Cigarette smoking in subjects maintained with methadone or buprenorphine: The role of psychiatric symptoms and psychological distress

Abstract

Objective: The relationship between cigarette smoking, psychiatric symptoms/psychological distress in subjects maintained with methadone or buprenorphine was studied.

Methods: 1049 subjects with a diagnosis of heroin use disorder were enrolled. The Symptom Checklist-90-Revised (SCL-90-R) and the General Health Questionnaire-12 (GHQ-12) were administered. The analyses were run in the whole sample and stratified for substitution therapies.

Results: In the whole sample as well as among subjects maintained with methadone, the number of cigarettes smoked daily was associated with SCL-90-R Global score (whole sample: p = 0.001; ΔR² = 0.012; subjects maintained with methadone: p ≤ 0.001; ΔR² = 0.019) and with GHQ-12 (whole sample: p = 0.001; ΔR² = 0.013; subjects maintained with methadone: p = 0.01; ΔR² = 0.010) while among subjects maintained with buprenorphine, the number of cigarettes smoked daily was associated with SCL-90-R Global score (p = 0.05; ΔR² = 0.020).

Conclusion: Psychiatric symptoms were associated with the number of cigarettes smoked daily among subjects maintained with methadone and among those maintained with buprenorphine, thus deserving clinical attention.

Keywords: Buprenorphine; Cigarette; Heroin; Methadone; Psychiatric symptoms; Smoking.