The Tobacco Dependence Clinic (TDC): Providing Smoking Cessation for a Drug Treatment Population

BACKGROUND: Drug treatment populations are disproportionately affected by tobacco use morbidity and mortality. However, with adequate intervention, individuals in drug treatment settings can succeed in their efforts towards smoking cessation. The Tobacco Dependence Clinic (TDC) is a program that provides smoking cessation counseling and pharmacotherapy for clients through the Addiction Services program of the Vancouver Coastal Health Authority, British Columbia, Canada. OBJECTIVES: To a) describe smoking cessation services and programs provided by the TDC, and b) evaluate 26 week smoking cessation outcomes of drug treatment clients in the TDC. METHODS: Participants of the TDC program receive a structured 8 week group therapy program, as well as pharmacotherapy for smoking cessation. Outcome measures include seven day point prevalence abstinence (validated by expired carbon monoxide), Fagerstrom Test for Nicotine Dependence (FTND) scores, number of cigarettes smoked per day (for non-abstinent participants), patient satisfaction, and relapse to other drug use. RESULTS: At 26 weeks there will be an expected 40% smoking abstinence rate. Non-abstinent smokers will reduce their total cigarettes smoked per day (relative to baseline) and have lower FTND scores. We expect 70% or higher satisfaction with the program. Smoking cessation will not be associated with relapse to drug use. CONCLUSIONS: Smoking cessation among drug treatment patients is an important factor in reducing the harms associated with tobacco use in this population. Drug treatment clients can successfully quit smoking at rates similar to the general population, with no negative impact on their drug use behavior, if given access to intensive treatment program