Reductions in cigarette use in a pilot intervention for opioid use disorder and PTSD.

Background

Posttraumatic stress disorder (PTSD) symptoms are associated with increased substance misuse, including cigarettes and opioids. People who use opioids often report a desire to quit cigarettes, but little research has explored concurrent reductions in opioid and cigarette use in treatments for PTSD and substance use disorders.

Objective

This exploratory study examined changes in cigarette use in a pilot study of an integrated psychotherapy for co-occurring opioid use disorder (OUD) and PTSD.Method: Daily cigarette use was measured using the Timeline Followback at 30 days before baseline, during weekly intervention sessions, and at 1-month follow-up. Bootstrapped linear mixed effect models tested for self-reported reductions in cigarette use across a subsample (n=4) who reported using cigarettes at baseline.

Results

Results showed reductions in the average number of cigarettes used per day (CPD) between baseline and 1-month follow-up (B=-.93, SE=.41, p=.04) from an average of 17.06 (SD=15.32) CPD at baseline to an average of 8.07 (SD=9.28) CPD at follow-up. Additionally, participants reported high satisfaction with the intervention, with a mean score of 28.33 (SD=2.78) on the Client Satisfaction Questionnaire and all participants completed the intervention.

Conclusions

Exploratory findings suggest that the integrated treatment for OUD/PTSD may have assisted in reductions of co-occurring cigarette use. Notable limitations include the study's small sample size, lack of a control group, and lack of nicotine product-specific self-report and biological measures. Although exploratory, observed changes suggest future work should explore concurrent reductions in opioid and cigarette use in randomized clinical trials for OUD/PTSD.