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

Huyen Phuc Do, Long Hoang Nguyen, Nhung Phuong Thi Nguyen, Chau Ngo, Huong Lan Thi Nguyen, Giang Tong Le, Linh Khanh Nguyen, Cuong Tat Nguyen, Bach Xuan Tran, Huong Thi Le, Thuc Minh Thi Vu, Huong Thu Thi Phan, Tho Dinh Tran, Carl A. Latkin, Michael P. Dunne

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


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.

Original languageEnglish (US)
Article numbere015889
JournalBMJ open
Issue number7
StatePublished - Jul 1 2017


  • Cigarette smoking
  • Vietnam
  • methadone maintenance treatment
  • nicotine dependence
  • tobacco use

ASJC Scopus subject areas

  • General Medicine


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