Relationship between tobacco smoking and medical symptoms among cocaine-, alcohol-, and opiate-dependent patients.

Despite widespread use of tobacco by alcohol and drug abusers, the medical effects of smoking remain understudied among such individuals. We investigated the relationship between tobacco smoking and medical symptoms among 87 cocaine-, 98 opiate- and 81 alcohol-dependent individuals receiving outpatient treatment. Smoking status was assessed and medical symptoms were recorded using a standardized 134-item self-report instrument (MILCOM). Almost 79% of patients were tobacco smokers. Analysis of variance revealed a main effect of tobacco smoking on medical symptoms. Smokers reported significantly more symptoms on the total scale as well as on the respiratory, cardiovascular, gastrointestinal, and nose/throat subscales compared to non-smokers. Furthermore, we found a significant interaction between tobacco smoking and substance abuse with respect to medical symptoms. While opiate and alcohol patients who smoked reported more symptoms than those who did not, unexpectedly, cocaine users who smoked reported fewer symptoms than those who did not smoke. While the findings support the link between smoking and medical problems among substance abusers, these effects do not seem to be uniform across various substances of abuse. In particular, cocaine patients seem to be affected differently than alcohol and opiate patients.