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Abstract
Patients of methadone maintenance treatment (MMT) exhibit an exceedingly high prevalence of tobacco use and disproportionately suffer from tobacco-related illnesses and mortality. A number of studies have sought to target MMT smokers with cessation interventions utilizing a variety of behavioral and pharmacological treatments. Such efforts have struggled to attain even modest rates of cessation at follow-up, suggesting a need for novel approaches. In an effort to accelerate this area of research, the current article proposes an alternative paradigm for MMT smokers: Nicotine Maintenance. The proposed model emphasizes five domains aimed at advancing the contextual fit between smoking cessation treatment and MMT: (1) A harm reduction and maintenance orientation; (2) a reconsideration of abstinence-oriented frameworks and techniques; (3) a longer-term perspective; (4) greater integration with the MMT treatment milieu; and (5) approaches that address the unique needs of MMT patients including shame, stigma, and the enhancement of treatment autonomy.
Disclosure statement
No potential conflict of interest was reported by the authors.