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

FRANÇAIS :
L'étude des données de l'enquête nationale auprès des ménages sur l'abus de drogues, de 1997, met en évidence que 71% des usagers de drogues sont des fumeurs et que 23% parviennent à arrêter de fumer, contre 56% pour les non-usagers. La consommation de cigarettes est plus fréquente chez les polyconsommateurs de drogues et elle est d'autant plus importante que la consommation de drogues est élevée.
ENGLISH :
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 = 16661). 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. (Author' s abstract)