Smoking cessation and alcohol abstinence: What do the data tell us?

Department of Psychiatry, Boston University, Boston, Massachusetts, United States
Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism (Impact Factor: 0.58). 02/2006; 29(3):208-12.
Source: PubMed


Cigarette smoking and nicotine dependence commonly co-occur with alcohol dependence. However, treatment for tobacco dependence is not routinely included in alcohol treatment programs, largely because of concerns that addressing both addictions concurrently would be too difficult for patients and would adversely affect recovery from alcoholism. To the contrary, research shows that smoking cessation does not disrupt alcohol abstinence and may actually enhance the likelihood of longer-term sobriety. Smokers in alcohol treatment or recovery face particular challenges regarding smoking cessation. Researchers and clinicians should take these circumstances into account when determining how best to treat these patients' tobacco dependence.

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Available from: Suzy Bird Gulliver, Apr 09, 2014
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    • "This would imply that the beneficial effect of drinking cessation is higher among smokers than non-smokers. The other side of this issue is that drinking cessation has a tendency to lead to smoking cessation [33]. As the current dose-risk estimation was based on summarised data, it was not possible to account for either of these issues in the current study. "
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    ABSTRACT: In the Bagnardi et al. (2001) meta-analysis, it was found that alcohol consumption increases the risk of stomach cancer (OR = 1.32 for heavy drinkers). However, it is unknown if drinking cessation reverses this alcohol-elevated risk. A systematic literature review was performed to provide the information for a meta-analysis where the dose-risk trend was estimated for years since drinking cessation and the risk of stomach cancer. A random effect generalised least squares model for trend estimation was used, employing study characteristics to control for heterogeneity. Nineteen observational studies were identified in the literature review, of which five studies quantified duration of cessation and risk of stomach cancer, giving a total of 1947 cancer cases. No significant effect of drinking cessation on the risk of stomach cancer could be found (OR = 0.99 CI: 0.97-1.02). This result should be interpreted with caution due to the limited number of studies in this area. Recent findings suggest a link between heavy drinking and stomach cancer, especially gastric noncardia, but not for moderate drinking. Since all but one of the included studies in this meta-analysis failed to control for consumption level, the current study could not test if the risk decline following drinking cessation differs between moderate and high consumers.
    Full-text · Article · Jun 2013 · BMC Public Health
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    • "Our analysis showed that heterosexual women and men were more likely to smoke than gay/bisexual men, which conflicts with documented higher smoking prevalence among LGB individuals (Ryan et al. 2001) and more specifically , gay and bisexual men, as compared to heterosexuals (American Lung Association 2010; Greenwood et al. 2005; New York State Department of Health 2007). This finding may be confounded by the greater proportion of heterosexual men (69 %) and women (52 %) that reported being " in recovery " as compared to gay/bisexual men (32 %; p<.001) as individuals with substance use disorders or those in substance use recovery or treatment report high rates of tobacco use (Gulliver et al. 2006; Kalman 1998; Kalman et al. 2005; Prochaska et al. 2004). Or, this finding may be attributable to confounding with regard to socioeconomic disparity across the gender/orientation analytic groups we used in analyses (Hiscock et al. 2012; New York State Department of Health 2007). "
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    ABSTRACT: The prevalence of HIV among adults 50 and older in the USA is increasing as a result of improvements in treatment and detection of HIV infection. Substance use by this population has implications for physical and mental health outcomes. We examined patterns of demographics, mental health, and recent substance use in a diverse sample of heterosexual, bisexual, and gay adults 50 and older living with HIV/AIDS (PLWHA) in New York City. The most commonly used substances were cigarettes or alcohol; however, the majority of the sample did not report recent use of marijuana, poppers, or hard drugs (crystal methamphetamine, cocaine, crack, heroin, ecstasy, GHB, ketamine, and LSD or PCP). Statistically significant associations between substance use and psychological states (well-being and loneliness) were generally weak, and depression scores were not significantly related to use; instead, drug use was associated with gender/sexual orientation. The study observations support addressing substance use specific to subpopulations within PLWHA.
    Full-text · Article · Feb 2013 · Prevention Science
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    • "In fact, tobacco smoking exhibits almost no harmful short-term consequences but most alcoholics die due to tobacco related long-term consequences (Hurt et al., 1996). Another myth is that smoking cessation is suggested to impede alcohol sobriety (Gulliver et al., 2006). However, literature predominantly concludes that there are no negative effects of smoking interventions for threatening abstinence (Cooney et al., 2007; Hurt et al., 1994; Metz et al., 2005a; Please cite this article in press as: Mueller, S.E., et al., Cognitive behavioral smoking cessation during alcohol detoxification treatment: A randomized, controlled trial. "
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    ABSTRACT: Background: Among alcohol-dependent subjects tobacco smoking is very common and causes a variety of health risks. Therefore, it is necessary to reach this high-risk population early with appropriate smoking interventions. Methods: Smokers in alcohol detoxification treatment were offered to participate in a smoking cessation study. A total of 103 patients was enrolled and randomly assigned to either the experimental group (EG) receiving a cognitive behavioral smoking cessation treatment (CBT) or the control group (CG) receiving autogenic training. Smoking outcomes were measured by self-report and carbon monoxide levels, directly after intervention and 6 months later, where additionally alcohol outcomes were recorded. Results: There were no differences in smoking quit rates directly after intervention. However, patients in the EG were significantly more likely to reduce their daily cigarette use compared to CG (p=.046). Sub-group analyses revealed that heavy smokers (FTND score ≥ 7) seemed to profit most in the EG regarding cigarette reduction. After 6 months, these positive effects had leveled out. No evidence was found that smoking cessation might jeopardize alcohol outcomes. Conclusions: Results suggest that alcohol-dependent smokers are interested in smoking interventions even during alcohol detoxification. CBT is promising in short-term smoking outcomes and in the approach of harm reduction, however, long-term effects are desirable. These findings underline the feasibility and the importance to provide smoking cessation interventions to patients in alcohol detoxification treatments.
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