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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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    • "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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    • "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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