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Wong BKC, Veldhuizen S, Minian N, Zawertailo L, Selby P. The effects of alcohol use on smoking cessation treatment with nicotine replacement therapy: An observational study. Addict Behav 2024; 155:108045. [PMID: 38692071 DOI: 10.1016/j.addbeh.2024.108045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/10/2024] [Accepted: 04/26/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION Concurrent users of tobacco and alcohol are at greater risk of harm than use of either substance alone. It remains unclear how concurrent tobacco and alcohol use affects smoking cessation across levels of alcohol use and related problems. This study assessed the relationship between smoking cessation and levels of alcohol use problems. METHODS 59,018 participants received nicotine replacement therapy through a smoking cessation program. Alcohol use and related symptoms were assessed using the Alcohol Use Disorders Identification Test (AUDIT-10) and the AUDIT-Concise (AUDIT-C). The primary outcome was 7-day point prevalence cigarette abstinence (PPA) at 6-month follow-up. We evaluated the association between alcohol use (and related problems) and smoking cessation using descriptive methods and mixed-effects logistic regression. RESULTS 7-day PPA at 6-months was lower in groups meeting hazardous alcohol consumption criteria, with the lowest probability of smoking abstinence observed in the highest risk group. The probability of successful tobacco cessation fell with increasing levels of alcohol use and related problems. Adjusted predicted probabilities were 30.3 (95 % CI = 29.4, 31.1) for non-users, 30.2 (95 % CI = 29.4, 31.0) for low-risk users, 29.0 (95 % CI = 28.1, 29.9) for those scoring below 8 on the AUDIT-10, 27.3 (95 % CI = 26.0, 28.6) for those scoring 8-14, and 24.4 (95 % CI = 22.3, 26.5) for those scoring 15 or higher. CONCLUSION Heavy, hazardous alcohol use is associated with lower odds of successfully quitting smoking compared to low or non-use of alcohol. Targeting alcohol treatment to this group may improve tobacco cessation outcomes.
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Affiliation(s)
- Benjamin K C Wong
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Scott Veldhuizen
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Laurie Zawertailo
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Pengpid S, Peltzer K. Tobacco use and heavy episodic drinking among persons aged 18-69 years in Bolivia in 2019. Public Health 2024; 233:8-14. [PMID: 38810508 DOI: 10.1016/j.puhe.2024.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/01/2024] [Accepted: 04/29/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVES The aim of this study was to estimate the prevalence and sociodemographic factors associated with tobacco use and heavy episodic drinking (TUHED), current tobacco use only (TU), and current heavy episodic drinking only (HED) among people 18-69 years in Bolivia in 2019. STUDY DESIGN Cross-sectional study. METHODS The analysis used cross-sectional data from Bolivia's STEPS 2019 survey; 4472 individuals answered questions about substance use and socio-demographic information. RESULTS The sample included 50.2% women and 49.8% men, 52.1% had secondary or higher education, 48.6% were Mestizo and 28.0% Quechua. The prevalence of TUHD was 6.0% (10.5% for men, 1.6% for women), TU 12.2% (20.0% for men, 4.4% for women), and HED 11.2% (13.4% for men and 9.1% for women). Male sex increased the risk of TU, HED and TUHED and belonging to the Amara ethnic group decreased the risk of TU and TUHED. Higher education was increased the odds of HED and among women of TUHED. Urban residence increased the risk of TUHED and among women of HED. For women, unemployment was associated with TU and marriage or cohabitation was inversely associated with TU, and for men, belonging to another ethnic group (such as Castellano or Tacana) increased the risk of TU and TUHED. CONCLUSION More than 10% of the general adult population in Bolivia participated in TU and HED, and among men in TUHED. Various factors associated with the different categories of substance use were identified.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Psychology, University of the Free State, Bloemfontein, South Africa; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Gelino BW, Reed DD, Spindle TR, Amlung M, Strickland JC. Association of electronic nicotine delivery system (ENDS) and cigarette solo and dual use with alcohol-related consequences among US adults. Addict Behav 2023; 146:107806. [PMID: 37473614 PMCID: PMC10528670 DOI: 10.1016/j.addbeh.2023.107806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Research reports a robust association between combustible cigarette use and alcohol use frequency and severity. Extension to the emerging landscape of electronic nicotine delivery system (ENDS) use is needed to inform prevention and treatment strategies. METHOD We evaluated data from the 2020 National Survey on Drug Use and Health (NSDUH). Respondents included adults reporting cigarettes or ENDS solo or dual use. Multivariable logistic regression models evaluated associations with alcohol use disorder (AUD) and alcohol-related risky behavior (i.e., heavy drinking, binge alcohol use, and driving after drinking) compared to never use controls and respondents with a history, but not current, use of cigarettes or ENDS. RESULTS Multivariable models showed greater odds of AUD for respondents with dual ENDS and cigarette use (AOR = 10.2), ENDS use (AOR = 6.27), cigarette use (AOR = 4.45), and a history, but not ongoing, use (AOR = 2.60) relative to respondents with no use history. Similarly, respondents with dual use (AOR = 3.94), ENDS use (AOR = 2.41), and cigarette use (AOR = 1.71) had greater odds of AUD relative to those with a history of, but not ongoing, use. The association between dual use and AUD was greater for adults ages 21-25 (AOR = 16.2) than for adults over 25 (AOR = 7.82). Cigarette and ENDS solo and dual-use were similarly associated with greater odds of alcohol-related risky behavior relative to control groups. CONCLUSION These findings demonstrate that nicotine use and dual use may be associated with indicators of problematic drinking. These results offer insight into emerging licit polysubstance profiles and call for mechanistic research to inform prevention and intervention efforts.
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Affiliation(s)
- Brett W Gelino
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Tory R Spindle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Michael Amlung
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US.
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Sun R, Mendez D, Warner KE. The Association Between Cannabis Use and Subsequent Nicotine Electronic Cigarette Use Among US Adolescents. J Adolesc Health 2023; 73:133-140. [PMID: 37031094 DOI: 10.1016/j.jadohealth.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/01/2023] [Accepted: 02/06/2023] [Indexed: 04/10/2023]
Abstract
PURPOSE The current study assessed the association between cannabis use among youth never e-cigarette users and subsequent e-cigarette use. METHODS The Population Assessment of Tobacco and Health Study is a nationally representative cohort study. Participants aged 12 years and older were selected using a 4-stage, stratified probability sample design from the US civilian, noninstitutionalized population. We included adolescents who participated in both wave 4.5 (2017-2018) and wave 5 (2018-2019) of Population Assessment of Tobacco and Health, and were never e-cigarette users at baseline (N = 9,925). Through multivariable logistic regressions, we examined the prospective association between cannabis use and subsequent e-cigarette use. RESULTS E-cigarette use at wave five was significantly more common among youth cannabis users at wave 4.5. The adjusted relative risks between ever cannabis use and subsequent past 12-month, past 30-day, and frequent e-cigarette use (≥20 days per month) were 1.53 (95% CI, 1.26-1.81), 1.70 (95% CI, 1.25-2.15), and 2.10 (95% CI, 1.17-3.03), respectively. The adjusted relative risks between past 30-day cannabis use and subsequent past 12-month, past 30-day, and frequent e-cigarette use were 1.54 (95% CI, 1.04-2.28), 2.01 (95% CI, 1.23-3.29), and 2.87 (95% CI, 1.44-5.71), respectively. We also found significant associations between ever cannabis vaping with subsequent e-cigarette use. DISCUSSION While previous research associates e-cigarette use with subsequent onset of cannabis use, we identify a reverse directional effect, where adolescent cannabis use is associated with increased likelihood of future e-cigarette use.
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Affiliation(s)
- Ruoyan Sun
- Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
| | - David Mendez
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Kenneth E Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Lal A, Mohebi M, White SL, Scollo M, McCaffrey N. Household expenditure of smokers and ex-smokers across socioeconomic groups: results from a large nationwide Australian longitudinal survey. BMC Public Health 2022; 22:1706. [PMID: 36076210 PMCID: PMC9461138 DOI: 10.1186/s12889-022-14083-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Countries with best practice tobacco control measures have experienced significant reductions in smoking prevalence, but socioeconomic inequalities remain. Spending on tobacco products, particularly by low-income groups can negatively affect expenditure on other goods and services. This study aims to compare the household expenditure of adults who smoke tobacco products and those who formerly smoked across socioeconomic groups. METHODS Daily smokers and ex-smokers were compared using the Household, Income and Labour Dynamics in Australia Survey, over 7 waves. Adults who never smoked were not included. Participants were continuing sample members across waves. Mean number of participants per wave was 2505, 25% were smokers and 75% ex-smokers. The expenditure variables investigated included tobacco products, alcohol, motor vehicle fuel, health practitioners, insurance, education, and meals eaten out. Regression models using the generalized estimating equation technique were employed to compare expenditure data aggregated across the waves by Socioeconomic Index for Areas (SEIFA) quintiles of relative socio-economic advantage/disadvantage while accounting for within-participant autocorrelation. Quintiles are ranked by information such as the income, occupation and access to material and social resources of the residents. RESULTS Smokers from all quintiles spent significantly less per year on meals out, education and insurance than ex-smokers (p < 0.001). Smokers from quintiles 2-5 spent less on groceries, medicines, and health practitioners (p < 0.01). Smokers from quintiles 1 and 2 (most disadvantaged), spent less on motor vehicle fuel than ex-smokers ($280;95%CI: $126-$434), ($213;95%CI: $82-$344). Smokers from quintiles 2 and 3 spent more on alcohol ($212;95%CI: $86-$339), ($231.8;95%CI: $94-$370) than ex-smokers. Smokers from the least disadvantaged groups spent less on clothing than ex-smokers ($348;95%CI: $476-$221), ($501; 95%CI: $743-$258). Across the whole sample, smokers spent more than ex-smokers on alcohol ($230;95%CI:$95-$365) and less on meals out ($361;95%CI:$216-$379), groceries ($529;95%CI:$277-$781), education ($456;95%CI:$288-$624), medicine ($71;95%CI:$38-$104), health practitioners ($345;95%CI:$245-$444) and insurance ($318;95%CI:$229-$407). CONCLUSIONS Smoking cessation leads to reallocation of spending across all socioeconomic groups, which could have positive impacts on households and their local communities. Less spending on alcohol by ex-smokers across the whole sample could indicate a joint health improvement associated with smoking cessation.
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Affiliation(s)
- Anita Lal
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Mohammadreza Mohebi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
| | | | - Michelle Scollo
- Quit, Cancer Council Victoria, Melbourne, Australia
- Cancer Council Victoria, Melbourne, Australia
| | - Nikki McCaffrey
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
- Cancer Council Victoria, Melbourne, Australia
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Venegas A, Du H, Cooper ZD, Ray LA. Cannabis and alcohol co-use: the effects of intensity of cannabis use among heavy drinkers. Addict Behav 2022; 135:107443. [DOI: 10.1016/j.addbeh.2022.107443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/04/2022] [Accepted: 07/23/2022] [Indexed: 11/15/2022]
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Parks MJ, Maggs JL, Patrick ME. Daily fluctuations in drinking intensity: Links with vaping and combustible use of nicotine and marijuana. Drug Alcohol Depend 2022; 233:109347. [PMID: 35219999 PMCID: PMC8957603 DOI: 10.1016/j.drugalcdep.2022.109347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Whether alcohol use intensity on a given day is linked with nicotine or marijuana use that same day is not well known, nor are links of drinking intensity with different modes of nicotine and marijuana use. This study examined these within-person links across 14 days in a national sample of young adults (YAs). METHODS Past 30-day drinkers participating in the U.S. nationally representative Monitoring the Future study of 12th graders in 2018, who also reported alcohol use during a 14-day data collection one year later in the Young Adult Daily Life Study in 2019, were included (N = 487). Weighted multilevel modeling estimated within- and between-person associations of drinking intensity with cigarette smoking, nicotine vaping, marijuana smoking, and marijuana vaping. RESULTS Within-person fluctuations in drinking intensity on a given day were associated with cigarette smoking, nicotine vaping, and marijuana smoking, but not marijuana vaping. There were significant between-person associations of means of drinking intensity and each outcome, except for cigarette smoking. CONCLUSION Drinking intensity on a given day was associated with multiple modes of nicotine use and marijuana smoking that day. Nicotine and marijuana use remain critical areas of concern for public health, and future research and interventions should consider the comorbidity of drinking intensity and multiple modes of nicotine and marijuana use. Focusing on the same-day use of alcohol may provide a tailored avenue for preventing and reducing nicotine and marijuana emerging trends among YAs.
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Affiliation(s)
- Michael J Parks
- Center for Applied Research and Educational Improvement, University of Minnesota, 1954 Buford Ave, St. Paul MN 55108, USA.
| | - Jennifer L Maggs
- Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Moore JR, Castro Y, Cubbin C, von Sternberg K. Associations of At-Risk Drinking, Current Smoking, and Their Co-Occurrence With Primary Care Service Utilization. Am J Health Promot 2022; 36:429-439. [PMID: 34865517 PMCID: PMC10409595 DOI: 10.1177/08901171211056130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Smoking and at-risk drinking are each associated with lower primary care utilization, but the influence of their co-occurrence is not known. The current study compared associations of endorsement of one behavior vs endorsement of both with primary care utilization. DESIGN Cross-sectional telephone survey. SETTING All United States and Territories. SUBJECTS 246 801 adults aged 18-64. MEASURES The outcome was endorsement of attending a past-year primary care visit. Predictor variables included drinking and smoking status examined individually and combined. ANALYSIS Multivariable logistic regressions, adjusted for socio-demographics and number of chronic health conditions. RESULTS The odds of attending a past-year primary care visit were 24% lower for persons who drank at risk levels compared to the odds of persons who did not drink and 36% lower for persons who smoked vs those who did not smoke. Among persons who endorsed at least one risk behavior, the odds of attending a past-year primary care visit were 25-35% lower for those who engaged in multiple behaviors compared to the odds of persons who engaged in one behavior. CONCLUSION Substance use screening and intervention services in primary care may not be reaching individuals with the greatest need for services. Proactive outreach and identification of primary care utilization barriers are needed, with special consideration of those with co-occurring substance use.
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Affiliation(s)
- John R. Moore
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Kirk von Sternberg
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
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Green R, Lin J, Montoya AK, Bello MS, Grodin EN, Ryu H, Ho D, Leventhal AM, Ray LA. Characteristics associated with treatment seeking for smoking cessation among heavy-drinking research participants. Front Psychiatry 2022; 13:951364. [PMID: 36245856 PMCID: PMC9554538 DOI: 10.3389/fpsyt.2022.951364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/25/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Treatment seeking for smoking cessation has tremendous clinical implications with the potential to reduce tobacco-related morbidity and mortality. The present study seeks to elucidate clinical variables that distinguish treatment seeking versus non-treatment seeking status for smoking cessation in a large sample of heavy drinking smokers using data-driven methods. MATERIALS AND METHODS This secondary data analysis examines n = 911 (n = 267 female) individuals who were daily smokers and heavy drinkers (≥ 7 drinks per week for women, ≥ 14 for men) that were enrolled in either a treatment-seeking study (N = 450) or a non-treatment seeking study (N = 461) using identical pharmacotherapies. Participants completed measures of demographics, alcohol and cigarette use, alcohol craving, the Barratt Impulsiveness Scale (BIS-11), and the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68). These measures were used in a random forest model to identify predictors of treatment seeking status. RESULTS The top variables of importance in identifying treatment seeking status were: age, drinks per drinking day, cigarettes per smoking day, BIS-11 cognitive impulsivity, WISDM social environmental goads, WISDM loss of control, WISDM craving, and WISDM tolerance. Age and drinks per drinking day were two of the most robust predictors, followed by measures of nicotine craving and tolerance. CONCLUSION Individuals who are daily smokers and consume more drinks per drinking day are less likely to belong to the smoking cessationtreatment-seeking group. Targeting heavy drinking smokers, particularly younger individuals, may be necessary to engage this group in smoking cessation efforts and to reduce the burden of disease of nicotine dependence earlier in the lifespan.
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Affiliation(s)
- ReJoyce Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Johnny Lin
- Institute for Digital Research and Education, University of California, Los Angeles, Los Angeles, CA, United States
| | - Amanda K Montoya
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mariel S Bello
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Erica N Grodin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Howon Ryu
- Institute for Digital Research and Education, University of California, Los Angeles, Los Angeles, CA, United States
| | - Diana Ho
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States.,Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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Yonek JC, Meacham MC, Shumway M, Tolou-Shams M, Satre DD. Smoking reduction is associated with lower alcohol consumption and depressive symptoms among young adults over one year. Drug Alcohol Depend 2021; 227:108922. [PMID: 34364192 PMCID: PMC8906192 DOI: 10.1016/j.drugalcdep.2021.108922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/22/2021] [Accepted: 07/06/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND This secondary analysis examined whether smoking reduction among young adults participating in a Facebook-based smoking cessation intervention study was associated with corresponding reductions in alcohol consumption and depressive symptoms. METHODS Participants were young adults who smoked and engaged in heavy episodic drinking (HED). Alcohol consumption (AUDIT-C, days of HED), depressive symptoms (PHQ-2), and past-month cigarettes per day (CPD) were self-reported at baseline and 12 months (N = 150). Linear regression estimated the relationship between the mean change in CPD and mean changes in alcohol consumption and depressive symptoms. RESULTS CPD, alcohol consumption, and depressive symptoms decreased significantly between baseline and 12 months. The adjusted mean reduction in CPD was significantly associated with mean reductions in AUDIT-C (Beta [β] = 0.09, 95 % confidence interval [CI] = 0.04-0.14), days of HED (β = 0.17, 95 % CI = 0.04-0.29) and PHQ-2 (β = 0.05, 95 % CI = 0.01-0.08). Smoking abstinence (n = 48) was associated with a significantly larger mean reduction in AUDIT-C compared to a ≥50 % reduction (n = 45) (-2.9 vs -1.7 points, p = 0.03) or <50 % reduction in CPD (n = 57) (-2.9 vs -1.1 points, p < 0.01). The mean reduction in AUDIT-C did not differ between a ≥50 % reduction and <50 % reduction in CPD (-1.7 vs.-1.1 points, p = 0.18). Mean reductions in days of HED and the PHQ-2 did not differ according to the level of reduction in CPD. CONCLUSION Smoking reduction was associated with reductions in alcohol consumption and depressive symptoms. Reductions appeared to be greater for those who achieved abstinence compared to a reduction in smoking.
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Affiliation(s)
- Juliet C. Yonek
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California at San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA,Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Avenue, San Francisco, CA 94110, USA,Corresponding author at: Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Avenue, Building 5, 7M15, San Francisco, CA 94110, USA. (J.C. Yonek)
| | - Meredith C. Meacham
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California at San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA
| | - Martha Shumway
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California at San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA; Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California at San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA; Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
| | - Derek D. Satre
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California at San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA,Division of Research, Kaiser Permanente Northern California Region, 2000 Broadway, Oakland, CA 94612, USA
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King A, Fucito L. Cigarette Smoking and Heavy Alcohol Drinking: The Challenges and Opportunities for Combination Treatments. Am J Psychiatry 2021; 178:783-785. [PMID: 34516230 DOI: 10.1176/appi.ajp.2021.21070692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Andrea King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (King); Department of Psychiatry, Yale University, Yale Cancer Center, and Smilow Cancer Hospital at Yale-New Haven, New Haven, Conn. (Fucito)
| | - Lisa Fucito
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (King); Department of Psychiatry, Yale University, Yale Cancer Center, and Smilow Cancer Hospital at Yale-New Haven, New Haven, Conn. (Fucito)
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12
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Ray LA, Green R, Enders C, Leventhal AM, Grodin EN, Li G, Lim A, Hartwell E, Venegas A, Meredith L, Nieto SJ, Shoptaw S, Ho D, Miotto K. Efficacy of Combining Varenicline and Naltrexone for Smoking Cessation and Drinking Reduction: A Randomized Clinical Trial. Am J Psychiatry 2021; 178:818-828. [PMID: 34080890 PMCID: PMC8999864 DOI: 10.1176/appi.ajp.2020.20070993] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Pharmacological treatments that can concomitantly address cigarette smoking and heavy drinking stand to improve health care delivery for these highly prevalent co-occurring conditions. This superiority trial compared the combination of varenicline and naltrexone against varenicline alone for smoking cessation and drinking reduction among heavy-drinking smokers. METHODS This was a phase 2 randomized double-blind clinical trial. Participants (N=165) who were daily smokers and drank heavily received either 2 mg/day of varenicline plus 50 mg/day of naltrexone or 2 mg/day of varenicline plus matched placebo pills for 12 weeks. Primary outcomes were 7-day point prevalence of nicotine abstinence (bioverified by a breath CO reading ≤5 ppm) at the 26-week follow-up and number of drinks per drinking day during the 12-week treatment phase. RESULTS Smoking abstinence at week 26 was significantly higher in the varenicline plus placebo condition than in the varenicline plus naltrexone condition (N=37 [45.1%] compared with N=22 [26.5%]). For drinks per drinking day, there was a medication effect favoring the combination of varenicline and naltrexone over varenicline alone across the 12-week treatment phase, although it did not meet the significance threshold. CONCLUSIONS These findings suggest that smoking cessation and drinking reduction can be concomitantly targeted with pharmacotherapy and that while varenicline alone may be sufficient as a smoking cessation aid in heavy-drinking smokers, the combination of varenicline and naltrexone may confer benefits with regard to drinking outcomes, particularly during the 12-week period of active medication treatment.
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Affiliation(s)
- Lara A. Ray
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - ReJoyce Green
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Craig Enders
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Adam M. Leventhal
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Erica N. Grodin
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Gang Li
- Department of Biostatistics, University of California at Los Angeles, Los Angeles, CA
| | - Aaron Lim
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Emily Hartwell
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Alex Venegas
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Lindsay Meredith
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Steven J. Nieto
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Steven Shoptaw
- Department of Family Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Diana Ho
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Karen Miotto
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
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13
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Grodin EN, Burnette EM, Green R, Lim AC, Miotto K, Ray LA. Combined varenicline and naltrexone attenuates alcohol cue-elicited activation in heavy drinking smokers. Drug Alcohol Depend 2021; 225:108825. [PMID: 34175784 PMCID: PMC9059649 DOI: 10.1016/j.drugalcdep.2021.108825] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is a strong bidirectional relationship between the use of alcohol and cigarettes which results in various challenges for treating those who co-use both substances. While varenicline and naltrexone each have FDA-approval for nicotine and alcohol use disorder, respectively, there is evidence that their clinical benefit may extend across the two disorders. Critically, the effect of combined varenicline and naltrexone on neural reactivity to alcohol cues among heavy drinking smokers has not yet been studied. Probing the effect of the combination therapy on alcohol cue-reactivity may give insight to the mechanisms underlying its efficacy. METHODS Forty-seven heavy drinking smokers enrolled in two medication studies were randomized to receive varenicline alone (n = 11), varenicline plus naltrexone (n = 11), or placebo (n = 25). Participants completed an fMRI alcohol cue-reactivity task and rated their in-scanner alcohol craving. Whole-brain analyses examined the effect of medication on alcohol cue-elicited neural response. RESULTS Varenicline plus naltrexone attenuated alcohol cue-elicited activation in mesolimbic regions relative to varenicline alone and to placebo (Z > 2.3, p < 0.05). The combination varenicline and naltrexone group also endorsed lower in-scanner alcohol craving relative to varenicline alone group (p = 0.04). CONCLUSIONS These findings provide evidence for the benefit of combined therapy of varenicline and naltrexone over varenicline alone for the attenuation of alcohol cue-elicited neural activation. This study provides a preliminary proof-of-mechanism for this combination pharmacotherapy and suggests that naltrexone may be driving the reductions in cue-elicited alcohol craving in the brain. Further clinical studies using the combined therapy to treat heavy drinking smokers are warranted.
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Affiliation(s)
- Erica N. Grodin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Elizabeth M. Burnette
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States,Neuroscience Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - ReJoyce Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Aaron C. Lim
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Karen Miotto
- Neuroscience Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, United States,Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, United States,Corresponding author at: University of California, Los Angeles, Psychology Department, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States. (L.A. Ray)
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14
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Siegel SD, Brooks M, Ragozine-Bush HE, Schnoll RA, Curriero FC. The co-occurrence of smoking and alcohol use disorder in a hospital-based population: Applying a multimorbidity framework using geographic information system methods. Addict Behav 2021; 118:106883. [PMID: 33714034 DOI: 10.1016/j.addbeh.2021.106883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 11/27/2022]
Abstract
Tobacco and alcohol use are leading causes of premature mortality in the US and concurrent use is associated with even greater health risks. A cross-sectional study of 20,310 patients admitted to a Mid-Atlantic acute health care system between July 1, 2018 and June 30, 2019 were categorized according to smoking and alcohol use disorder (AUD) status. Of the total admissions, 1464 (7.2%) were current smokers with an AUD. These patients were younger (52.4 vs. 63.9), more likely to be male (64.1% vs. 38.0%) and covered by Medicaid (46.9% vs. 11.6%), and resided in proximity to higher counts of tobacco (10.3 vs. 4.72) and alcohol (2.24 vs. 1.14) retailers than never smokers without an AUD. Clinically, these patients had higher rates of other substance use disorders (60.4% vs. 6.1%), depression (64.6% vs. 34.8%), HIV/AIDS (3.3% vs. 0.6%), and liver disease (40.7% vs. 13.2%) than never smokers without an AUD. Patients who concurrently smoke and have an AUD face unique and serious health risks. A multimorbidity framework can guide clinical and community-based interventions for individuals with concurrent psychiatric and chronic medical conditions, complex social needs, and adverse environmental exposures.
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Affiliation(s)
- Scott D Siegel
- Value Institute, Christiana Care Health System, USA; Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, USA.
| | | | | | - Robert A Schnoll
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, USA
| | - Frank C Curriero
- Johns Hopkins Spatial Science for Public Health Center, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA
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15
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Hemenway M, Witkiewitz K, Unrod M, Brandon KO, Brandon TH, Wetter DW, Sutton SK, Vinci C. Development of a mindfulness-based treatment for smoking cessation and the modification of alcohol use: A protocol for a randomized controlled trial and pilot study findings. Contemp Clin Trials 2021; 100:106218. [PMID: 33197610 PMCID: PMC7887009 DOI: 10.1016/j.cct.2020.106218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 02/06/2023]
Abstract
The combined use of cigarettes and alcohol is associated with an increased risk of morbidity and mortality. Yet, efficacious interventions that address both behaviors concurrently are lacking. Smoking cessation and alcohol modification not only garner health benefits, but there is also value in addressing alcohol use in the context of smoking cessation to reduce the risk for smoking relapse. In this paper we describe the development of mindfulness-based relapse prevention for smoking cessation and alcohol modification (MBRP-SA) and pilot study findings (Phase 1). Next, details regarding the methods and design of an ongoing, randomized controlled trial, Project RISE (Phase 2), are described. MBRP-SA is a group-based intervention that consists of eight weekly treatment sessions. Results from the Phase 1 pilot study (N = 21 enrolled) indicated that participants planned to use the skills learned in their everyday activities and to address their smoking and alcohol goals. Based on the progression of Phase 1 cohorts, modifications were made to the inclusion/exclusion criteria and recruitment methods that will be implemented in Phase 2. Phase 2 will assess the feasibility and acceptability of MBRP-SA, delivered via live online groups, as a primary treatment option for smoking cessation and alcohol use modification.
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Affiliation(s)
| | | | | | | | | | | | - Steven K Sutton
- Moffitt Cancer Center, USA; University of South Florida, USA
| | - Christine Vinci
- Moffitt Cancer Center, USA; University of South Florida, USA.
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16
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An integrated behavioural intervention combined with varenicline for heavy-drinking smokers: a randomized pilot study. J Smok Cessat 2020; 15:119-127. [PMID: 33312238 DOI: 10.1017/jsc.2020.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives Combined smoking and heavy drinking is a significant health burden. Varenicline, an efficacious tobacco pharmacotherapy that also shows promise for drinking, has yielded mixed results among heavy-drinking smokers. This pilot study investigated integrated tobacco and alcohol counselling plus varenicline for this vulnerable group. Design Twelve-week parallel, randomized controlled pilot trial of two behavioural interventions in combination with open-label varenicline. Participants were randomized using computer-generated tables, stratified by sex. Setting Outpatient academic medical centre research clinic. Participants Volunteers who reported smoking and heavy drinking and sought tobacco or alcohol treatment (N = 26). Intervention. (1) Integrated tobacco + alcohol counselling (INT; n = 13) or (2) counselling focused on their presenting concern (i.e., tobacco or alcohol) (SINGLE; n = 13), plus varenicline (2 mg) for 12 weeks. Main outcomes Feasibility/acceptability, smoking quit rates and heavy drinking. Results INT feasibility/acceptability was high among men but not women. More participants quit smoking in INT than SINGLE. This outcome was only in men, not significant, but had a medium effect size. Both conditions yielded significant drinking reductions. Conclusion Integrated tobacco and alcohol behavioural counselling plus varenicline may be feasible and promote smoking cessation among men who smoke and drink heavily, but a larger sample is needed to replicate this finding.
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17
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McClure EA, Baker NL, Hood CO, Tomko RL, Squeglia LM, Flanagan JC, Carpenter MJ, Gray KM. Cannabis and Alcohol Co-Use in a Smoking Cessation Pharmacotherapy Trial for Adolescents and Emerging Adults. Nicotine Tob Res 2020; 22:1374-1382. [PMID: 31612956 DOI: 10.1093/ntr/ntz170] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/02/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The co-use of cannabis and alcohol among tobacco-using youth is common. Alcohol co-use is associated with worse tobacco cessation outcomes, but results are mixed regarding the impact of cannabis on tobacco outcomes and if co-use leads to increased use of non-treated substances. This secondary analysis from a youth smoking cessation trial aimed to (1) evaluate the impact of cannabis or alcohol co-use on smoking cessation, (2) examine changes in co-use during the trial, and (3) explore secondary effects of varenicline on co-use. METHODS The parent study was a 12-week, randomized clinical trial of varenicline for smoking cessation among youth (ages 14-21, N = 157; Mage = 19, 40% female; 76% White). Daily cigarette, cannabis, and alcohol use data were collected via daily diaries during treatment and Timeline Follow-back for 14 weeks post-treatment. RESULTS Baseline cannabis co-users (68%) had double the odds of continued cigarette smoking throughout the trial compared with noncannabis users, which was pronounced in males and frequent cannabis users. Continued smoking during treatment was associated with higher probability of concurrent cannabis use. Baseline alcohol co-users (80%) did not have worse smoking outcomes compared with nonalcohol users, but continued smoking was associated with higher probability of concurrent drinking. Varenicline did not affect co-use. CONCLUSIONS Inconsistent with prior literature, results showed that alcohol co-users did not differ in smoking cessation, whereas cannabis co-users had poorer cessation outcomes. Youth tobacco treatment would benefit from added focus on substance co-use, particularly cannabis, but may need to be tailored appropriately to promote cessation. IMPLICATIONS Among youth cigarette smokers enrolled in a pharmacotherapy evaluation clinical trial, alcohol and/or cannabis co-use was prevalent. The co-use of cannabis affected smoking cessation outcomes, but more so for males and frequent cannabis users, whereas alcohol co-use did not affect smoking cessation. Reductions in smoking were accompanied by concurrent reductions in alcohol or cannabis use. Substance co-use does not appear to affect all youth smokers in the same manner and treatment strategies may need to be tailored appropriately for those with lower odds of smoking cessation.
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Affiliation(s)
- Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Caitlyn O Hood
- Department of Psychology, University of Kentucky, Lexington, KY
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Julianne C Flanagan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
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18
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Kaye JT, Johnson AL, Baker TB, Piper ME, Cook JW. Searching for Personalized Medicine for Binge Drinking Smokers: Smoking Cessation Using Varenicline, Nicotine Patch, or Combination Nicotine Replacement Therapy. J Stud Alcohol Drugs 2020; 81:426-435. [PMID: 32800078 PMCID: PMC7437557 DOI: 10.15288/jsad.2020.81.426] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 02/26/2020] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE Heavy drinking is common among smokers and is associated with especially poor health outcomes. Varenicline may affect mechanisms and clinical outcomes that are relevant for both smoking cessation and alcohol use. The current study examines whether varenicline, relative to nicotine replacement therapy, yields better smoking cessation outcomes among binge drinking smokers. METHOD Secondary data analyses of a comparative effectiveness randomized controlled trial of three smoking cessation pharmacotherapies (12 weeks of varenicline, nicotine patch, or nicotine patch and lozenge) paired with six counseling sessions were conducted. Adult daily cigarette smokers (N = 1,078, 52% female) reported patterns of alcohol use, cigarette craving, and alcohol-related cigarette craving at baseline and over 4 weeks after quitting. Smoking cessation outcome was 7-day biochemically confirmed point-prevalence abstinence. RESULTS Binge drinkers had higher relapse rates than moderate drinkers at 4-week post-target quit day but not at the end of treatment or long-term follow up (12 and 26 weeks). Varenicline did not yield superior smoking cessation outcomes among binge drinkers, nor did it affect alcohol use early in the quit attempt. Varenicline did produce relatively large reductions in alcohol-related cigarette craving and overall cigarette craving during the first 4 weeks after quitting. CONCLUSIONS Varenicline did not yield higher smoking abstinence rates or reduce alcohol use among binge drinkers. Varenicline did reduce alcohol-related cigarette craving but this did not translate to meaningful differences in smoking abstinence. Varenicline's effects on smoking abstinence do not appear to vary significantly as a function of drinking status.
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Affiliation(s)
- Jesse T. Kaye
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health (UW-CTRI), Madison, Wisconsin
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Adrienne L. Johnson
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health (UW-CTRI), Madison, Wisconsin
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Timothy B. Baker
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health (UW-CTRI), Madison, Wisconsin
| | - Megan E. Piper
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health (UW-CTRI), Madison, Wisconsin
| | - Jessica W. Cook
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health (UW-CTRI), Madison, Wisconsin
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
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19
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Roche DJO, Bujarski S, Green R, Hartwell EE, Leventhal AM, Ray LA. Alcohol, tobacco, and marijuana consumption is associated with increased odds of same-day substance co- and tri-use. Drug Alcohol Depend 2019; 200:40-49. [PMID: 31085377 PMCID: PMC6675401 DOI: 10.1016/j.drugalcdep.2019.02.035] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 02/07/2019] [Accepted: 02/09/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Little is known about event-level patterns of marijuana co- or tri-use with alcohol and tobacco. Thus, the study goal was to examine patterns of same-day alcohol, cigarette, and marijuana co- and tri-use at the individual level in non-treatment-seeking alcohol users. METHODS Participants (N = 551) completed an in-person interview for alcohol, cigarette, and marijuana use over the previous 30 days, and the event-level substance use patterns of n = 179 participants who reported using each of these substances at least once per month were analyzed. RESULTS The use of alcohol, marijuana, or cigarettes independently increased the probability of subsequent, simultaneous co-use of one of the two remaining substances. The co-use of alcohol with cigarettes and marijuana with cigarettes produced generally additive effects on the odds of same day tri-use of marijuana and alcohol, respectively. Conversely, the co-use of alcohol and marijuana produced sub-additive effects on likelihood of cigarette use. Sex moderated several of the observed patterns of co- and tri-use: the relationship between alcohol or cigarette use predicting marijuana co-use was stronger in men, whereas the observed additive relationships between drug co-use leading to tri-use was stronger in women. CONCLUSIONS The presented results may aid in the understanding of how simultaneous co-use of marijuana with alcohol and/or tobacco relates to the etiology, maintenance, and treatment of comorbid and trimorbid substance use disorder. Replication and extension of the results in treatment seeking populations using more fine-grained analysis approaches, e.g. ecological momentary assessment, is needed.
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Affiliation(s)
- D J O Roche
- Department of Psychiatry, University of Maryland, Baltimore, MD, USA
| | - S Bujarski
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - R Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - E E Hartwell
- Mental Illness Research, Education and Clinical Center, Corporal Michael J Crescenz VA Medical Center, Philadelphia, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - A M Leventhal
- Departments of Preventive Medicine and Psychpology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - L A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
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20
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Roche DJO, Trela CJ, Argos M, Jasmine F, Kibriya MG, Ahsan H, King AC. Lack of Association between Opioid-Receptor Genotypes and Smoking Cessation Outcomes in a Randomized, Controlled Naltrexone Trial. Alcohol Alcohol 2019; 54:559-565. [PMID: 31206155 PMCID: PMC7963143 DOI: 10.1093/alcalc/agz046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 05/08/2019] [Accepted: 05/18/2019] [Indexed: 02/01/2023] Open
Abstract
AIMS The present study examined how variation in mu- (OPRM1), kappa- (OPRK), and delta- (OPRD) opioid receptor genes may influence the efficacy of naltrexone in the context of a smoking cessation trial. METHODS The study's primary objective was to examine the association of the Asn40Asp OPRM1 single nucleotide polymorphism (SNP) with naltrexone's effects on smoking quit rate, weight gain, and heavy drinking behavior during a double-blind, randomized clinical trial in 280 adult DSM-IV nicotine-dependent participants. The secondary goal of the study was to examine the relationship of 20 additional SNPs of OPRM1, OPRK, and OPRD with the aforementioned outcomes. RESULTS Results indicated a null association between any opioid-receptor gene SNP and naltrexone's effects on smoking quit rate, weight gain, and heavy drinking behavior in this sample of nicotine dependent participants. CONCLUSIONS In sum, these results do not suggest that genetic variation in opioid-receptors is related to treatment responses to naltrexone in a smoking cessation trial.
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Affiliation(s)
- Daniel J O Roche
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Constantine J Trela
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA
| | - Farzana Jasmine
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA
- Department of Public Health Studies, University of Chicago, Chicago, IL 60637, USA
| | - Muhammad G Kibriya
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA
| | - Habibul Ahsan
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA
| | - Andrea C King
- Department of Psychiatry and Behavioral Sciences, University of Chicago, Chicago, IL 60637, USA
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21
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Weinberger AH, Pacek LR, Giovenco D, Galea S, Zvolensky MJ, Gbedemah M, Goodwin RD. Cigarette Use Among Individuals with Alcohol Use Disorders in the United States, 2002 to 2016: Trends Overall and by Race/Ethnicity. Alcohol Clin Exp Res 2018; 43:79-90. [PMID: 30408209 DOI: 10.1111/acer.13922] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/12/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Individuals with alcohol use disorders (AUDs) who smoke cigarettes experience greater health risks than those using either substance alone. Further, disparities exist in AUDs and smoking by race/ethnicity. Although smoking has declined in the general population, it is not known whether the smoking prevalence has changed over time for individuals with AUDs. The current study used representative U.S. data to estimate the prevalence of current cigarette use from 2002 to 2016 by AUD status and severity overall and by race/ethnicity. METHODS Data were drawn from the National Survey on Drug Use and Health, an annual cross-sectional study of U.S. individuals, from 2002 to 2016 (total analytic sample n = 837,326). Cigarette smoking prevalence was calculated annually among those with and without past-year AUD and by AUD severity level (mild, moderate, severe AUD). Time trends in smoking prevalence by AUD status and severity were tested using logistic regression for the overall sample and significant interactions were subsequently stratified by race/ethnicity (non-Hispanic [NH] White, NH Black, Hispanic, NH Other). RESULTS Cigarette use was persistently over twice as common among those with AUDs compared to without AUDs (2016: 37.84% vs. 16.29%). Cigarette use was also more common among those at each level of AUD severity criteria (2016: mild AUD 34.59%; moderate AUD 35.35%; severe AUD 52.23%). Approximately half of NH Black respondents with AUDs, and three-quarters of NH Black respondents with severe AUDs, reported smoking in 2016. The prevalence of smoking decreased significantly over time among respondents with and without AUDs; however, there were differences by race. There was no decline in smoking prevalence among NH Black respondents with AUDs over time in contrast to a significant decrease for every other racial/ethnic group with and without AUDs. CONCLUSIONS Individuals with AUDs may need additional resources and interventions to quit smoking, especially NH Black individuals.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology , Yeshiva University, Bronx, New York.,Department of Epidemiology & Population Health , Albert Einstein College of Medicine, Bronx, New York
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences , Duke University School of Medicine, Durham, North Carolina
| | - Daniel Giovenco
- Department of Sociomedical Sciences , Mailman School of Public Health, Columbia University, New York, New York
| | - Sandro Galea
- Department of Epidemiology , Boston University School of Public Health, Boston, Massachusetts
| | | | - Misato Gbedemah
- Department of Epidemiology and Biostatistics , Graduate School of Public Health and Health Policy, The City University of New York, New York, New York.,Institute for Implementation Science in Population Health , The City University of New York, New York, New York
| | - Renee D Goodwin
- Department of Epidemiology and Biostatistics , Graduate School of Public Health and Health Policy, The City University of New York, New York, New York.,Institute for Implementation Science in Population Health , The City University of New York, New York, New York.,Department of Epidemiology , Mailman School of Public Health, Columbia University, New York, New York
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22
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An improved model of ethanol and nicotine co-use in female P rats: Effects of naltrexone, varenicline, and the selective nicotinic α6β2* antagonist r-bPiDI. Drug Alcohol Depend 2018; 193:154-161. [PMID: 30384323 PMCID: PMC6239925 DOI: 10.1016/j.drugalcdep.2018.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 12/17/2022]
Abstract
Background Although pharmacotherapies are available for alcohol (EtOH) or tobacco use disorders individually, it may be possible to develop a single pharmacotherapy to treat heavy drinking tobacco smokers by capitalizing on the commonalities in their mechanisms of action. Methods Female alcohol-preferring (P) rats were trained for EtOH drinking and nicotine self-administration in two phases: (1) EtOH alone (0 vs. 15% EtOH, 2-bottle choice) and (2) concomitant access, during which EtOH access continued with access to nicotine (0.03 mg/kg/infusion, i.v.) using a 2-lever choice procedure (active vs. inactive lever) in which the fixed ratio (FR) requirement was gradually increased to FR30. When stable co-use was obtained, rats were pretreated with varying doses of naltrexone, varenicline, or r-bPiDI, an α6β2* subtype-selective nicotinic acetylcholine receptor antagonist shown previously to reduce nicotine self-administration. Results While EtOH intake was initially suppressed in phase 2 (co-use), pharmacologically relevant intake for both substances was achieved by raising the "price" of nicotine to FR30. In phase 2, naltrexone decreased EtOH and water consumption but not nicotine intake; in contrast, naltrexone in phase 1 (EtOH only) did not significantly alter EtOH intake. Varenicline and r-bPiDI in phase 2 both decreased nicotine self-administration and inactive lever pressing, but neither altered EtOH or water consumption. Conclusions These results indicate that increasing the "price" of nicotine increases EtOH intake during co-use. Additionally, the efficacy of naltrexone, varenicline, and r-bPiDI was specific to either EtOH or nicotine, with no efficacy for co-use. Nevertheless, future studies on combining these treatments may reveal synergistic efficacy.
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Lim AC, Roche DJO, Ray LA. Distress Tolerance and Craving for Cigarettes Among Heavy Drinking Smokers. J Stud Alcohol Drugs 2018; 79:918-928. [PMID: 30573023 PMCID: PMC6308171 DOI: 10.15288/jsad.2018.79.918] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 07/23/2018] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Heavy drinking smokers experience significant difficulties with smoking cessation. Craving is closely tied to relapses during cessation attempts, and alcohol consumption increases cigarette craving among heavy drinking smokers. To date, however, few moderators of the relationship between craving and relapse have been identified. Individuals' capacity for distress tolerance predicts smoking cessation outcomes and may be connected to craving. Relatedly, pharmacotherapies like varenicline and naltrexone reduce cigarette and alcohol cravings, respectively. No studies have examined the interrelationships among distress tolerance, craving, and pharmacotherapy effects. This study therefore examines distress tolerance as a moderator of the relationship between overnight abstinence-induced cigarette craving and subsequent alcohol- and cigarette-induced changes in craving among heavy drinking smokers. This study also examines the impact of varenicline and naltrexone on these relationships. METHOD A total of 120 non-treatment-seeking heavy drinking smokers were randomized and titrated to one of the following conditions: (a) placebo, (b) varenicline, (c) naltrexone, or (d) varenicline + naltrexone. Participants then completed a laboratory paradigm after overnight abstinence that included consumption of alcohol (target .06 g/dl breath alcohol concentration) and one cigarette. Craving was assessed as abstinence-induced (Time 1), alcohol-induced (Time 2), and cigarette-induced (Time 3). RESULTS Within varenicline + naltrexone, low distress tolerance individuals exhibited higher increases from abstinence- to alcohol-induced cigarette craving relative to high distress tolerance individuals. Across medications, low distress tolerance individuals reported flatter decreases from abstinence- to cigarette-induced cigarette craving relative to high distress tolerance individuals. CONCLUSIONS Distress tolerance may differentially predict alcohol-induced cigarette craving when titrated to pharmacotherapy, as well as moderate decreases in craving after cigarette consumption. Future exploration of the identified interactive effects could elucidate specific conditions in which cravings are more proximally related to abstinence-induced smoking.
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Affiliation(s)
- Aaron C Lim
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Daniel J O Roche
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
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24
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Lim AC, Roche DJO, Ray LA. Distress Tolerance and Craving for Cigarettes Among Heavy Drinking Smokers. J Stud Alcohol Drugs 2018; 79:918-928. [PMID: 30573023 PMCID: PMC6308171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE Heavy drinking smokers experience significant difficulties with smoking cessation. Craving is closely tied to relapses during cessation attempts, and alcohol consumption increases cigarette craving among heavy drinking smokers. To date, however, few moderators of the relationship between craving and relapse have been identified. Individuals' capacity for distress tolerance predicts smoking cessation outcomes and may be connected to craving. Relatedly, pharmacotherapies like varenicline and naltrexone reduce cigarette and alcohol cravings, respectively. No studies have examined the interrelationships among distress tolerance, craving, and pharmacotherapy effects. This study therefore examines distress tolerance as a moderator of the relationship between overnight abstinence-induced cigarette craving and subsequent alcohol- and cigarette-induced changes in craving among heavy drinking smokers. This study also examines the impact of varenicline and naltrexone on these relationships. METHOD A total of 120 non-treatment-seeking heavy drinking smokers were randomized and titrated to one of the following conditions: (a) placebo, (b) varenicline, (c) naltrexone, or (d) varenicline + naltrexone. Participants then completed a laboratory paradigm after overnight abstinence that included consumption of alcohol (target .06 g/dl breath alcohol concentration) and one cigarette. Craving was assessed as abstinence-induced (Time 1), alcohol-induced (Time 2), and cigarette-induced (Time 3). RESULTS Within varenicline + naltrexone, low distress tolerance individuals exhibited higher increases from abstinence- to alcohol-induced cigarette craving relative to high distress tolerance individuals. Across medications, low distress tolerance individuals reported flatter decreases from abstinence- to cigarette-induced cigarette craving relative to high distress tolerance individuals. CONCLUSIONS Distress tolerance may differentially predict alcohol-induced cigarette craving when titrated to pharmacotherapy, as well as moderate decreases in craving after cigarette consumption. Future exploration of the identified interactive effects could elucidate specific conditions in which cravings are more proximally related to abstinence-induced smoking.
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Affiliation(s)
- Aaron C Lim
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Daniel J O Roche
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, California.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
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25
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Maggio SE, Saunders MA, Baxter TA, Nixon K, Prendergast MA, Zheng G, Crooks P, Dwoskin LP, Slack RD, Newman AH, Bell RL, Bardo MT. Effects of the nicotinic agonist varenicline, nicotinic antagonist r-bPiDI, and DAT inhibitor (R)-modafinil on co-use of ethanol and nicotine in female P rats. Psychopharmacology (Berl) 2018; 235:1439-1453. [PMID: 29455292 PMCID: PMC6058964 DOI: 10.1007/s00213-018-4853-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 02/06/2018] [Indexed: 12/26/2022]
Abstract
RATIONALE Co-users of alcohol and nicotine are the largest group of polysubstance users worldwide. Commonalities in mechanisms of action for ethanol (EtOH) and nicotine proposes the possibility of developing a single pharmacotherapeutic to treat co-use. OBJECTIVES Toward developing a preclinical model of co-use, female alcohol-preferring (P) rats were trained for voluntary EtOH drinking and i.v. nicotine self-administration in three phases: (1) EtOH alone (0 vs. 15%, two-bottle choice), (2) nicotine alone (0.03 mg/kg/infusion, active vs. inactive lever), and (3) concurrent access to both EtOH and nicotine. Using this model, we examined the effects of (1) varenicline, a nicotinic acetylcholine receptor (nAChR) partial agonist with high affinity for the α4β2* subtype; (2) r-bPiDI, a subtype-selective antagonist at α6β2* nAChRs; and (3) (R)-modafinil, an atypical inhibitor of the dopamine transporter (DAT). RESULTS In phases 1 and 2, pharmacologically relevant intake of EtOH and nicotine was achieved. In the concurrent access phase (phase 3), EtOH consumption decreased while nicotine intake increased relative to phases 1 and 2. For drug pretreatments, in the EtOH access phase (phase 1), (R)-modafinil (100 mg/kg) decreased EtOH consumption, with no effect on water consumption. In the concurrent access phase, varenicline (3 mg/kg), r-bPiDI (20 mg/kg), and (R)-modafinil (100 mg/kg) decreased nicotine self-administration but did not alter EtOH consumption, water consumption, or inactive lever pressing. CONCLUSIONS These results indicate that therapeutics which may be useful for smoking cessation via selective inhibition of α4β2* or α6β2* nAChRs, or DAT inhibition, may not be sufficient to treat EtOH and nicotine co-use.
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Affiliation(s)
- Sarah E Maggio
- Department of Psychology, University of Kentucky, Lexington, KY, 40536, USA
| | | | - Thomas A Baxter
- Department of Psychology, University of Kentucky, Lexington, KY, 40536, USA
| | - Kimberly Nixon
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, KY, 40536, USA
| | - Mark A Prendergast
- Department of Psychology, University of Kentucky, Lexington, KY, 40536, USA
| | - Guangrong Zheng
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas, Little Rock, AR, 72205, USA
| | - Peter Crooks
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas, Little Rock, AR, 72205, USA
| | - Linda P Dwoskin
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, KY, 40536, USA
| | - Rachel D Slack
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse-Intramural Research Program, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Amy H Newman
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse-Intramural Research Program, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Richard L Bell
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Michael T Bardo
- Department of Psychology, University of Kentucky, Lexington, KY, 40536, USA.
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26
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Holahan CJ, Brennan PL, Schutte KK, Holahan CK, Hixon JG, Moos RH. Drinking Level Versus Drinking Pattern and Cigarette Smoking Among Older Adults. Alcohol Clin Exp Res 2018; 42:795-802. [PMID: 29417610 DOI: 10.1111/acer.13607] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 01/30/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND There is a lack of research on the role of alcohol consumption in cigarette smoking among older adults, and the few studies on alcohol use and smoking with older adults have failed to distinguish between average level and pattern of drinking as predictors of smoking. The main purpose of this study was to examine the independent contributions of average level versus pattern of drinking as predictors of cigarette smoking among older adults. A subsidiary purpose was to examine the link between continued smoking and mortality among older smokers. METHODS We investigated average level and pattern of drinking as predictors of current smoking among 1,151 older adults at baseline and of continued smoking and mortality among the subset of 276 baseline smokers tracked across 20 years. We used multiple linear and logistic regression analyses and, to test mediation, bias-corrected bootstrap confidence intervals. RESULTS A high level of average drinking and a pattern of episodic heavy drinking were concurrently associated with smoking at baseline. However, only episodic heavy drinking was prospectively linked to continued smoking among baseline smokers. Continued smoking among baseline smokers increased the odds of 20-year mortality and provided an indirect pathway through which heavy episodic drinking related to mortality. CONCLUSIONS Smokers who misuse alcohol are a challenging population for smoking cessation efforts. Older adults who concurrently misuse alcohol and smoke cigarettes provide a unique target for public health interventions.
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Affiliation(s)
- Charles J Holahan
- Department of Psychology , University of Texas at Austin, Austin, Texas
| | - Penny L Brennan
- Institute for Health and Aging , University of California, San Francisco, San Francisco, California
| | - Kathleen K Schutte
- Center for Health Care Evaluation , VA Palo Alto Health Care System, Palo Alto, California
| | - Carole K Holahan
- Department of Kinesiology and Health Education , University of Texas at Austin, Austin, Texas
| | - J Gregory Hixon
- Department of Psychology , University of Texas at Austin, Austin, Texas
| | - Rudolf H Moos
- Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine, Stanford, California
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27
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Kritsotakis G, Konstantinidis T, Androulaki Z, Rizou E, Asprogeraka EM, Pitsouni V. The relationship between smoking and convivial, intimate and negative coping alcohol consumption in young adults. J Clin Nurs 2017; 27:2710-2718. [DOI: 10.1111/jocn.13889] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2017] [Indexed: 02/04/2023]
Affiliation(s)
- George Kritsotakis
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Theocharis Konstantinidis
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Zacharenia Androulaki
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Efthymia Rizou
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Eleni Maria Asprogeraka
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Vasiliki Pitsouni
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
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28
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Weinberger AH, Gbedemah M, Goodwin RD. Cigarette smoking quit rates among adults with and without alcohol use disorders and heavy alcohol use, 2002-2015: A representative sample of the United States population. Drug Alcohol Depend 2017; 180:204-207. [PMID: 28918239 PMCID: PMC5693304 DOI: 10.1016/j.drugalcdep.2017.07.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/09/2017] [Accepted: 07/15/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND While the overall smoking quit rate has increased over time, it is not known whether the quit rate has also increased among persons with alcohol use disorders (AUDs) or heavy alcohol use (HAU). The current study examined quit rates among adults with and without AUDs and HAU over a 12-year period in a representative sample of US adults. METHODS Data were drawn from the National Household Survey on Drug Use, an annual cross-sectional study of US persons. Quit rate (i.e., the rate of former smokers to ever smokers) was calculated annually from 2002 to 2014 (for HAU) and 2015 (for AUD). Time trends in quit rates by AUD/HAU status were tested using linear regression. RESULTS The prevalence of past-month cigarette smoking was much higher for persons with, compared to without, AUDs (38% vs. 18%) and HAU (49% vs. 19%). In the most recent data year, the quit rate for persons with AUDs was approximately half that of persons without AUDs (26% versus 49%) and for persons with HAU was less than half that of persons without HAU (22% versus 48%). Over time, the smoking quit rate increased for persons with and without AUDs/HAU and the rate of increase was greater for persons with AUDs/HAU. Yet, quit rates for persons with AUDs and HAU remained much lower than persons without AUDs and HAU. CONCLUSIONS It may be beneficial for public health and clinical efforts to incorporate screenings and treatment for tobacco use into programs for adults with AUDs and HAU.
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Affiliation(s)
- Andrea H. Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY 10461 USA,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461 USA
| | - Misato Gbedemah
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA.
| | - Renee D. Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY USA,Institute for Implementation Science and Population Health, CUNY School of Public Health and Health Policy, New York, NY USA,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
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29
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Durazzo TC, Meyerhoff DJ. Psychiatric, Demographic, and Brain Morphological Predictors of Relapse After Treatment for an Alcohol Use Disorder. Alcohol Clin Exp Res 2016; 41:107-116. [PMID: 27883214 DOI: 10.1111/acer.13267] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/14/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Relapse in alcohol use disorders (AUD) is related to a complex interplay among multiple biological, psychiatric, psychological, and psychosocial factors, which may change dynamically during and after treatment. At treatment entry for AUD, morphological abnormalities in anterior frontal regions and the insula have been observed in those who ultimately relapse following treatment. The goal of this study was to determine whether anterior frontal and insula measures of brain thickness, surface area, and volume predict posttreatment drinking status (i.e., relapser or abstainer) over an extended period after outpatient treatment for AUD, while concurrently considering common psychiatric, psychological, and psychosocial factors previously associated with relapse. METHODS Alcohol-dependent individuals (n = 129) were followed for 18 months after treatment to determine posttreatment drinking status (abstainers [n = 47] or relapsers [n = 82]). Brain morphometrics were derived from FreeSurfer. Receiver operating characteristic (ROC) curve analysis was used to identify the regional brain thickness, surface area, and volume (all scaled to intracranial volume), demographic, psychiatric, other substance use (e.g., cigarette smoking), and alcohol consumption variables, obtained at entry into treatment, that best predicted posttreatment drinking status. Survival analyses determined variables that were related to duration of abstinence after treatment. RESULTS ROC analyses indicated that mood disorders, education, and volumes of the right caudal anterior cingulate cortex (ACC), right rostral ACC, and total right frontal gray matter were significant predictors of posttreatment drinking status. Among relapsers, survival analyses showed smokers and individuals with a comorbid medical condition relapsed earlier after treatment. Additionally, a greater frequency of smokers relapsed within 6 months of AUD treatment. CONCLUSIONS Results reinforce that relapse in AUD is a function of multiple biological, psychiatric, psychological, and psychosocial factors. Effective treatment of depressive disorders and cigarette smoking concurrent with AUD-focused interventions may promote better treatment outcomes.
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Affiliation(s)
- Timothy C Durazzo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.,Mental Illness Research and Education Clinical Centers and Sierra-Pacific War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, California
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.,Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, San Francisco, California
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30
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Green R, Bujarski S, Roche DJO, Ray LA. Relationship between negative affect and smoking topography in heavy drinking smokers. Addict Behav 2016; 61:53-7. [PMID: 27240211 PMCID: PMC6090554 DOI: 10.1016/j.addbeh.2016.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 04/29/2016] [Accepted: 05/16/2016] [Indexed: 12/16/2022]
Abstract
Heavy drinking smokers represent a sizeable subgroup of smokers for whom nicotine deprivation and alcohol use increases the urge to smoke in the laboratory and predicts lapses during smoking cessation. The manner in which individuals smoke a cigarette (i.e. smoking topography) provides a reliable index of smoking intensity and reinforcement, yet the effects of affect on smoking topography have not been thoroughly examined in heavy drinking smokers. The current study examined how affect and nicotine deprivation predict smoking behavior as participants (N=27) smoked one cigarette using a smoking topography device after 12-h of nicotine abstinence and after a priming dose of alcohol (target BrAC=0.06g/dl). Primary smoking topography measures were puff volume, velocity, duration, and inter-puff interval (IPI). The effect of nicotine deprivation was measured by the Minnesota Nicotine Withdrawal Scale (MNWS) and the Profile of Mood States (POMS). Measures were obtained at baseline (i.e. 12-h of nicotine abstinence and pre-alcohol) and 30-minutes after alcohol administration (i.e. peak BrAC). Results revealed post-priming negative affect significantly moderated the trajectories of puff volume, puff duration and IPI (p's<0.05) over the course of the cigarette, such that those with greater negative affect had flatter slopes for volume and duration and increasingly infrequent puffs. Our results suggest that baseline and post-priming negative affect following nicotine deprivation alters smoking patterns and increases nicotine exposure throughout a single cigarette. Future studies need to examine differential amounts of nicotine deprivation on response to alcohol and smoking in heavy drinking smokers.
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Affiliation(s)
- ReJoyce Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Spencer Bujarski
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Daniel J O Roche
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, United States.
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31
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Kasten CR, Frazee AM, Boehm SL. Developing a model of limited-access nicotine consumption in C57Bl/6J mice. Pharmacol Biochem Behav 2016; 148:28-37. [PMID: 27242276 DOI: 10.1016/j.pbb.2016.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/26/2016] [Accepted: 05/26/2016] [Indexed: 01/31/2023]
Abstract
Although United States smoking rates have been on the decline over the past few decades, cigarette smoking still poses a critical health and economic threat. Very few treatment options for smoking exist, and many of them do not lead to long-term abstinence. Preclinical models are necessary for understanding the effects of nicotine and developing treatments. Current self-administration models of nicotine intake may require surgical procedures and often result in low levels of intake. Further, they do not lend themselves to investigating treatments. The current study sought to develop a limited-access model of nicotine intake using the Drinking-in-the-Dark paradigm, which results in high levels of binge-like ethanol consumption that can be pharmacologically manipulated. The present study found that mice will consume nicotine under a range of parameters. Intakes under the preferred condition of 0.14mg/ml nicotine in 0.2% saccharin reached over 6mg/kg in two hours and were reduced by an injection of R(+)-baclofen. Mecamylamine did not significantly affect nicotine consumption. As nicotine and ethanol are often co-abused, nicotine intake was also tested in the presence of ethanol. When presented in the same bottle, mice altered nicotine intake under various concentrations to maintain consistent levels of ethanol intake. When nicotine and ethanol were presented in separate bottles, mice greatly reduced their nicotine intake while maintaining ethanol intake. In conclusion, these studies characterize a novel model of limited-access nicotine intake that can be pharmacologically manipulated.
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Affiliation(s)
- C R Kasten
- Department of Psychology, Indianapolis University Purdue University - Indianapolis, 402 N Blackford St LD 124, Indianapolis, IN 46202, United States.
| | - A M Frazee
- Department of Psychology, Indianapolis University Purdue University - Indianapolis, 402 N Blackford St LD 124, Indianapolis, IN 46202, United States
| | - S L Boehm
- Department of Psychology, Indianapolis University Purdue University - Indianapolis, 402 N Blackford St LD 124, Indianapolis, IN 46202, United States; Indiana Alcohol Research Center, 545 Barnhill Drive EH 317, Indianapolis, IN, United States.
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