However, the pattern of cigarette smoking over the course of pregnancy in these women, including those treated with opioid agonists, has not been fully examined. Given that pregnancy is a time of high motivation to change for many women, it is possible that those opioid-dependent pregnant patients Y-27632 solubility who smoke may be a group particularly interested and willing to stop smoking. There are two main medications used to treat opioid dependence: methadone and buprenorphine. Studies of various nonpregnant agonist-treated samples suggest that both methadone and buprenorphine can interact with nicotine. Work conducted over 25 years ago suggests that opioid use, including heroin, methadone, and buprenorphine, is associated with increased smoking (Chait, & Griffiths, 1984; Mello, Lukas, & Mendelson, 1985; Mello, Mendelson, Sellers, & Kuehnle, 1980).

More recent research has demonstrated that concurrent nicotine use enhances methadone��s effect on opioid-withdrawal scores in methadone-maintained patients (Elkader, Brands, Selby, & Sproule, 2009), and buprenorphine increases the number of cigarettes smoked per day (CPD) (Mutschler, Stephen, Teoh, Mendelson, & Mello, 2002). Findings of interactions between nicotine and methadone, and nicotine and buprenorphine, suggest that there may be important clinical implications to substance use and its treatment in persons with opioid dependence who smoke cigarettes. However, direct comparisons of smoking among individuals on methadone and buprenorphine have received little attention. One recent study (Pajusco et al.

, 2012) compared smoking behavior in patients treated with methadone versus buprenorphine and confirmed high rates of smoking and cigarette use patterns among the two groups with no apparent difference between medications. To the authors�� knowledge, no other studies have directly compared cigarette smoking behavior associated with buprenorphine and methadone medication treatment, in either general or pregnant opioid-dependent populations. Given that buprenorphine is increasingly prescribed during pregnancy (Jones et al., 2010; Lacroix et al., 2011) and that the potential public health risks associated with even a small increase in cigarette smoking during pregnancy are great, there is a need to probe for any differences in cigarette smoking behavior among opioid-dependent pregnant patients treated with buprenorphine and methadone.

Because there are signals that suggest methadone and buprenorphine each can interact with smoking and because pregnancy represents a prime opportunity to study the time course of smoking cessation (given women��s motivation to stop), these analyses were conducted to see if there were differential effects Dacomitinib by opioid treatment agent��either in overall cessation rates of smoking or in the time course of changes in smoking. The Maternal Opioid Treatment: Human Experimental Research (MOTHER) study (Jones et al.