Factors associated with nicotine dependence during methadone maintenance treatment: findings from a multisite survey in Vietnam

• Published in: BMJ open 2017-07, Vol.7 (7), p.e015889
• Main Authors: Do, Huyen Phuc, Nguyen, Long Hoang, Thi Nguyen, Nhung Phuong, Ngo, Chau, Thi Nguyen, Huong Lan, Le, Giang Tong, Nguyen, Linh Khanh, Nguyen, Cuong Tat, Tran, Bach Xuan, Le, Huong Thi, Vu, Thuc Minh Thi, Phan, Huong Thu Thi, Tran, Tho Dinh, Latkin, Carl A, Dunne, Michael P
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Addiction; Adult; AIDS; Alcohol Drinking - epidemiology; Analgesics, Opioid - therapeutic use; Cross-Sectional Studies; Developing Countries; Drug use; Female; HIV; HIV Seropositivity - epidemiology; Human immunodeficiency virus; Humans; Logistic Models; Male; Methadone; Methadone - therapeutic use; Middle Aged; Multivariate Analysis; Opiate Substitution Treatment - methods; Opioid-Related Disorders - complications; Opioid-Related Disorders - drug therapy; Self Report; Smoking - epidemiology; Smoking cessation; Socioeconomic Factors; Tobacco Use Disorder - epidemiology; Vietnam - epidemiology; Well being
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-015889

ObjectivesSmoking is associated with adverse health outcomes among drug users, including those in treatment. To date, however, there has been little evidence about smoking patterns among people receiving opioid-dependence treatment in developing countries. We examined self-reported nicotine dependence and associated factors in a large sample of opioid-dependent patients receiving methadone maintenance treatment (MMT) in northern Vietnam.SettingFive clinics in Hanoi (urban area) and Nam Dinh (rural area).ParticipantsPatients receiving MMT in the settings during the study period.Primary and secondary outcome measuresWe collected data about smoking patterns, levels of nicotine dependence and other covariates such as socioeconomic status, health status, alcohol use and drug use. The Fagerström test was used to measure nicotine dependence (FTND). Logistic regression and Tobit regression were employed to examine relationships between the smoking rate, nicotine dependence and potentially associated variables.ResultsAmong 1016 drug users undergoing MMT (98.7% male), 87.2% were current smokers. The mean FTND score was 4.5 (SD 2.4). Longer duration of MMT (OR 0.98, 95% CI 0.96 to 0.99) and being HIV-positive (OR 0.46, 95% CI 0.24 to 0.88) were associated with lower likelihood of smoking. Being employed, older age at first drug injection and having long duration of MMT were inversely related with FTND scores. Higher age and continuing drug and alcohol use were significantly associated with higher FTND scores.ConclusionSmoking prevalence is high among methadone maintenance drug users. Enhanced smoking cessation support should be integrated into MMT programmes in order to reduce risk factors for cigarette smoking and improve the health and well-being of people recovering from opiate dependence.