Addressing tobacco use disorder in smokers in early remission from alcohol dependence: The case for integrating smoking cessation services in substance use disorder treatment programs

Department of Psychiatry, University of Massachusetts School of Medicine, Worcester, MA 01655, USA.
Clinical psychology review (Impact Factor: 7.18). 09/2009; 30(1):12-24. DOI: 10.1016/j.cpr.2009.08.009
Source: PubMed

ABSTRACT Despite the declining overall rate of cigarette smoking in the general population in the United States, the prevalence of smoking is estimated to be as high as 80% among treatment-seeking alcoholics. The serious adverse health effects of tobacco and heavy alcohol use are synergistic and recent evidence suggests that smoking slows the process of cognitive recovery following alcohol abstinence. In addition, substantial evidence shows that treatment for tobacco dependence does not jeopardize alcohol abstinence. In this paper, we focus on the impact and treatment implications of tobacco dependence among treatment-seeking alcoholics through a review of five areas of research. We begin with brief reviews of two areas of research: studies investigating the genetic and neurobiological vulnerability of comorbid tobacco and alcohol dependence and studies investigating the consequences of comorbid dependence on neurobiological and cognitive functioning. We then review literature on the effects of smoking cessation on drinking urges and alcohol use and the effectiveness of smoking cessation interventions with alcoholic smokers. Finally, we offer recommendations for research with an emphasis on clinical research for enhancing smoking cessation outcomes in this population.

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    • "Also other mood disorders like dysthymia and anxiety disorders have been found to be associated with smoking (Degenhardt et al., 2001; Cuijpers et al., 2007), physical inactivity (Barbour et al., 2007; NICE, 2011a), heavy drinking (King et al., 1993; Marquenie et al., 2007; NICE, 2011a) and unhealthy diet (Jacka et al., 2010, 2012). Further, smoking is related to alcohol as well as drug use disorders (Cuijpers et al., 2007; Kalman et al., 2010; NICE, 2011b). "
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    ABSTRACT: Health risk behaviours tend to co-occur and are found to be related to mental health symptoms. This is the first study to identify health behaviour clusters in relation to mental disorders.
    Journal of Affective Disorders 09/2014; 171C:111-119. DOI:10.1016/j.jad.2014.09.031 · 3.71 Impact Factor
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    • "Interestingly, among those who used tobacco regularly, alcohol use was not associated with dental fear. The high prevalence of tobacco use among people with hazardous, harmful or alcohol-dependent alcohol use [10,33] and dental fear [5] might affect the association between alcohol use and dental fear. As tobacco- and alcohol use [10,33] and tobacco use and dental fear are associated [5], tobacco use could mediate the effect of alcohol use disorder on dental fear. "
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    ABSTRACT: Background: Tobacco- and alcohol use are associated with psychological problems. Individuals with high dental fear also more often report other psychological problems than do those with lower level of dental fear. We evaluated the association between dental fear and tobacco- and alcohol use while controlling for age, gender, general mood and feelings in social situations. Methods: The data (n = 8514) were collected from all universities in Finland with an electronic inquiry sent to all first-year university students. Dental fear was measured with the question: "How afraid are you of visiting a dentist?" with reply alternatives "Not at all", "Somewhat" and "Very". Regularity of tobacco use was determined with the question: "Do you smoke or use snuff?", with reply alternatives "Not at all", "Occasionally" and "Daily". The Alcohol Use Disorders Identification Test (AUDIT) was used for determination of alcohol use; an AUDIT sum score of 8 or more indicated hazardous, harmful or dependent alcohol use. The statistical tests used were Chi-square tests and Multiple logistic regression analyses. Results: When controlled for age, gender, alcohol use, general mood and feelings in social situations, those who used tobacco regularly were more likely to have high dental fear than were those who used tobacco occasionally or not at all. When controlled for age, gender, general mood and feelings in social situations, those with hazardous, harmful or dependent alcohol use were more likely to have high dental fear than were those with low-risk of alcohol use, the association between alcohol use and dental fear was not strong. When tobacco use was added into this model, alcohol use was no longer statistically significantly associated with dental fear. Conclusions: The findings of this study support the suggestion that some people may have common vulnerability factors linked to tobacco use, alcohol use, and dental fear.
    BMC Oral Health 07/2014; 14:86. DOI:10.1186/1472-6831-14-86 · 1.15 Impact Factor
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    • "In general, Filipino, Japanese, Korean and multi-ethnic Asian Americans had high rates of binge drinking or alcohol-related problems compared to Chinese Americans (Chang et al., 2008; Lum et al., 2009; Maxwell et al., 2012). Among the psychosocial factors affecting alcohol use, smoking has been well known for its strong association with alcohol use (see a review by Kalman et al., 2010). College students who had ever smoked cigarettes reported consuming significantly more drinks per occasion as compared to those who had never smoked (Reed et al., 2007). "
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