A population-based study of cigarette smoking among illicit drug users in the United States

• Published in: Addiction (Abingdon, England) Vol. 97; no. 7; pp. 861 - 869
• Main Authors: Richter, Kimber Paschall, Ahluwalia, Harsohena K., Mosier, Michael C., Nazir, Niaman, Ahluwalia, Jasjit S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-07-2002; Blackwell
• Subjects: Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Aged; Biological and medical sciences; Chi-Square Distribution; Cigarettes; Drug abuse; Drug abusers; Drug addiction; Drug use; Drug users; epidemiology; harm reduction; Health; Health Knowledge, Attitudes, Practice; Health Surveys; Humans; Logistic Models; Medical sciences; Medical treatment; Middle Aged; Multivariate Analysis; Prevalence; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Smoking; Smoking - epidemiology; Smoking - psychology; Smoking Cessation - statistics & numerical data; Social problems; Statistics, Nonparametric; Substance abuse; Substance-Related Disorders - epidemiology; tobacco; Tobacco, tobacco smoking; Toxicology; treatment; U.S.A; United States - epidemiology; USA; United States; North America; America; Human; Drug addiction; Concomitant disease; Prevalence; Illicit drug; Tobacco smoking; Epidemiology; Public health
• ISSN: 0965-2140; 1360-0443
• DOI: 10.1046/j.1360-0443.2002.00162.x

ABSTRACT
Aims
People who use illicit drugs are thought to have high rates of cigarette smoking; however, few population‐based studies have been reported. We describe smoking patterns among illicit drug users, assess whether cigarette smoking is more prevalent among illicit drug users than it is among non‐users and explore how smoking relates to level and type of drug use.
Design, setting, participants
We used adult responses to the 1997 National Household Survey on Drug Abuse (n = 16 661). Multivariate analyses used SUDAAN to adjust standard errors for the sampling design and controlled for age, race, sex, education, depression, treatment history and alcohol.
Measurements
Smoking rates, cessation rates and smoking levels.
Findings
Seventy‐one per cent of recent illicit drug users smoked cigarettes at least once in the past month. Their adjusted odds of being a smoker were much greater than for the general population (OR = 3.07, P < 0.0001). Their quit rate, although substantial, was half that of non‐users (23% versus 56%, P = 0.0001). Odds of being a smoker were higher for poly‐ versus monodrug users (OR = 2.35, P = 0.0020) and rose with increased drug use (OR = 1.36, P = 0.0374). Illicit drug users who perceived smoking to be risky were four times less likely to smoke (OR = 0.23, P = 0.0008).
Conclusions
Although most recent illicit drug users smoke, some are able to quit. Better understanding of concurrent cigarette and illicit drug use may provide impetus for policy change and shed light on underlying mechanisms of addiction. Clinicians, policy makers and user advocates should address tobacco use in drug treatment and in harm reduction interventions.