{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:33:26Z","timestamp":1791452006141,"version":"4.3.3"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T00:00:00Z","timestamp":1557187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HD069314"],"award-info":[{"award-number":["R01 HD069314"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Smokers who use opioids smoke more cigarettes per day (CPD) than non-opioid users, which could be due to the effects of opioids on nicotine metabolism. Moreover, nicotine metabolism increases during pregnancy, potentially making quitting more difficult for pregnant smokers. We examined nicotine metabolism and its association with opioid use (OU) and CPD in pregnant smokers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited pregnant women who smoked at least 5 CPD for a clinical trial of smoking cessation. Plasma nicotine metabolite ratio (NMR; trans-3\u2032-hydroxycotinine (3HC)\/cotinine)\u2014a biomarker of nicotine metabolism\u2014OU (involving methadone, buprenorphine, fentanyl, oxycodone, or tramadol), and CPD were assessed at baseline. We used linear regression to examine the associations between log-transformed NMR, OU, and CPD, adjusting for race\/ethnicity and menthol smoking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 129 pregnant smokers, 25 (19%) were opioid users; most were maintained on methadone (n = 14). Compared to non-OU smokers, OU smokers had higher median CPD (10.0 vs. 7.0, p = .0007), serum 3HC (81.0 vs. 42.0 ng\/mL, p = .0001), and NMR (0.63 vs. 0.43, p &amp;lt; .0001). In addition, methadone-maintained smokers had a higher median NMR than non-OU smokers (0.66 vs. 0.43, p = .0004). Adjusting for covariates, log-transformed NMR was greater in OU smokers (p = .012), specifically methadone-maintained smokers (p = .024), than non-OU smokers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our preliminary results show that OU is associated with a higher NMR in pregnant smokers. A larger study sample is needed to replicate this finding, examine potential mechanisms, and determine its clinical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Among pregnant smokers, we observed that nicotine metabolism was significantly faster among opioid users\u2014the majority of whom were on methadone maintenance\u2014compared to nonusers, which could have implications for smoking cessation. Further studies are needed to replicate this finding, evaluate potential mechanisms, and determine its clinical significance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntz073","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T11:20:39Z","timestamp":1557141639000},"page":"1046-1050","source":"Crossref","is-referenced-by-count":9,"title":["Opioid Use and Rate of Nicotine Metabolism Among Pregnant Smokers"],"prefix":"10.1093","volume":"22","author":[{"given":"Cheryl","family":"Oncken","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Connecticut School of Medicine, Farmington, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9720-2658","authenticated-orcid":false,"given":"Erin L","family":"Mead","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Connecticut School of Medicine, Farmington, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen A","family":"Dornelas","sequence":"first","affiliation":[{"name":"Division of Oncology, Department of Medicine, Hartford Hospital, Hartford, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Ling","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Connecticut School of Medicine, Farmington, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather Z","family":"Sankey","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, UMMS-Baystate, Springfield, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry R","family":"Kranzler","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Pennsylvania Perelman School of Medicine and Crescenz VAMC, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Thurlow","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Connecticut School of Medicine, Farmington, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,5,7]]},"reference":[{"key":"2020052609495935000_CIT0001","volume-title":"The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General","author":"U.S. Department of Health and Human Services","year":"2014"},{"issue":"1","key":"2020052609495935000_CIT0002","first-page":"1","article-title":"Smoking prevalence and cessation before and during pregnancy: data from the birth certificate, 2014","volume":"65","author":"Curtin","year":"2016","journal-title":"Natl Vital Stat Rep."},{"issue":"192","key":"2020052609495935000_CIT0003","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/978-3-540-69248-5_2","article-title":"Nicotine chemistry, metabolism, kinetics and biomarkers","author":"Benowitz","year":"2009","journal-title":"Handb. 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