Daily cigarette smoking among inpatients for substance use disorders in France, 2010-2020: Commonalities and specificities across substances.

Introduction: This study aims to estimate the prevalence and factors associated with cigarette smoking among patients in treatment for substance use disorders (SUD) in France.

Methods: We analyze a nation-wide dataset retrieving information on patients entering treatment for alcohol, opioid and stimulant use disorders between 2010 and 2020. We conduct multilevel Poisson regressions to determine the main factors associated with daily cigarette smoking among all patients who entered treatment for alcohol (n=607122), opioid (n=283381) or stimulant (n=57189) use disorders, and zero-truncated negative-binomial regressions to predict the average number of cigarettes per day.

Results: Daily cigarette smoking remains a widespread behavior among patients with SUD (overall prevalence: 72.2%, 95% CI: 72.1-72.3), with lower prevalence of daily cigarette smoking among patients treated for alcohol use disorders (69.9%, 95% CI: 69.8-70.0), and higher for patients treated for opioid (78.8%, 95% CI: 78.6-79.0) or stimulant use disorders (75.8%, 95% CI: 75.4-76.2). There was an overall increase in daily cigarette smoking over time (69.9%, 95% CI: 69.8-70.0 in 2010 vs 76.8%, 95% CI: 76.5-76.9 in 2020); however, the average number of cigarettes per day decreased (17.8 per day, 95% CI: 17.7-17.9 in 2010 vs 16.3 per day, 95% CI: 16.2-16.4 in 2020). The higher the education level, the fewer number of cigarettes per day; conversely, the higher the occupational status, the higher the number of cigarettes.

Conclusions: The high prevalence of smoking among patients treated for SUD in France departs from the decreasing trend observed in the general population and remains a source of concern. It is necessary to implement tailored prevention strategies that target specific patient subgroups and increase staff awareness.