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

Factors associated with nicotine dependence during methadone maintenance treatment: findings from a multisite survey in Vietnam.
Author Information (click to view)

Do HP, Nguyen LH, Thi Nguyen NP, Ngo C, Thi Nguyen HL, Le GT, Nguyen LK, Nguyen CT, Tran BX, Le HT, Vu TMT, Phan HTT, Tran TD, Latkin CA, Dunne MP,


Do HP, Nguyen LH, Thi Nguyen NP, Ngo C, Thi Nguyen HL, Le GT, Nguyen LK, Nguyen CT, Tran BX, Le HT, Vu TMT, Phan HTT, Tran TD, Latkin CA, Dunne MP, (click to view)

Do HP, Nguyen LH, Thi Nguyen NP, Ngo C, Thi Nguyen HL, Le GT, Nguyen LK, Nguyen CT, Tran BX, Le HT, Vu TMT, Phan HTT, Tran TD, Latkin CA, Dunne MP,

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BMJ open 2017 07 177(7) e015889 doi 10.1136/bmjopen-2017-015889

Abstract
OBJECTIVES
Smoking 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.

SETTING
Five clinics in Hanoi (urban area) and Nam Dinh (rural area).

PARTICIPANTS
Patients receiving MMT in the settings during the study period.

PRIMARY AND SECONDARY OUTCOME MEASURES
We 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.

RESULTS
Among 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.

CONCLUSION
Smoking 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.

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