Evaluation of the effects of rivastigmine on cigarette smoking by methamphetamine-dependent volunteers

Compared to smokers alone, smokers with co-morbid substance use disorders are at greater risk of suffering from smoking-related death. Despite this, relatively few studies have examined smoking cessation treatments for those with stimulant dependence. In the current study, we sought to evaluate the effects produced by short-term exposure to the cholinesterase inhibitor rivastigmine (0, 3 or 6. mg) on cigarette smoking in non-treatment-seeking, methamphetamine-dependent volunteers. This was a double-blind, placebo-controlled, crossover study that took place over 9. days. The data indicate that rivastigmine treatment did not alter Fagerström Test for Nicotine Dependence scores, carbon monoxide readings, or cigarettes smoked per day, but a trend toward reduced urges to smoke (p< 0.09) was detected during treatment with rivastigmine 3. mg. These data, while preliminary, indicate that cholinesterase inhibitors warrant consideration as treatments for nicotine dependence, including use in stimulant-dependent individuals who exhibit significantly higher rates of smoking than the general population.