the meanings of cigarettes, and situational factors influencing smoking were significant predictors of group membership.

Conclusions

Nondaily smoking in young adulthood may result in several discrete patterns of smoking between age 18 and 21. Predictors that differentiate smoking trajectories may be useful to promote cessation or reduction in young adult smoking.     

Relapse among Cigarette Smokers: The CARDIA longitudinal study - 1985–2011

Rationale

There is little information about long-term relapse patterns for cigarette smokers.

Objective

To describe long-term prevalence of relapse and related smoking patterns by sex, race, age, and education level among a community-based cohort of young adults followed for 25 years.

Methods

We examined 25 years of data from Coronary Artery Risk Development in Young Adults (CARDIA), an ongoing study of a community-based cohort of 5115 men and women aged 18 to 30 years at baseline with periodic re-examinations. At each examination smoking, quitting, and relapse were queried. We examined prevalence of smoking relapse among 3603 participants who attended at least 6 of the 8 examinations.

Results

About 53% of 3603 participants never reported smoking on a regular basis. Among the remaining 1682 ever smokers, 52.8% of those who reported current smoking at baseline were still smoking by the end of the study, compared to 10.7% of those who initiated smoking by year 5. Among those classified as former smokers at baseline, 39% relapsed at least once; of these, 69.5% had quit again by the end of the study. Maximum education level attained, age at study baseline, and race were associated with failure to quit smoking by the end of the study and relapse among those who did quit. Maximum education level attained and age at study baseline were also associated with ability to successfully quit after a relapse.

Conclusions

Smoking relapse after quitting is common, especially in those with lower education level. Education was the strongest predictor of all three outcomes. Improvements in access to treatment and treatment options, especially for underserved populations, are needed to prevent relapse when smokers quit.     

Moderating effects of race in clinical trial participation and outcomes among marijuana-dependent young adults

Background

Few studies have examined clinical trial participation rates and treatment outcomes among underserved young adults who are dependent on marijuana, the most commonly abused illicit drug.

Method

The present study was a secondary analysis of a trial of court-referred marijuana-dependent young adults (ages 18–25) randomized to one of four treatment conditions: Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT), MET/CBT + Contingency Management (CM), Drug Counseling (DC) or DC + CM. African American (N = 81) participants were compared to White (N = 31) participants with respect to rates of participation in phases of treatment and substance use outcomes. In addition, the interaction of race and treatment condition was examined to ascertain if the interventions yielded different effects based on race.

Results

Among those who started treatment, African American young adults were significantly less likely to complete the treatment and posttreatment phases of the clinical trial than their White counterparts. Irrespective of treatment type, substance use outcomes (i.e., percentage of marijuana-negative specimens and longest duration of continuous abstinence) did not vary by race. However, there was a significant interaction effect between treatment type and race; African American young adults did not benefit differentially from any specific type of treatment, but CM was effective in reducing proportion of marijuana positive samples among White young adults.

Conclusions

Findings suggest that clinical trial treatment and posttreatment completion rates vary by race in this population, as does response to specific treatment types. More treatment research focusing specifically on African American marijuana-dependent young adults is warranted.     

Effects of bupropion on cognitive performance during initial tobacco abstinence

Background

Bupropion may aid tobacco abstinence by quickly relieving symptoms of nicotine withdrawal, perhaps including impaired cognitive performance. We examined whether bupropion would attenuate abstinence-induced cognitive deficits on the first day of a brief quit attempt, when smokers are most likely to relapse.

Methods

Smokers (N = 24) with high quit interest were recruited for within-subjects cross-over test of bupropion vs placebo on ability to abstain during separate short-term practice quit smoking attempts. After introduction to working memory (N-back) and sustained attention (continuous performance task; CPT) tasks during the pre-quit smoking baseline, performance on these tasks was assessed after abstaining overnight (CO < 10 ppm) on the first day of each quit attempt, while on bupropion and on placebo.

Results

Compared to placebo, bupropion after abstinence improved correct response times for working memory (p = .01 for medication by memory load interaction) and for one measure of sustained attention (numbers, but not letters; p < .05).

Discussion

Bupropion may attenuate some features of impaired cognitive performance due to withdrawal on the first day of a quit attempt. Future studies could examine whether this effect of bupropion contributes to its efficacy for longer-term smoking cessation.     

Smoking prevalence,cigarette consumption and advice received from physicians: Change between 1996 and 2006 in Geneva,Switzerland

Objective

To assess change between 1996 and 2006 in smoking prevalence, cigarette consumption, quit attempts, motivation to quit and advice received from physicians in Geneva, Switzerland.

Methods

Postal surveys in cross-sectional, representative samples of the general population of Geneva in 1996 and 2006.

Results

There were 742 participants in 1996 (response rate 75%) and 1487 in 2006 (response rate 76%). Smoking prevalence remained stable between 1996 (28.0%, 95% confidence interval: 24.7 to 31.3%) and 2006 (26.5%, 24.3 to 28.7%, p = 0.46). Among smokers, cigarette consumption fell from 15 to 13 cig./day between 1996 and 2006 (p = 0.003). However, tobacco dependence, as measured by the Heaviness of Smoking Index, remained stable (mean = 1.9 vs. 1.7, p = 0.18). The proportion of smokers who made a 24-hour quit attempt in the previous year remained stable (29.2% in 1996, 32.1% in 2006, p = 0.52), but more smokers reported that they intended to quit in the next 6 months in 2006 (39.6%) than in 1996 (29.1%, p = 0.045). The association between smoking prevalence and income was stronger in 2006 (chi² = 53.7, p < 0.001) than in 1996 (chi² = 10.9, p = 0.012). In 2006 (no change since 1996), few smokers reported that, during their last medical visit, their physician told them to quit smoking (27.3%) or offered them help to quit (13.3%).

Conclusions

Over these 10 years, smoking prevalence, nicotine dependence levels and the frequency of quit attempts remained stable, but smokers' motivation to quit increased. We observed a growing social gap in smoking prevalence and cigarette consumption. Smoking cessation advice was seldom received during medical visits.     

Level of cigarette consumption and quit behavior in a population of low-intensity smokers—Longitudinal results from the International Tobacco Control (ITC) survey in Mexico

Background

Mexican smokers are more likely to be non-daily smokers and to consume fewer cigarettes per day than smokers in other countries. Little is known about their quit behaviors.

Aim

The aim of this study is to determine factors associated with having made a quit attempt and being successfully quit at 14-month follow-up in a population-based cohort of adult Mexicans who smoke at different levels of intensity.

Design

A longitudinal analysis of wave-III and wave-IV (2010) Mexican administration of International Tobacco Control Policy Evaluation Project was conducted.

Setting

This study was conducted in six large urban centers in Mexico

Participants

The participants of this study comprised 1206 adults who were current smokers at wave-III and who were followed to wave-IV.

Measurements

We compared three groups of smokers: non-daily smokers—who did not smoke every day in the past 30 days (n = 398), daily light smokers who smoked every day at a rate of ≤ 5 cigarettes per day (n = 368) and daily heavy smokers who smoked every day at a rate of > 5 cigarettes per day (n = 434). Data on smoking behavior, psychosocial characteristics and socio-demographics were collected at baseline and after 14 months.

Findings

In multivariate logistic regression predicting having made a quit attempt at follow-up, significant factors included being a non-daily smoker versus a heavy daily smoker (ORadj = 1.83, 95% CI: 1.19–2.83), less perceived addiction (ORadj = 1.86, 95% CI: 1.20–2.87), greater worry that cigarettes will damage health (ORadj = 2.04, 95% CI: 1.16–3.61) and having made a quit attempt in the past year at baseline (ORadj = 1.70, 95% CI: 1.23–2.36). In multivariate logistic regression predicting being successfully quit at one-year follow-up, significant factors included being a non-daily smoker versus a heavy daily smoker (ORadj = 2.54, 95% CI: 1.37–4.70) and less perceived addiction (not addicted: ORadj = 3.26, 95% CI: 1.73–6.14; not much: ORadj = 1.95, 95% CI: 1.05–3.62 versus very much).

Conclusions

Mexican adult smokers who are non-daily smokers were more likely than daily heavy smokers to have attempted to quit during follow-up and to succeed in their quit attempt. Future research should determine whether tobacco control policies and programs potentiate this tendency and which interventions are needed to help heavier smokers to quit.     

Mental health problems and interest in marijuana treatment among marijuana-using college students

Background

There is growing recognition that marijuana use among college students is associated with marijuana-related problems. Yet little work has examined whether use is associated with mental health problems and whether there is a dose effect such that individuals engaging in more frequent use evince relatively greater psychiatric impairments. Further, little is known about factors related to interest in marijuana treatment among students experiencing marijuana-related problems.

Method

The current study examined academic and psychiatric functioning as well as interest in marijuana treatment among undergraduates (N = 1,689). Approximately 29% acknowledged marijuana use, with 9.8% using weekly or more.

Results

More frequent marijuana use was related to more academic difficulties. Marijuana use (among both weekly and less frequent users) was related to greater psychiatric impairment. Interest in marijuana treatment was examined among students with 2+ marijuana-related problems (n = 251). Of those, 22.7% expressed interest in marijuana treatment. Factors positively related to treatment interest included: marijuana use frequency, use-related problems, friends' marijuana use, age, employment status, and some types of mental health problems.

Conclusions

Marijuana use among college students is associated with academic, psychiatric, and marijuana-related impairments. However, there is some interest in treatment to manage marijuana use among undergraduates, particularly among those with more frequent and more problematic marijuana use.     

Latent class analysis of polysubstance use,sexual risk behaviors,and infectious disease among South African drug users

Background

HIV transmission risk among non-injection drug users is high due to the co-occurrence of drug use and sexual risk behaviors. The purpose of the current study was to identify patterns of drug use among polysubstance users within a high HIV prevalence population.

Methods

The study sample included 409 substance users from the Pretoria region of South Africa. Substances used by 20% or more the sample included: cigarettes, alcohol, marijuana and heroin in combination, marijuana and cigarettes in combination, and crack cocaine. Latent class analysis was used to identify patterns of polysubstance use based on types of drugs used. Multivariate logistic regression analyses compared classes on demographics, sexual risk behavior, and disease status.

Results

Four classes of substance use were found: MJ + Cig (40.8%), MJ + Her (30.8%), Crack (24.7%), and Low Use (3.7%). The MJ + Cig class was 6.7 times more likely to use alcohol and 3 times more likely to use drugs before/during sex with steady partners than the Crack class. The MJ + Cig class was 16 times more likely to use alcohol before/during sex with steady partners than the MJ + Her class. The Crack class was 6.1 times more likely to engage in transactional sex and less likely to use drugs before/during steady sex than the MJ + Her class.

Conclusions

Findings illustrate patterns of drug use among a polysubstance using population that differ in sexual risk behavior. Intervention strategies should address substance use, particularly smoking as a route of administration (ROA), and sexual risk behaviors that best fit this high-risk population.     

Adolescent nicotine exposure sensitizes cue-induced reinstatement of cocaine seeking in rats bred for high and low saccharin intake

Background

Quit attempts may have different outcomes based on menstrual cycle phase on quit day. This is the first preliminary study examining whether smoking cessation outcomes vary by menstrual cycle phase of quit date in women receiving a 6-week open trial of sustained release (SR) bupropion.

Methods

Thirty-three treatment-seeking premenopausal women were studied. Abstinence outcomes were compared for women quitting during the luteal versus follicular phase.

Results

Women receiving bupropion SR whose self-selected quit date occurred in the luteal phase had significantly higher rates of point prevalence abstinence during the final week of a 6-week post-quit treatment period than women quitting in the follicular phase (62.5% versus 29.4%; p < 0.05). A similar, but non-significant, pattern of findings was demonstrated for continuous abstinence during the treatment phase and for point prevalence abstinence at 3-month follow-up.

Conclusions

Women receiving bupropion SR were significantly more likely to be abstinent at treatment completion if quitting occurred during the luteal phase. This is consistent with recent findings of outcome related to cycle phase at quit date in the absence of pharmacotherapy, and differs from findings utilizing nicotine replacement. Results add to emerging data suggesting that smoking cessation interventions with varying mechanisms of action may result in different outcomes for premenopausal women based on gonadal hormones at quit date.     

Smoking cessation aids and strategies among former smokers in Canada

Objectives

There is a need to better understand the prevalence of use of pharmaceutical aids among former smokers, and explore concerns that those former smokers may have had about using such products. This paper examines the use of various cessation aids and strategies as well as reasons for not using cessation aids among a nationally representative sample of former smokers from Canada.

Methods

Using data from the 2006 Canadian Tobacco Use Monitoring Survey (CTUMS), univariate analyses were performed to examine the use of different cessation aids, strategies to quit smoking, and reasons for not using cessation aids among former smokers who had quit in the previous two years.

Results

In 2006, over one in four Canadians (27.1% or about 7.2 million persons) aged 15 and older was a former smoker. Overall, female former smokers were more likely to report that they reduced their consumption of cigarettes as a quitting strategy, whereas male former smokers were more likely to report using a pharmacological aids when quitting. Among reasons given for not using cessation aids, lack of trust that these products would work was the most common (15.4%), following by issue of cost (8.5%), concern about possible side effects (5.8%) and lack of information about products (1.8%).

Conclusion

These results suggest that men and women use different approaches to quit smoking. Our findings provide new insight which could be used to target cessation programs to the individuals where they are most likely to be effective.     

Perceived stress and substance use in methadone-maintained smokers

Background

In methadone maintenance treatment programs (MMTPs), 80–90% of participants smoke cigarettes. Patients in MMTPs are at particular risk for life stress, and nicotine, as well as other substances like alcohol, benzodiazepines, cocaine, marijuana, and opiates have been shown to reduce the effects of stress. Use of these addictive substances to cope with stress may precipitate illicit opiate relapse in MMTP patients. In the current study, we examined the relationship between perceived stress and substance abuse.

Methods

Participants were 315 cigarette smokers recruited from nine MMTPs for a smoking cessation study. Logistic regression was used to evaluate the adjusted association of perceived stress with dichotomous indicators of hazardous alcohol use and recent substance use at baseline.

Results

After controlling for demographic and smoking-related variables, perceived stress was associated positively and significantly with the likelihood of screening positive for hazardous drinking or alcohol-related problems (OR = 1.13, 95%CI 1.02; 1.25), with the likelihood of recent cocaine use (OR = 1.18, 95%CI 1.02; 1.37), and with the likelihood of recent benzodiazepine use (OR = 1.24, 95%CI 1.07).

Conclusions

Perceived stress may be a marker of patients’ risk for illicit substance use, a known risk factor for illicit opiate relapse. These findings indicate that cigarette use might not be sufficient in managing stress and methadone-maintained persons turn to other substances for relief.