Trained as a medical doctor, I have been working in addiction medicine since 2010. In 2016, I became a specialist in addiction medicine in Norway and have since been working as a consultant in inpatient addiction wards at the University Hospital of Bergen, Norway. In recent years, my fields of interest have been inpatient detoxification/ withdrawal treatment, as well as long term inpatient treatment following detoxification. I am currently in the final stages of my PhD, aiming to develop tobacco harm reduction strategies for patients receiving OAT.

Abstract

Integrated smoking intervention effectively reduced smoking for people receiving opioid agonist therapy (OAT)

Most people receiving OAT smoke tobacco. Tobacco-related diseases are a frequent cause of mortality and morbidity among persons with opioid dependency. If people receiving OAT reduce the amount of cigarettes smoked this can reduce the risk of smoking related diseases. We aimed to test if an integrated smoking intervention could help people receiving OAT reduced the amount smoked by at least one half. Multicentre pragmatic RCT in the Norwegian cities of Bergen and Stavanger from April 2022 until October 2023. Participants randomized to the intervention group were offered a 16-week intervention delivered at the local OAT clinic consisting of nicotine replacement products and behavioural support. Participants in the control group received standard OAT. The primary outcome was self-reported number of cigarettes smoked at 16-weeks. Results: Among the 259 participants 135 were allocated to the intervention group and 124 to the control group. Intention to treat analysis showed that participants receiving the intervention had an odds ratio of 2.07 (95% CI, 1.14-3.75) of at least halving the number of cigarettes smoked at 16 weeks. Integrated nicotine replacement and behavioural support provided at OAT clinics effectively helped opioid-dependent participants reduce the number of cigarettes smoked. This intervention could reduce smoking associated risks and be a first step towards smoking cessation.