Epidemiology of Smoking Behavior and Nicotine Dependence Among Opioid Addicts in China

Bao, Yan-ping; Sun, Gui-kuan; Lian, Zhi; and Liu, Zhimin National Institute on Drug Dependence, Peking University, China

Background: This study sought to explore the smoking habits and characteristics of nicotine dependence among opiate addicts in China.

Methods: A survey was conducted among 357 opiate addicts from four different provinces in a drug detoxification and rehabilitation center by using a self designed questionnaire.

Results: Among the 357 drug users, 355 (99.4%) had a history of smoking. Among them, the mean number of cigarettes smoked per day was 19.1, 34.9, 21.5, and 21.5 sticks before drug taking, during the addiction period, during the abstinence period, and after abstinence, espectively. The repeated two-way analysis of variance showed that a different period of drug addiction and route of drug administration were associated with the mean number of cigarettes smoked per day (F=46.9, p<0.0001 and F=20.3, p<0.0001). Among 347 smokers with a Fagerstrom Test for Nicotine Dependence (FTND) score, the median FTND score was 7.0 and 67.2 percent were severe nicotine addicts (FTND score >7.0). Adjusted variables associated with the degree of nicotine dependence were education, occupation, the age began smoking, the administration of drug abuse, polydrug use, and the number of relapses. Multiple logistic regression analysis showed that a lower level of education, administration by injection, polydrug use, and three or more relapses were risk factors for severe nicotine dependence; the adjusted odds ratios were 3.8 (1.5–10.0), 2.3 (1.3–4.0), 3.7 (2.1–6.5), and 1.9 (1.1–3.4), respectively.

Conclusions: A high prevalence of smoking was found in Chinese opiate drug users. The prevention and treatment of nicotine dependence among drug users is helpful for the prevention of injection drug use, polydrug use, and relapse.