Developing a Smoking Cessation Intervention for Methadone Maintained Smokers

Most individuals in methadone maintenance treatment are tobacco smokers. Also, people in methadone treatment are more likely to experience the health issues related to smoking than the general population. Yet, research has found that smokers receiving methadone treatment are interested in quitting and receiving tobacco cessation treatment, and people in drug treatment who quit smoking are less likely to use drugs. To better help methadone maintained smokers quit smoking and prevent them from starting smoking again, we want to evaluate the effects of a new smoking cessation counseling intervention, designed for methadone maintained smokers as compared to a smoking cessation counseling intervention used with the general population. Eligible participants will: * Be English speaking (i.e., able to participate in counseling sessions in English and to complete study interviews in English); * Be enrolled in methadone treatment for at least three months; * Be able to give informed consent; * Be willing and able to participate in all study activities; * Not have taken smoking cessation related medication or participated in smoking cessation counseling in the past six months; * Have smoked at least 100 cigarettes during their lifetime and currently smoke every day or most days; * Not currently be pregnant or breastfeeding or plan on getting pregnant or breastfeeding during the next six months; * Have access to a working telephone; and, * Be interested in participating in a smoking cessation intervention and quitting smoking within the next six months. Participants will be randomly assigned to receive either a smoking cessation intervention tailored for methadone maintained smokers or a referral to a smoking cessation program available to the general population (NJ Quitline). Participants assigned to receive the tailored intervention, will participate in approximately eight individual counseling sessions, with a smoking cessation counselor, over three months. Each session will last approximately 45 minutes and occur in the participant's methadone clinic. Treatment needs will be assessed during the first session and the intervention will be tailored to participants' needs. Prior to quitting participants will receive nicotine replacement patches and lozenges and instructions on how to use them. Study staff will contact the NJ Quitline for participants assigned to the control condition, and a counselor from the Quitline will call them. Regardless of treatment assignment, participants will be asked to provide a urine sample for a drug test and pregnancy test (for women) and complete an interview, using a computer or face-to-face, before beginning treatment or receiving the NJ Quitline referral and three months and six months after study enrollment.Each interview will take approximately 45 minutes to one hour to complete. Participants will receive a $20 gift card for completing each research visit (i.e., computer or face-to-face interview), but will not be reimbursed for counseling visits.