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Zvolensky MJ, Shepherd JM, Clausen BK, Redmond BY, Correa-Fernández V, Ditre JW. Combustible cigarette smokers versus e-cigarette dual users among Latinx individuals: Differences in alcohol and drug use severity. Exp Clin Psychopharmacol 2024; 32:197-206. [PMID: 37470998 PMCID: PMC10799193 DOI: 10.1037/pha0000673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
The Latinx population in the United States (U.S.) experiences significant tobacco and other substance use-related health disparities. Yet, little is known about the couse of combustible cigarettes and e-cigarettes (dual use) in relation to substance use behavior among Latinx smokers. The present investigation compared English-speaking Latinx adults living in the United States who exclusively smoke combustible cigarettes versus dual users in terms of alcohol use and other drug use problem severity. Participants were 297 Hispanic/Latinx daily cigarette smokers (36.4% female, Mage = 35.9 years, SD = 8.87) recruited nationally across the United States using Qualtrics Panels to complete self-report measures of behavioral health outcomes. Five analysis of covariance models were conducted to evaluate differences in overall alcohol consumption, dependence, related problems, hazardous drinking, and drug use problem severity between exclusive combustible cigarette smokers (N = 205) and dual users (N = 92). Results indicated that dual users evinced greater levels of alcohol consumption, dependence, alcohol-related problems, and hazardous drinking compared to exclusive combustible cigarette smokers (ps < .001). Dual users also reported greater levels of drug use problems relative to exclusive combustible cigarette smokers (p < .001). The current findings are among the first to document that dual cigarette and e-cigarette use status (compared to exclusive combustible cigarette smoking) may serve as a clinically relevant risk indicator for a range of deleterious substance use problems among Latinx individuals. Future research is needed to corroborate these findings and examine dual-use status as a longitudinal predictor of alcohol and other substance-related problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
- HEALTH Institute, University of Houston
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Krutz M, Acharya P, Elliott J, Zhao D, Mhawej R, Queimado L. Tobacco Cessation Following Laryngeal Cancer Diagnosis Predicts Response to Treatment and Laryngectomy-Free Survival. Otolaryngol Head Neck Surg 2024; 170:438-446. [PMID: 37890055 PMCID: PMC10872773 DOI: 10.1002/ohn.567] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/19/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE To determine the effect of tobacco cessation following laryngeal cancer diagnosis on response to first-line therapy, laryngectomy-free survival, and overall survival in patients who were current smokers at the time of diagnosis. STUDY DESIGN Retrospective, case-control study. SETTING OU Stephenson Cancer Center, National Cancer Institute-Designated Cancer Center. METHODS We included 140 patients diagnosed with laryngeal squamous cell carcinoma, who were current smokers at the time of diagnosis, and were treated with first-line definitive radiation or chemo/radiation with the intent to cure. The association between patient characteristics and treatment response was assessed using the χ2 test and logistic regression analysis. Survival outcomes were analyzed using Kaplan-Meier methods and Cox proportional-hazards models. RESULTS Of the 140 current smokers, 61 patients (45%) quit smoking prior to treatment initiation. In adjusted logistic regression analysis, quitters had 3.7 times higher odds of achieving a complete response to first-line therapy than active smokers (odds ratio: 3.694 [1.575-8.661]; P = .003). In the adjusted Cox proportional-hazards model, quitters were 54% less likely to require salvage laryngectomy within 7 years of diagnosis than active smokers (hazard ratio: 0.456 [0.246-0.848]; P = .013). Quitters had a statistically significant increase in 7-year overall survival compared to active smokers (P = .02). CONCLUSION This is the first study to show that in newly diagnosed laryngeal cancer patients who are current smokers at the time of diagnosis, tobacco cessation significantly increases therapy response, laryngectomy-free survival, and overall survival. These data stress the importance of systematically incorporating tobacco cessation programs into laryngeal cancer treatment plans.
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Affiliation(s)
- Matthew Krutz
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
| | - Pawan Acharya
- Department of Biostatistics & Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
| | - Jacey Elliott
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
| | - Daniel Zhao
- Department of Biostatistics & Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Rachad Mhawej
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
| | - Lurdes Queimado
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Cell Biology, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
- TSET Health Promotion Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Vander Weg MW, Howren MB, Grant KM, Prochazka AV, Duffy S, Burke R, Cretzmeyer M, Parker C, Thomas EBK, Rizk MT, Bayer J, Kinner EM, Clark JM, Katz DA. A smoking cessation intervention for rural veterans tailored to individual risk factors: A multicenter randomized clinical trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 156:209191. [PMID: 37866436 DOI: 10.1016/j.josat.2023.209191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/24/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Rates of cigarette use remain elevated among those living in rural areas. Depressive symptoms, risky alcohol use, and weight concerns frequently accompany cigarette smoking and may adversely affect quitting. Whether treatment for tobacco use that simultaneously addresses these issues affects cessation outcomes is uncertain. METHODS The study was a multicenter, two-group, randomized controlled trial involving mostly rural veterans who smoke (N = 358) receiving treatment at one of five Veterans Affairs Medical Centers. The study randomly assigned participants to a tailored telephone counseling intervention or referral to their state tobacco quitline. Both groups received guideline-recommended smoking cessation pharmacotherapy, selected using a shared decision-making approach. The primary outcome was self-reported seven-day point prevalence abstinence (PPA) at three and six months. The study used salivary cotinine to verify self-reported quitting at six months. RESULTS Self-reported PPA was significantly greater in participants assigned to Tailored Counseling at three (OR = 1.66; 95 % CI: 1.07-2.58) but not six (OR = 1.35; 95 % CI: 0.85-2.15) months. Post hoc subgroup analyses examining treatment group differences based on whether participants had a positive screen for elevated depressive symptoms, risky alcohol use, and/or concerns about weight gain indicated that the cessation benefit of Tailored Counseling at three months was limited to those with ≥1 accompanying concern (OR = 2.02, 95 % CI: 1.20-3.42). Biochemical verification suggested low rates of misreporting. CONCLUSIONS A tailored smoking cessation intervention addressing concomitant risk factors enhanced short-term abstinence but did not significantly improve long-term quitting. Extending the duration of treatment may be necessary to sustain treatment effects.
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Affiliation(s)
- Mark W Vander Weg
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, United States of America; Department of Community and Behavioral Health, University of Iowa College of Public Health, United States of America; Department of Internal Medicine, University of Iowa Carver College of Medicine, United States of America; Department of Psychological and Brain Sciences, University of Iowa, United States of America; VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, United States of America.
| | - M Bryant Howren
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, United States of America; Department of Behavioral Sciences and Social Medicine, Florida State University, United States of America; Florida Blue Center for Rural Health Research & Policy, United States of America
| | - Kathleen M Grant
- VA Nebraska-Western Iowa Health Care System, United States of America; University of Nebraska Medical Center Department of Medicine, United States of America
| | - Allan V Prochazka
- Primary Care, VA Eastern Colorado Health Care System, United States of America; Denver Seattle Center for Veteran-centric Value-based Research (DiSCoVVR), United States of America
| | - Sonia Duffy
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, United States of America; College of Nursing, Ohio State University, United States of America
| | - Randy Burke
- Mental Health Service, G.V. (Sonny) Montgomery VA Medical Center, United States of America; Department of Psychiatry, University of Mississippi School of Medicine, United States of America
| | | | - Christopher Parker
- Department of Pharmacy Practice and Science, University of Iowa College of Pharmacy, United States of America
| | - Emily B K Thomas
- Department of Psychological and Brain Sciences, University of Iowa, United States of America
| | | | - Jennifer Bayer
- Department of Psychological and Brain Sciences, University of Iowa, United States of America
| | - Ellen M Kinner
- Department of Psychological and Brain Sciences, University of Iowa, United States of America
| | - Jennifer M Clark
- Department of Neurology, University of Iowa, Carver College of Medicine, United States of America
| | - David A Katz
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, United States of America; Department of Internal Medicine, University of Iowa Carver College of Medicine, United States of America; Department of Epidemiology, University of Iowa College of Public Health, United States of America
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Liu C, Yong HH, Gravely S, East K, Kasza K, Gartner C, Cummings KM, Fong GT. Gender differences in cigarette smoking cessation attempts among adults who smoke and drink alcohol at high levels: Findings from the 2018-2020 International Tobacco Control Four Country Smoking and Vaping Surveys. Addict Behav 2023; 147:107817. [PMID: 37536221 PMCID: PMC10866688 DOI: 10.1016/j.addbeh.2023.107817] [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: 03/21/2023] [Revised: 07/16/2023] [Accepted: 07/27/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND This study examined the association between alcohol consumption and smoking cessation behaviour of adults who smoke in four countries. METHODS Data came from 4275 adults (≥18 years) who smoked tobacco ≥ monthly and participated in the 2018 and 2020 International Tobacco Control Four Country Smoking and Vaping Surveys (Australia: n = 720; Canada: n = 1250; US: n = 1011; England: n = 1294). The 2018 Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) survey data coded into three levels ('never/low', 'moderate' or 'heavy' consumption) were analysed using multivariable logistic regression models to predict any smoking cessation attempts and successful cessation by 2020 survey, and whether this differed by gender and country. RESULTS Compared to never/low alcohol consumers, only those who drink heavily were less likely to have made a quit smoking attempt (40.4 % vs. 43.8 %; AOR = 0.69, 95 % CI = 0.57-0.83, p < .001). The association differed by gender and country (3-way interaction, p < .001), with females who drink heavily being less likely to attempt to quit smoking in England (AOR = 0.27, 95 % CI = 0.15-0.49, p < .001) and Australia (AOR = 0.38, 95 % CI = 0.19-0.77, p = .008), but for males, those who drink moderately (AOR = 2.18, 95 % CI = 1.17-4.06, p = .014) or heavily (AOR = 2.61, 95 % CI = 1.45-4.68, p = .001) were more likely to make a quit attempt in England only. Alcohol consumption did not predict quit success. CONCLUSION Heavy alcohol use among adults who smoke appears to only undermine the likelihood of trying to quit smoking with some variation by gender and country of residence, but not their chances of succeeding if they tried.
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Affiliation(s)
- Chenyang Liu
- School of Psychology, Deakin University, Geelong, Victoria, Australia.
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Geelong, Victoria, Australia.
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
| | - Katherine East
- National Addiction Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Karin Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
| | - Coral Gartner
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada; Ontario Institute for Cancer Research, Toronto, Ontario M5G 0A3, Canada.
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Probst L, Monnerat S, Vogt DR, Lengsfeld S, Burkard T, Meienberg A, Bathelt C, Christ-Crain M, Winzeler B. Effects of dulaglutide on alcohol consumption during smoking cessation. JCI Insight 2023; 8:e170419. [PMID: 37991022 PMCID: PMC10721313 DOI: 10.1172/jci.insight.170419] [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: 03/28/2023] [Accepted: 10/04/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUNDAlcohol use disorder has a detrimental impact on global health and new treatment targets are needed. Preclinical studies show attenuating effects of glucagon-like peptide-1 (GLP-1) agonists on addiction-related behaviors in rodents and nonhuman primates. Some trials have shown an effect of GLP-1 agonism on reward processes in humans; however, results from clinical studies remain inconclusive.METHODSThis is a predefined secondary analysis of a double-blind, randomized, placebo-controlled trial evaluating the GLP-1 agonist dulaglutide as a therapy for smoking cessation. The main objective was to assess differences in alcohol consumption after 12 weeks of treatment with dulaglutide compared to placebo. The effect of dulaglutide on alcohol consumption was analyzed using a multivariable generalized linear model.RESULTSIn the primary analysis, participants out of the cohort (n = 255) who reported drinking alcohol at baseline and who completed 12 weeks of treatment (n = 151; placebo n = 75, dulaglutide n = 76) were included. The median age was 42 (IQR 33-53) with 61% (n = 92) females. At week 12, participants receiving dulaglutide drank 29% less (relative effect = 0.71, 95% CI 0.52-0.97, P = 0.04) than participants receiving placebo. Changes in alcohol consumption were not correlated with smoking status at week 12.CONCLUSIONThese results provide evidence that dulaglutide reduces alcohol intake in humans and contribute to the growing body of literature promoting the use of GLP-1 agonists in treatment of substance use disorders.TRIAL REGISTRATIONClinicalTrials.gov NCT03204396.FUNDINGSwiss National Foundation, Gottfried Julia Bangerter-Rhyner Foundation, Goldschmidt-Jacobson Foundation, Hemmi Foundation, University of Basel, University Hospital Basel, Swiss Academy of Medical Science.
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Affiliation(s)
- Leila Probst
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Sophie Monnerat
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Deborah R. Vogt
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Sophia Lengsfeld
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Thilo Burkard
- Department of Cardiology, and
- Medical Outpatient Department, University Hospital Basel, Basel, Switzerland
| | - Andrea Meienberg
- Department of Cardiology, and
- Medical Outpatient Department, University Hospital Basel, Basel, Switzerland
| | - Cemile Bathelt
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Mirjam Christ-Crain
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Bettina Winzeler
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
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Osibogun O, Erinoso O, Gautam P, Bursac Z, Osibogun A. Marijuana use modifies the association between heavy alcohol consumption and tobacco use patterns among US adults: Findings from Behavioral Risk Factor Surveillance System, 2020. Addict Behav 2022; 135:107435. [DOI: 10.1016/j.addbeh.2022.107435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 11/01/2022]
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Kuru Sönmez Ö, Yakut E, Çankal A. Factors affecting smoking: the case of students of a university in Turkey. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2144506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Özlem Kuru Sönmez
- Department of Management Information Systems, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Emre Yakut
- Department of Management Information Systems, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Ahmet Çankal
- Department of Management Information Systems, Osmaniye Korkut Ata University, Osmaniye, Turkey
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Krishnan N, Berg CJ, Elmi A, Klemperer EM, Sherman SE, Abroms LC. Predictors of electronic nicotine product quit attempts and cessation: Analysis of waves 3 and 4 of the PATH study. Addict Behav 2022; 134:107419. [PMID: 35810644 DOI: 10.1016/j.addbeh.2022.107419] [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: 04/18/2022] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Identifying theory-based predictors of electronic nicotine product (ENP) quit attempts and cessation can guide the development of effective vaping cessation interventions, which are currently limited. This study examined predictors of ENP quit attempts and cessation among adult ENP users. METHODS Using data from wave 3 (W3; 2015-2016) current established ENP users in the Population Assessment of Tobacco and Health study, we used multivariable logistic regression to identify predictors of (i) wave 4 (W4; 2016-2018) quit attempts (unweighted n = 1,135); and (ii) W4 cessation among those who made a quit attempt (unweighted n = 610). Predictors included Social Cognitive Theory (SCT)-based cognitive (interest in quitting, self-efficacy to quit, outcome expectancies, risk perception), behavioral (smoking status, and use of combustibles, non-combustibles, cannabis, and alcohol), and socio-environmental (perceived disapproval, household rules, exposure to advertising) factors. RESULTS Between W3 and W4, 51.7% of W3 ENP users made a quit attempt. Among those who tried quitting, 68.4% stopped using ENPs. SCT-based predictors of ENP quit attempts included higher interest in quitting ENPs (aOR = 1.18), greater self-efficacy to quit ENPs (aOR = 1.31), and currently using cigarettes (vs non-smoker; aOR = 1.71), non-combustibles (aOR = 2.25), and cannabis (aOR = 1.80). Predictors of ENP cessation included greater self-efficacy to quit ENPs (aOR = 1.33), greater perceived risk of ENPs (aOR = 1.35), and being a current smoker (vs non-smoker; aOR = 3.28). CONCLUSIONS ENP cessation interventions should address cognitive factors, particularly self-efficacy, as it predicted quit attempts and cessation. Cigarette smoking among dual users should be monitored and addressed to ensure that those who quit using ENPs do not maintain cigarette use.
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Affiliation(s)
- Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Angelo Elmi
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Elias M Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Scott E Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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Yang LC, Yang A, Chen LN, Firth N, Prabhu SR, Zachar J. Knowledge of Oral Cancer Amongst Dental Patients Attending Public Clinics in South East Queensland, Australia. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:924-931. [PMID: 33068265 DOI: 10.1007/s13187-020-01901-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2020] [Indexed: 06/11/2023]
Abstract
Patient knowledge of risk factors, signs and symptoms associated with oral cancers is crucial for increasing the likelihood of patient presentation for opportunistic screening and reducing delay in patient appraisal for early detection. This study aimed to assess the knowledge of oral cancer and to ascertain socio-demographic factors that influence knowledge amongst adult dental patients attending public clinics in Brisbane, Australia. A convenience sample of 213 adult dental patients who attended the Herston and Stafford public health clinics in Brisbane, Australia, between July and August 2019 participated in the self-administered questionnaire. Multivariate analyses were performed to identify predictors for oral cancer knowledge. Patients were well informed of smoking as a risk factor (n = 135; 84.4%), whereas only 53.8% (n = 82) of participants agreed that heavy alcohol consumption was a risk factor. A larger proportion of participants identified difficulty of moving the tongue (n = 79; 49.4%) and pain on swallowing (n = 72; 45.0%) compared to the proportion who identified fixed red patches (n = 61; 38.1%) and fixed white patches (n = 57; 35.6%) as a sign or symptom. Education level and gender were significant knowledge predictors for alcohol (p = 0.01), old age (p = 0.008) and family history (p = 0.004) as a risk factors for oral cancer. Those with a family history of cancer were more likely to identify a red patch (p = 0.02), bleeding gums (p = 0.001) and altered sensation (p = 0.023) as a sign or symptom of oral cancer. Overall, patient knowledge was greater for risk factors than for signs and symptoms for oral cancer. Symptoms associated with later stages of cancer were recognised by a greater proportion of patients compared to early stages of oral cancer. These results indicate the need for targeted public health initiatives to improve patient knowledge.
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Affiliation(s)
- Li-Chen Yang
- School of Dentistry, The University of Queensland, Brisbane, Australia.
| | - Alan Yang
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | - Lin Na Chen
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | - Norman Firth
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | | | - Jessica Zachar
- School of Dentistry, The University of Queensland, Brisbane, Australia
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Chen G, Ghazal M, Rahman S, Lutfy K. The impact of adolescent nicotine exposure on alcohol use during adulthood: The role of neuropeptides. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 161:53-93. [PMID: 34801174 DOI: 10.1016/bs.irn.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Nicotine and alcohol abuse and co-dependence represent major public health crises. Indeed, previous research has shown that the prevalence of alcoholism is higher in smokers than in non-smokers. Adolescence is a susceptible period of life for the initiation of nicotine and alcohol use and the development of nicotine-alcohol codependence. However, there is a limited number of pharmacotherapeutic agents to treat addiction to nicotine or alcohol alone. Notably, there is no effective medication to treat this comorbid disorder. This chapter aims to review the early nicotine use and its impact on subsequent alcohol abuse during adolescence and adulthood as well as the role of neuropeptides in this comorbid disorder. The preclinical and clinical findings discussed in this chapter will advance our understanding of this comorbid disorder's neurobiology and lay a foundation for developing novel pharmacotherapies to treat nicotine and alcohol codependence.
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Affiliation(s)
- G Chen
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, United States; Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
| | - M Ghazal
- Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
| | - S Rahman
- Department of Pharmaceutical Sciences, South Dakota State University, Brookings, SD, United States
| | - K Lutfy
- Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States.
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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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12
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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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13
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Voci S, Veldhuizen S, Tien S, Barker M, Minian N, Selby P, Zawertailo L. A comparison of quit outcomes for men and women in a smoking cessation program offering personalized nicotine replacement therapy and counselling in primary care clinics. Nicotine Tob Res 2021; 23:1673-1681. [PMID: 33912963 DOI: 10.1093/ntr/ntab082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/22/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Women may have greater difficulty achieving long-term abstinence following a quit attempt compared to men. We sought to determine whether there were differences in treatment characteristics or outcome between female and male primary care patients enrolled in a smoking cessation program providing personalized nicotine replacement therapy (NRT) with counselling support. METHODS The sample included 27,601 Ontarians (53% female, 47% male) who enrolled in the Smoking Treatment for Ontario Patients program between 2016 and 2018. Dose, type, and duration of NRT supplied was personalized to need. Thirty-day point prevalence tobacco smoking abstinence was self-reported via online or telephone survey at 6 months post-enrollment. RESULTS Both female and male participants received a median of 8 weeks of NRT. Types of NRT received were similar, with 80% of both female and male participants receiving patch and short-acting NRT. Total cumulative dose was somewhat higher for men (1373 mg vs. 1265 mg, p<0.001); but when calculated as dose per day, per cigarette smoked at baseline, dose was slightly higher among women (1.6 mg vs. 1.5 mg, p<0.001). Quit rates at 6 months were lower for women versus men (24% vs. 27%; AOR = 0.84 [95% CI = 0.78-0.90], p<0.001). There were no significant interactions between gender and dose, type or duration of NRT supplied. CONCLUSIONS Women were slightly less likely to quit than men, despite receiving similar treatment. There was no evidence that women benefitted more or less from variations in dose, type or duration of NRT supply.
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Affiliation(s)
- Sabrina Voci
- Nicotine Dependence Service, Centre for Addiction and Mental Health, 1025 Queen St. W., Toronto, ON, M6J 1H4, Canada
| | - Scott Veldhuizen
- Nicotine Dependence Service, Centre for Addiction and Mental Health, 1025 Queen St. W., Toronto, ON, M6J 1H4, Canada
| | - Stephanie Tien
- Nicotine Dependence Service, Centre for Addiction and Mental Health, 1025 Queen St. W., Toronto, ON, M6J 1H4, Canada
| | - Megan Barker
- Nicotine Dependence Service, Centre for Addiction and Mental Health, 1025 Queen St. W., Toronto, ON, M6J 1H4, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada
| | - Nadia Minian
- Nicotine Dependence Service, Centre for Addiction and Mental Health, 1025 Queen St. W., Toronto, ON, M6J 1H4, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Ave., Toronto, ON M5G 1V7, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 60 White, Squirrel Way, Toronto, ON M6J 1H4, Canada
| | - Peter Selby
- Nicotine Dependence Service, Centre for Addiction and Mental Health, 1025 Queen St. W., Toronto, ON, M6J 1H4, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Ave., Toronto, ON M5G 1V7, Canada.,Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON M5T 1R8, Canada
| | - Laurie Zawertailo
- Nicotine Dependence Service, Centre for Addiction and Mental Health, 1025 Queen St. W., Toronto, ON, M6J 1H4, Canada.,Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
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14
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Britton M, Derrick JL, Shepherd JM, Haddad S, Garey L, Viana AG, Zvolensky MJ. Associations between alcohol consumption and smoking variables among Latinx daily smokers. Addict Behav 2021; 113:106672. [PMID: 33011492 PMCID: PMC7736511 DOI: 10.1016/j.addbeh.2020.106672] [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: 04/06/2020] [Revised: 08/18/2020] [Accepted: 09/19/2020] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Accumulating evidence demonstrates a strong link between alcohol consumption and smoking status among Latinx individuals. However, there is a need to evaluate the cognitive processes and experiences related to quitting smoking among Latinx smokers. The purpose of the current paper was to examine the association between alcohol consumption and smoking expectancies, barriers to cessation, cigarette dependence, quit problems, and intentions and confidence to quit. METHODS Data were taken from a sample of Spanish-speaking Latinx daily smokers (N = 359; 59% female; Mage = 33.20, SD = 9.71) who completed an online survey. The alcohol consumption subscale of the Alcohol Use Disorders Identification Test (AUDIT; Babor, Higgins-Biddle, Saunders, & Monteiro, & World Health Organization, 2001) was used to predict smoking variables. RESULTS Consistent with our prediction, alcohol consumption significantly predicted smoking variables indicative of poorer smoking cessation ability. Specifically, greater alcohol consumption was associated with greater positive and negative smoking expectancies, barriers to cessation, and quit problems experienced during prior cessation attempts. Unexpectedly, greater alcohol consumption was also associated with greater confidence to quit smoking. CONCLUSIONS The current research suggests that alcohol consumption should be considered in the context of smoking cessation among Latinx individuals. The findings confirm and extend previous research by demonstrating that alcohol consumption is associated with proximal predictors of smoking outcomes that can be targeted during treatment. Implications for future research include addressing alcohol consumption during intervention and treatment of Latinx daily smokers.
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Affiliation(s)
- Maggie Britton
- Department of Psychology, University of Houston, 3695 Cullen Blvd, Houston, TX 77204 5022, United States
| | - Jaye L Derrick
- Department of Psychology, University of Houston, 3695 Cullen Blvd, Houston, TX 77204 5022, United States
| | - Justin M Shepherd
- Department of Psychology, University of Houston, 3695 Cullen Blvd, Houston, TX 77204 5022, United States
| | - Sana Haddad
- Department of Psychology, University of Houston, 3695 Cullen Blvd, Houston, TX 77204 5022, United States
| | - Lorra Garey
- Department of Psychology, University of Houston, 3695 Cullen Blvd, Houston, TX 77204 5022, United States
| | - Andres G Viana
- Department of Psychology, University of Houston, 3695 Cullen Blvd, Houston, TX 77204 5022, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd, Houston, TX 77204 5022, United States; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States; HEALTH Institute, University of Houston, Houston, TX, United States.
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15
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Buczkowski K, Dachtera-Frąckiewicz M, Luszkiewicz D, Klucz K, Sawicka-Powierza J, Marcinowicz L. Reasons for and Scenarios Associated with Failure to Cease Smoking: Results from a Qualitative Study Among Polish Smokers Who Had Unsuccessfully Attempted to Quit. Patient Prefer Adherence 2021; 15:2071-2084. [PMID: 34556977 PMCID: PMC8453429 DOI: 10.2147/ppa.s320798] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/27/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Most smokers attempt to quit smoking, but few are successful. Data regarding the reasons for this relapse and the course of the relapse process may be helpful for determining efficient methods of smoking cessation. This study aimed to identify the causes of and scenarios associated with smoking relapse after effective smoking cessation. PATIENTS AND METHODS We conducted 20 semi-structured interviews with smokers who had previously unsuccessfully attempted to quit. The data underwent qualitative content analysis. RESULTS Three major themes were identified: reasons for smoking relapse; smoking relapse scenarios; and perception of the influence of personal environments, including family and physicians, on refraining from smoking after cessation. The first theme comprised the following subthemes: insufficient willpower and self-discipline, contact with smokers, exposure to stressful situations, lack of family support, weight gain, and insufficient improvement in one's mental and physical well-being. The second theme contained enjoyable social events, professional life, critical events, and encouragement to smoke from family members. The respondents frequently emphasized the large role of interaction with other smokers. CONCLUSION The predominant factors underlying smoking relapse include insufficient willpower and self-discipline and exposure to stress. The most frequent relapse scenario concerned experiencing negative or positive emotions when interacting with other smokers.
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Affiliation(s)
- Krzysztof Buczkowski
- Department of Family Medicine, Nicolaus Copernicus University, Torun, Poland
- Correspondence: Krzysztof Buczkowski Email
| | | | - Dorota Luszkiewicz
- Department of Family Medicine, Nicolaus Copernicus University, Torun, Poland
| | - Katarzyna Klucz
- Department of Family Medicine, Nicolaus Copernicus University, Torun, Poland
| | | | - Ludmila Marcinowicz
- Department of Obstetrics, Gynaecology and Maternity Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
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16
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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: 5] [Impact Index Per Article: 1.3] [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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17
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Kahler CW, Cohn AM, Costantino C, Toll BA, Spillane NS, Graham AL. A Digital Smoking Cessation Program for Heavy Drinkers: Pilot Randomized Controlled Trial. JMIR Form Res 2020; 4:e7570. [PMID: 32348286 PMCID: PMC7308890 DOI: 10.2196/formative.7570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/29/2020] [Accepted: 03/29/2020] [Indexed: 11/29/2022] Open
Abstract
Background Heavy drinking (HD) is far more common among smokers compared with nonsmokers and interferes with successful smoking cessation. Alcohol-focused smoking cessation interventions delivered by counselors have shown promise, but digital versions of these interventions—which could have far greater population reach—have not yet been tested. Objective This pilot randomized controlled trial aimed to examine the feasibility, acceptability, and effect sizes of an automated digital smoking cessation program that specifically addresses HD using an interactive web-based intervention with an optional text messaging component. Methods Participants (83/119, 69.7% female; 98/119, 82.4% white; mean age 38.0 years) were daily smokers recruited on the web from a free automated digital smoking cessation program (BecomeAnEX.org, EX) who met the criteria for HD: women drinking 8+ drinks/week or 4+ drinks on any day and men drinking 15+ drinks/week or 5+ drinks on any day. Participants were randomized to receive EX with standard content (EX-S) or an EX with additional content specific to HD (EX-HD). Outcomes were assessed by web-based surveys at 1 and 6 months. Results Participants reported high satisfaction with the website and the optional text messaging component. Total engagement with both EX-S and EX-HD was modest, with participants visiting the website a median of 2 times, and 52.9% of the participants enrolled to receive text messages. Participants in both the conditions showed substantial, significant reductions in drinking across 6 months of follow-up, with no condition effects observed. Although smoking outcomes tended to favor EX-HD, the condition effects were small and nonsignificant. A significantly smaller proportion of participants in EX-HD reported having a lapse back to smoking when drinking alcohol (7/58, 16%) compared with those in EX-S (18/61, 41%; χ21=6.2; P=.01). Conclusions This is the first trial to examine a digital smoking cessation program tailored to HD smokers. The results provide some initial evidence that delivering such a program is feasible and may reduce the risk of alcohol-involved smoking lapses. However, increasing engagement in this and other web-based interventions is a crucial challenge to address in future work. Trial Registration ClinicalTrials.gov NCT03068611; https://clinicaltrials.gov/ct2/show/NCT03068611
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Affiliation(s)
- Christopher W Kahler
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, United States
| | - Amy M Cohn
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | | | - Benjamin A Toll
- Medical University of South Carolina, Charleston, SC, United States
| | - Nichea S Spillane
- Department of Psychology, University of Rhode Island, South Kingston, RI, United States
| | - Amanda L Graham
- Innovations Center, Truth Initiative, Washington, DC, United States.,Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, United States
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18
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Thomas DP, Davey M, Sterren AE, Panaretto KS, Lyons L. Do stress, life satisfaction, depression and alcohol use predict quitting among Aboriginal and Torres Strait Islander smokers? Aust N Z J Public Health 2020; 44:186-192. [DOI: 10.1111/1753-6405.12993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 02/01/2020] [Accepted: 03/01/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- David P. Thomas
- Menzies School of Health ResearchCharles Darwin University Northern Territory
| | | | - Anke E. Sterren
- Alcohol Tobacco and Other Drug Association ACT Australian Capital Territory
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19
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Lynch KL, Twesten JE, Stern A, Augustson EM. Level of Alcohol Consumption and Successful Smoking Cessation. Nicotine Tob Res 2020; 21:1058-1064. [PMID: 29986105 DOI: 10.1093/ntr/nty142] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 07/03/2018] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The negative association between heavy alcohol use and likelihood of successful smoking cessation is well established. However, evidence on the effects of moderate alcohol consumption on smoking cessation is sparse. This analysis evaluated the association between alcohol use and smoking and the interaction of alcohol use and use of pharmacotherapy interventions in relation to smoking cessation. METHODS Data from adults (n = 923) recruited through a smoking cessation website between November 2011 and March 2012 were analyzed. Data on past-year alcohol use, tobacco use, and demographics were collected at baseline. Self-reported smoking abstinence and current alcohol use data were collected at 1 and 7 months posttreatment. Chi-square and multivariate logistic regression analyses were conducted. RESULTS At 1 month, adjusted odds of continued smoking were 1.54 times greater (95% confidence interval [CI] = 1.05% to 2.23%) for moderate drinkers and 2.59 times greater (95% CI = 1.33% to 4.28%) for heavy drinkers than nondrinkers. At 7 months, adjusted odds of continued smoking were not greater for moderate drinkers than nondrinkers, and were 2.32 times greater (95% CI = 1.35% to 3.96%) among heavy alcohol drinkers than nondrinkers. At 1 month, adjusted odds of smoking cessation were 2.33 times greater (95% CI = 1.04% to 3.09%) for alcohol users assigned to nicotine replacement therapy than for those not assigned to nicotine replacement therapy. This relationship was not observed at 7 months. CONCLUSIONS Moderate and heavy drinking might impact smoking cessation efforts. Recent moderate drinking may be associated with short-term continued smoking and heavy drinking associated with relapse in the short and long term. IMPLICATIONS This study suggests that moderate drinking may influence the process to quit smoking. Further study is needed to better understand the implications of moderate drinking for smoking cessation. Providing information alone may not be effective in helping people abstain from drinking during smoking cessation, especially if moderate drinkers do not perceive their behavior as reducing their chance for a successful quit attempt. Tailoring smoking cessation interventions to include strategies to reduce moderate-to-heavy alcohol consumption may improve smoking cessation outcomes among alcohol users attempting to quit smoking.
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Affiliation(s)
| | | | | | - Erik M Augustson
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD
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20
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Bold KW, Rosen RL, Steinberg ML, Epstein EE, McCrady BS, Williams JM. Smoking characteristics and alcohol use among women in treatment for alcohol use disorder. Addict Behav 2020; 101:106137. [PMID: 31648138 PMCID: PMC7096210 DOI: 10.1016/j.addbeh.2019.106137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/16/2019] [Accepted: 09/16/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Understanding the association between smoking and alcohol use among women may help inform the delivery of targeted interventions to address both of these health behaviors. METHODS This study analyzed data from N = 138 women enrolled in a randomized clinical trial comparing female-specific individual versus group cognitive-behavior therapy for alcohol use disorder (AUD). We assessed cigarette use patterns, participants' interest in quitting smoking and motivation to quit smoking during treatment for AUD, and examined the relationship between smoking and alcohol use before and during alcohol treatment. RESULTS Over a third of the sample reported smoking cigarettes at baseline (N = 47, 34.1%), with the majority of smokers reporting daily cigarette use. At baseline, those who smoked reported a high interest in quitting smoking M = 7.8 out of 10 (SD = 2.7), although most believed they should quit smoking only after achieving some success in quitting drinking (50.0%). However, participants who smoked cigarettes (compared to non-smokers) reported more alcohol abuse and dependence symptoms (p = .001), lower rates of completing the alcohol treatment (p = .03), attended significantly fewer treatment sessions (p = .008), and consumed significantly more drinks per day on average both at baseline (p = .002) and during the treatment period (p = .04). CONCLUSIONS Findings suggest that women with AUD who also smoke cigarettes have greater difficulty engaging in or responding to treatment for their alcohol use. However, these participants reported high interest in quitting smoking but low perceived readiness during AUD treatment, suggesting that motivational interventions should be considered that could take advantage of the opportunity to treat women for both of these co-occurring behaviors while in treatment.
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Affiliation(s)
- Krysten W Bold
- Department of Psychiatry, Yale University School of Medicine, 34 Park Street CMHC, New Haven, CT 06519, United States.
| | - Rachel L Rosen
- Department of Psychology, Rutgers, The State University of New Jersey, 152 Frelinghuysen Rd, New Brunswick, NJ 08854, United States
| | - Marc L Steinberg
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, 317 George Street, New Brunswick, NJ 08901, United States
| | - Elizabeth E Epstein
- Center of Alcohol Studies, Rutgers, the State University of New Jersey, 607 Allison Rd, Piscataway, NJ 08854, United States; Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA 01605, United States
| | - Barbara S McCrady
- Center of Alcohol Studies, Rutgers, the State University of New Jersey, 607 Allison Rd, Piscataway, NJ 08854, United States; Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd. SE, Albuquerque, NM 87106, United States
| | - Jill M Williams
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, 317 George Street, New Brunswick, NJ 08901, United States
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21
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Murray EG, Isbister GK, McCrabb S, Halpin SA, Bonevski B. An examination of factors associated with tobacco smoking amongst patients presenting with deliberate self-poisoning. J Affect Disord 2020; 260:544-549. [PMID: 31539691 DOI: 10.1016/j.jad.2019.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/05/2019] [Accepted: 09/11/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Understand factors related to related to tobacco smoking amongst individuals who present with deliberate self-harm is important. This article explores the relationship between tobacco use with mental health diagnoses and substance use in a cohort of overdose admissions. METHODS Secondary analysis of an existing health service database with 7133 patients admitted for deliberate self-poisonings from 1997 to 2013 was conducted. A data collection form was used on admission to capture information on patient demographics, drugs ingested, use of drugs of misuse, regular medications and management and complications of poisoning. The data was analysed using a multiple logistic regression model. RESULTS Within a deliberate self-poisoning population, those diagnosed with: an amphetamine substance use disorder (OR = 1.84, p < .001), alcohol use disorder (OR = 1.68, p < .001), other substance use disorder (OR = 1.77, p < .001), psychotic diagnoses (OR = 1.17, p = .032), or had a history of self-harm (OR = 1.15, p = .011) were more likely to be a current tobacco smoker. Those who were older (OR = 0.99, p < .001) or diagnosed with a mood disorder (OR = 0.87, p = .018) were less likely to smoke tobacco. LIMITATIONS The study was unable to differentiate between suicide attempts and self-harm self-poisonings. CONCLUSIONS Among a deliberate self-poisoning population those who were younger, diagnosed with a variety of substance use disorders, or had a history of previous self-poisoning were more likely to use tobacco. Those with a mood disorder were less likely to smoke tobacco.
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Affiliation(s)
- Edward G Murray
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Geoffrey K Isbister
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308, Australia; Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Waratah NSW 2294, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308, Australia
| | - Sean A Halpin
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308, Australia.
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22
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Green R, Bujarski S, Lim AC, Venegas A, Ray L. Naltrexone and alcohol effects on craving for cigarettes in heavy drinking smokers. Exp Clin Psychopharmacol 2019; 27:257-264. [PMID: 30628813 PMCID: PMC7227763 DOI: 10.1037/pha0000252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Naltrexone has been extensively studied for the treatment of alcohol use disorder. However, less is known about the effects of naltrexone on smoking outcomes in the context of alcohol use among East Asian individuals who have been suggested to differ in response to alcohol and to naltrexone. The present study is a secondary analysis that used a double-blind placebo-controlled design (n = 31) to examine the (a) effects of alcohol on basal craving for cigarettes, (b) effects of naltrexone on cigarette craving and alcohol craving during alcohol administration, and (c) relationship between craving for alcohol and cigarettes. Heavy drinking smokers of East Asian descent completed two counterbalanced intravenous alcohol administration sessions, one after taking naltrexone (50 mg) for five days and one after taking a placebo for five days. Self-reported subjective craving for cigarettes and for alcohol was recorded during each experimental session. Craving for cigarettes and alcohol increased significantly throughout the intravenous alcohol administration. A significant breath alcohol concentration (BrAC) × Medication interaction revealed that naltrexone blunted cigarette craving during alcohol administration, compared to placebo. Naltrexone significantly reduced craving for alcohol during alcohol administration in this group of heavy drinking smokers. Alcohol craving significantly predicted cigarette craving, however this effect did not vary across rising alcohol administration or by medication. These findings demonstrate that naltrexone reduces the urge to smoke and to drink during alcohol administration. Clinical studies are needed to further ascertain whether naltrexone may be of benefit to this distinct subgroup of heavy drinking smokers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- ReJoyce Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Spencer Bujarski
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Aaron C. Lim
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alexandra Venegas
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lara Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
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23
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Bold KW, Zweben A, Fucito LM, Piepmeier ME, Muvvala S, Wu R, Gueorguieva R, O'Malley SS. Longitudinal Findings from a Randomized Clinical Trial of Varenicline for Alcohol Use Disorder with Comorbid Cigarette Smoking. Alcohol Clin Exp Res 2019; 43:937-944. [PMID: 30817018 DOI: 10.1111/acer.13994] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 02/20/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study is the first to examine longitudinal posttreatment outcomes of a placebo-controlled trial of varenicline for alcohol use disorder (AUD) with comorbid cigarette smoking. METHODS Participants were 131 adults (n = 39 female) seeking alcohol treatment in a randomized, double-blind, parallel group, placebo-controlled, 16-week multisite trial of varenicline combined with medical management (MM). Timeline follow-back assessments of alcohol and smoking behavior were conducted at the end of treatment (4 months), with follow-ups at 6, 9, and 12 months. Outcomes were percentage of heavy drinking days (PHDD), percent of participants with no heavy drinking days (NHDD), cotinine-confirmed prolonged smoking abstinence (PA), and good clinical outcome on either NHDD or PA. RESULTS Treatment improvements were maintained posttreatment. For the sample overall, PHDD or NHDD did not differ significantly by treatment condition (ps > 0.13), but varenicline produced higher rates of PA versus placebo at 4, 9, and 12 months (p < 0.05). Significant differences were observed by sex: Males had higher rates of NHDD with varenicline (28.9%) versus placebo (6.4%) at the end of treatment (p = 0.004), and these effects were maintained at 12 months (varenicline: 40.0% vs. placebo: 19.2%, p = 0.03). Higher rates of PA were seen for varenicline in both males (8.9%) and females (21.1%) versus placebo (males/females: 0%) at the end of treatment (p = 0.05), and this effect was maintained at 12 months for females (varenicline: 21.1% vs. placebo, 0.0%, p = 0.05). CONCLUSIONS Varenicline treatment combined with MM appears to have enduring benefits for patients with co-occurring AUD and cigarette smoking, and these effects may differ by sex.
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Affiliation(s)
- Krysten W Bold
- Department of Psychiatry , Yale School of Medicine, New Haven, Connecticut
| | - Allen Zweben
- School of Social Work , Columbia University, New York, New York
| | - Lisa M Fucito
- Department of Psychiatry , Yale School of Medicine, New Haven, Connecticut
| | | | - Srinivas Muvvala
- Department of Psychiatry , Yale School of Medicine, New Haven, Connecticut
| | - Ran Wu
- Department of Psychiatry , Yale School of Medicine, New Haven, Connecticut
| | - Ralitza Gueorguieva
- Department of Psychiatry , Yale School of Medicine, New Haven, Connecticut.,Department of Biostatistics , Yale School of Public Health, New Haven, Connecticut
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24
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McCrabb S, Baker AL, Attia J, Balogh ZJ, Lott N, Palazzi K, Naylor J, Harris IA, Doran CM, George J, Wolfenden L, Skelton E, Bonevski B. Comorbid tobacco and other substance use and symptoms of anxiety and depression among hospitalised orthopaedic trauma patients. BMC Psychiatry 2019; 19:28. [PMID: 30654783 PMCID: PMC6337866 DOI: 10.1186/s12888-019-2021-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 01/09/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND No study has examined the prevalence of tobacco, other substance use, and symptoms of anxiety and depression, and rates of comorbidities among the orthopaedic trauma population, despite the impact they have on recovery from surgery. This study aims to 1) describe the rates of symptoms and substance use; 2) compare rates of symptoms and substance use among smokers versus non-smokers; and 3) examine the relationship between symptoms and substance use with smoking status. METHODS A cross-sectional survey of orthopaedic trauma patients was conducted in two Australian public hospitals. Demographic characteristics, smoking status, alcohol consumption, recent cannabis use, and symptoms of anxiety and/or depression were examined. Differences between current and non-smokers were compared using Pearson Chi2 tests. Multivariate logistic regression explored variables related to tobacco smoking. RESULTS Eight hundred nineteen patients participated. Over one-fifth (21.8%) identified as a current smoker, half (51.8%) reported consuming alcohol at hazardous levels in the last 12 months, and about 10% stated that they had used cannabis in the last 30 days (9.7%), or experienced symptoms of either anxiety (12.4%), or depression (12.9%) in the last two weeks. Over one-fifth of current tobacco smokers (21.8%) reported drinking heavily in the last 12 months and using cannabis recently. Males, with a lower educational attainment, who were unmarried, had used cannabis recently, and report drinking heavily were more likely to be current smokers. CONCLUSIONS Health behaviour interventions addressing comorbidities are warranted among the orthopaedic trauma population given the high rate of comorbidity and impact these may have on recovery.
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Affiliation(s)
- Sam McCrabb
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia.
| | - Amanda L. Baker
- 0000 0000 8831 109Xgrid.266842.cSchool of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308 Australia
| | - John Attia
- 0000 0000 8831 109Xgrid.266842.cSchool of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308 Australia ,0000 0000 8831 109Xgrid.266842.cHunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales 2305 Australia ,0000 0004 0577 6676grid.414724.0Department of General Medicine, John Hunter Hospital, New Lambton Heights, New South Wales 2305 Australia
| | - Zsolt J. Balogh
- 0000 0000 8831 109Xgrid.266842.cSchool of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308 Australia ,0000 0004 0577 6676grid.414724.0Department of Traumatology, John Hunter Hospital, New Lambton, New South Wales 2305 Australia
| | - Natalie Lott
- 0000 0004 0577 6676grid.414724.0Department of Traumatology, John Hunter Hospital, New Lambton, New South Wales 2305 Australia
| | - Kerrin Palazzi
- 0000 0000 8831 109Xgrid.266842.cHunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales 2305 Australia
| | - Justine Naylor
- 0000 0004 0527 9653grid.415994.4Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, New South Wales 2170 Australia ,0000 0004 4902 0432grid.1005.4South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, New South Wales 2170 Australia
| | - Ian A. Harris
- 0000 0004 0527 9653grid.415994.4Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, New South Wales 2170 Australia ,0000 0004 4902 0432grid.1005.4South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, New South Wales 2170 Australia
| | - Christopher M. Doran
- 0000 0001 2193 0854grid.1023.0School of Human, Health and Social Sciences, Central Queensland University, Brisbane, Queensland 4000 Australia
| | - Johnson George
- 0000 0004 1936 7857grid.1002.3Centre for Medicine Use and Safety, Monash University, Parkville, Victoria 3052 Australia
| | - Luke Wolfenden
- 0000 0000 8831 109Xgrid.266842.cSchool of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308 Australia ,Hunter New England Population Health, Wallsend, NSW 2287 Australia
| | - Eliza Skelton
- 0000 0000 8831 109Xgrid.266842.cSchool of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308 Australia
| | - Billie Bonevski
- 0000 0000 8831 109Xgrid.266842.cSchool of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308 Australia
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25
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Cohn AM, Amato MS, Zhao K, Wang X, Cha S, Pearson JL, Papandonatos GD, Graham AL. Discussions of Alcohol Use in an Online Social Network for Smoking Cessation: Analysis of Topics, Sentiment, and Social Network Centrality. Alcohol Clin Exp Res 2018; 43:108-114. [PMID: 30326140 DOI: 10.1111/acer.13906] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 10/10/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few Internet smoking cessation programs specifically address the impact of alcohol use during a quit attempt, despite its common role in relapse. This study used topic modeling to describe the most prevalent topics about alcohol in an online smoking cessation community, the prevalence of negative sentiment expressed about alcohol use in the context of a quit attempt (i.e., alcohol should be limited or avoided during a quit attempt) within topics, and the degree to which topics differed by user social connectivity within the network. METHODS Data were analyzed from posts from the online community of a larger Internet cessation program, spanning January 1, 2012 to May 31, 2015 and included records of 814,258 online posts. Posts containing alcohol-related content (n = 7,199) were coded via supervised machine learning text classification to determine whether the post expressed negative sentiment about drinking in the context of a quit attempt. Correlated topic modeling (CTM) was used to identify a set of 10 topics of at least 1% prevalence based on the frequency of word occurrences among alcohol-related posts; the distribution of negative sentiment and user social network connectivity was examined across the most salient topics. RESULTS Three salient topics (with prevalence ≥10%) emerged from the CTM, with distinct themes of (i) cravings and temptations; (ii) parallel between nicotine addiction and alcoholism; and (iii) celebratory discussions of quit milestones including "virtual" alcohol use and toasts. Most topics skewed toward nonnegative sentiment about alcohol. The prevalence of each topic differed by users' social connectivity in the network. CONCLUSIONS Future work should examine whether outcomes in Internet interventions are improved by tailoring social network content to match user characteristics, topics, and network behavior.
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Affiliation(s)
- Amy M Cohn
- Battelle Memorial Institute, Arlington, Virginia.,Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia
| | - Michael S Amato
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Kang Zhao
- Department of Management Sciences, The University of Iowa, Iowa City, Iowa
| | - Xi Wang
- School of Information, Central University of Finance and Economics, Beijing, China
| | - Sarah Cha
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- School of Community Health Sciences, University of Nevada, Reno, Nevada.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Amanda L Graham
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia.,Schroeder Institute at Truth Initiative, Washington, District of Columbia
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26
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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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27
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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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28
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Cohn AM. Never, non-daily, and daily smoking status and progression to daily cigarette smoking as correlates of major depressive episode in a national sample of youth: Results from the National Survey of Drug Use and Health 2013 to 2015. Addict Behav 2018; 84:118-125. [PMID: 29684762 DOI: 10.1016/j.addbeh.2018.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 02/28/2018] [Accepted: 03/01/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cigarette smoking is associated with depression, and new initiates who progress more quickly to daily smoking may be at enhanced risk. In a nationally representative sample of youth, this study examined the association between daily, non-daily, and never smoking with past-year and lifetime major depressive episode (MDE) and, among daily smokers, whether faster progression to daily smoking was associated with increased MDE risk. METHODS Data were from n = 44,921 youth aged 12-17 in the 2013-2015 National Survey on Drug Use and Health. Weighted adjusted multivariable logistic regression models were used to examine the association of smoking status (daily, non-daily, never) with lifetime and past-year MDE, and the association between progression from cigarette trial to daily smoking with MDE outcomes among daily smokers. RESULTS Daily and non-daily smokers had similar rates of lifetime and past-year MDE; rates of MDE were approximately 50% lower among never smokers. Compared to never smokers, adjusted models showed that non-daily smokers had a higher risk of past-year and lifetime MDE, while daily smokers had a higher risk of past-year but not lifetime MDE. Daily smoking youth who progressed more quickly from cigarette trial to daily use had an increased risk of both lifetime and past-year MDE. CONCLUSIONS Prevention programs should target factors associated with the shift from cigarette experimentation to regular use to curb deleterious consequences of use.
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29
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Osibogun O, Ben Taleb Z, Bahelah R, Salloum RG, Maziak W. Correlates of poly-tobacco use among youth and young adults: Findings from the Population Assessment of Tobacco and Health study, 2013-2014. Drug Alcohol Depend 2018; 187:160-164. [PMID: 29674249 PMCID: PMC5959787 DOI: 10.1016/j.drugalcdep.2018.02.024] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/24/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Poly-tobacco use is common among youth and young adults. This study examined sociodemographic, tobacco-related, and substance use characteristics of poly-tobacco use compared to mono-tobacco use among youth and young adults (12-34 years) in the United States. METHODS We conducted a descriptive analysis by age-group of 12898 youth (12-17 years), 8843 younger young adults (18-24 years), and 6081 older young adults (24-34 years) from the 2013-2014 Population Assessment of Tobacco and Health study. Multiple logistic regression modeling was conducted to assess the sociodemographic, tobacco-related, and substance use associations with current (past 30 days) tobacco use on a binary scale (poly- versus mono-tobacco use) among tobacco users. RESULTS Between 2013 and 2014, 3.6% of youth, 21.7% of younger young adults, and 15.8% of older young adults were current poly-tobacco users in the general population. In the regression analyses, among youth tobacco users, heavy drinking was the only factor associated with higher odds of poly-tobacco use. Factors associated with higher odds of poly-tobacco use among younger young adults included being male, having less than high school diploma or GED, residing in the South, having 2 and ≥3 quit attempts, heavy drinking, and marijuana use. Residing in the South, older ages of exposure to tobacco use, and marijuana use were associated with higher odds of poly-tobacco use among older young adults. CONCLUSIONS Regardless of tobacco product type, poly-tobacco use was common among youth and young adults. Interventions designed to address factors associated with poly-tobacco use among youth and young adults are warranted.
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Affiliation(s)
- Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC5, Miami, FL 33199, USA.
| | - Ziyad Ben Taleb
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC5, Miami, FL 33199, USA
| | - Raed Bahelah
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC5, Miami, FL 33199, USA
| | - Ramzi G. Salloum
- Department of Health Outcomes and Policy, University of Florida, PO Box 100177, Gainesville, FL 32610-0177, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC5, Miami, FL 33199, USA
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30
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Ho KY, Li HCW, Lam KKW, Chan SSC, Wang MP, Chan VWF, Xia VW, Lam TH. Exploratory study on the relationship between smoking and other risk behaviours among young smokers. J Clin Nurs 2018; 27:2859-2867. [PMID: 29633459 DOI: 10.1111/jocn.14375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore the relationship between smoking and other risk behaviours among Chinese young people in Hong Kong. BACKGROUND There is growing concern about coexisting risk behaviours in young smokers. Information about smoking and other risk behaviours is crucial for developing interventions to promote smoking abstinence and adoption of healthy lifestyles. The relationship between smoking and other risk behaviours among Chinese young people in Hong Kong has not been explored. DESIGN This is a mixed-method retrospective population-based study. METHODS A retrospective population-based study was conducted with 1,147 young smokers through Youth Quitline between November 2011-July 2016. Attitudes, behaviours and experiences related to smoking and risk behaviours among Chinese young smokers were examined in semi-structured qualitative interviews with 30 participants randomly selected from the retrospective population-based study. RESULTS In total, 45.5% participants reported engaging in at least one other risk behaviour. The interviews revealed that drinking alcohol may have a significant impact on quitting smoking. In addition, smoking may be a gateway for more serious risk behaviours during adolescence. Low health awareness may explain the unhealthy lifestyles among young smokers. CONCLUSIONS This study bridges a gap in existing literature by exploring relationships between smoking and other risk behaviours among young people in Hong Kong. RELEVANCE TO CLINICAL PRACTICE Given the interrelationships between smoking and other risk behaviours, a holistic approach should be used to promote smoking cessation and healthy lifestyles among young smokers. If young smokers improve their health and quit smoking at the same time, their physical and mental development will benefit as a secondary outcome.
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Affiliation(s)
- Ka Yan Ho
- School of Nursing, University of Hong Kong, Pokfulam, Hong Kong
| | | | | | | | - Man Ping Wang
- School of Nursing, University of Hong Kong, Pokfulam, Hong Kong
| | | | - Viveka Wei Xia
- School of Nursing, University of Hong Kong, Pokfulam, Hong Kong
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
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31
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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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32
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Sells JR, Waters AJ, MacLean RR. Evaluating the influence of at-risk alcohol use on factors associated with smoking cessation: Combining laboratory and ecological momentary assessment. Drug Alcohol Depend 2017; 179:267-270. [PMID: 28822262 PMCID: PMC5630265 DOI: 10.1016/j.drugalcdep.2017.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 05/26/2017] [Accepted: 06/01/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Most smokers want to quit but most cessation attempts end in failure. Alcohol consumption is associated with smoking behavior and relapse. We examined the associations between severity of drinking and psychological processes during a cessation attempt in the laboratory and during a quit attempt. METHODS Smokers (N=209) enrolled in a smoking cessation study were followed from 2 weeks pre-quit through 4 weeks post-quit. Participants scoring 0-7 and 8-15 on the Alcohol Use Disorders Identification Test (AUDIT) were classified as low-risk and high-risk drinkers, respectively. Participants attended one pre-quit laboratory session before which they were required to abstain from smoking and another pre-quit session before which they smoked normally. Craving was assessed in the laboratory with the Questionnaire for Smoking Urges (QSU). A subsample of the participants also completed a 1-week ecological momentary assessment (EMA) study starting on the quit day. During EMA, craving for cigarettes was assessed, and attentional bias was assessed using a smoking Stroop task (n=119). RESULTS High (vs. low) risk participants reported greater abstinence-induced increases in craving in the laboratory, and also exhibited greater attentional bias on the smoking Stroop task during EMA. CONCLUSIONS High-risk drinkers exhibited a stronger increase in desire to smoke in abstinence and greater attentional bias to smoking cues early in a quit attempt, both of which may motivate continued smoking behaviors. High-risk drinkers may require more intensive or different smoking cessation interventions.
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Affiliation(s)
- Joanna R Sells
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Andrew J Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - R Ross MacLean
- Department of Psychiatry, Yale University, 300 George Street, Suite 901, New Haven, CT 06511, USA; VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA
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Cioe PA, Gamarel KE, Pantalone DW, Monti PM, Mayer KH, Kahler CW. Characteristics of intermittent smokers and their association with quit intentions in a sample of heavy-drinking HIV-infected men who have sex with men. AIDS Care 2017; 29:759-766. [PMID: 27690619 PMCID: PMC5543409 DOI: 10.1080/09540121.2016.1237612] [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: 10/20/2022]
Abstract
Intermittent smokers (ITS) have increased health risks compared with non-smokers (NS). Cigarette smoking remains prevalent among men who have sex with men (MSM) and persons living with HIV (PLWH), yet most studies in PLWH do not discriminate between daily smokers (DS) and ITS. In this study, the characteristics and quit intentions of ITS and DS are compared in a sample of heavy-drinking HIV-infected MSM. Of the 185 participants enrolled, 49.2% reported having smoked cigarettes in the past month; among those, 50.5% were DS, and 49.5% were ITS. Compared with DS, ITS were significantly more likely to be White and to have a college degree or higher. DS reported significantly higher average number of drinks per week compared with both ITS and NS. Compared with DS, ITS were significantly more likely to report future quit intentions (i.e., within 6 months or more) compared to no intentions at all; DS were more likely to report immediate quit intentions (i.e., within 30 days) compared to future quit intentions. Among heavy-drinking MSM living with HIV, intermittent smoking was associated with being White, college educated, and having future quit intentions. Considering that smoking in ITS may be less driven by nicotine dependence, tailored approaches to smoking cessation may be needed. Specifically, it may be important for interventions for ITS to address social and situational cues to smoke, including the influence of heavy alcohol use on smoking behaviors, and to provide information regarding the adverse health effects of even low-level smoking.
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Affiliation(s)
- Patricia A. Cioe
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02912, USA
| | - Kristi E. Gamarel
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI 02912, USA
| | - David W. Pantalone
- The Fenway Institute, Fenway Health, Boston, MA, USA
- University of Massachusetts Boston, Boston, MA, USA
| | - Peter M. Monti
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02912, USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Christopher W. Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02912, USA
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Kahler CW, Cioe PA, Tzilos GK, Spillane NS, Leggio L, Ramsey SE, Brown RA, O'Malley SS. A Double-Blind Randomized Placebo-Controlled Trial of Oral Naltrexone for Heavy-Drinking Smokers Seeking Smoking Cessation Treatment. Alcohol Clin Exp Res 2017; 41:1201-1211. [PMID: 28401564 DOI: 10.1111/acer.13396] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 04/06/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Post hoc analyses of 2 randomized controlled trials suggest naltrexone may reduce alcohol use and improve smoking cessation outcomes among heavy drinkers receiving smoking cessation treatment. However, no studies have been conducted specifically to examine naltrexone for this purpose or to test whether naltrexone has benefit when added to smoking cessation counseling that explicitly addresses heavy drinking. METHODS We recruited heavy-drinking smokers from the community and randomized them to receive 10 weeks of either (i) 50 mg naltrexone (n = 75) or (ii) placebo (n = 75) daily. Participants received 6 weeks of transdermal nicotine patch and 6 sessions of counseling that addressed both heavy drinking and smoking. Participants were followed for 26 weeks after their target quit smoking date. RESULTS Across medication conditions, there were substantial reductions at follow-up in percent heavy drinking days (primary outcome) and average drinks per week (secondary outcome). However, participants receiving naltrexone did not differ significantly from those receiving placebo on percent heavy drinking days (effect size d = -0.04, 95% CI [-0.30, 0.22], p = 0.76) or average drinks per week (d = -0.09, 95% CI [-0.35, 0.18], p = 0.54) during follow-up. Naltrexone compared to placebo was not associated with a significant increase in smoking abstinence rates during follow-up, odds ratio = 0.93, 95% CI [0.46, 1.86], p = 0.83. The effect of naltrexone on these outcomes was not significantly moderated by current alcohol dependence or gender. CONCLUSIONS Results indicate that heavy-drinking smokers, including those with current alcohol dependence, can make substantial reductions in drinking in the context of smoking cessation treatment. However, this study provided no evidence that naltrexone is efficacious for enhancing reductions in drinking or improving smoking cessation in this population. Limitations of this study included lower-than-desired sample size and modest adherence to study medication.
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Affiliation(s)
- Christopher W Kahler
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Patricia A Cioe
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Golfo K Tzilos
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - Nichea S Spillane
- Department of Psychology, University of Rhode Island, South Kingston, Rhode Island
| | - Lorenzo Leggio
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island.,Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, Bethesda, Maryland
| | - Susan E Ramsey
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island.,Department of Medicine, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
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Cohn AM, Ehlke SJ, Cobb CO, Soule EK. Hookah tobacco smoking in a large urban sample of adult cigarette smokers: Links with alcohol and poly-tobacco use. Addict Behav 2017; 68:1-5. [PMID: 28086138 PMCID: PMC5293175 DOI: 10.1016/j.addbeh.2016.12.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/15/2016] [Accepted: 12/23/2016] [Indexed: 10/20/2022]
Abstract
Hookah tobacco smoking (HTS) has been increasing, particularly among young adults and has similar health effects compared to cigarette smoking. The link between HTS and poly-tobacco use is well documented, but fewer show an association between HTS and alcohol use. It is essential to identify factors that increase the risk for or addictiveness and consequences of HTS, given its growing prevalence. This study examined whether the association between HTS and poly-tobacco use differed as a function of age and alcohol consumption within in a sample of 1223 adult cigarette smokers. Approximately 20% of participants reported HTS. Compared to non-users, hookah users were more likely to be male, highly educated, and to report drug and alcohol use, binge drinking, and poly-tobacco use but were less likely to be heavy smokers (≥10 cigarettes per day). Regression analyses predicting number of tobacco products used (excluding cigarettes and HTS) indicated a three-way interaction of HTS, frequency of alcohol use, and age such that the association between HTS and number of tobacco products used was strongest for younger respondents who consumed alcohol more frequently. As observed in previous studies, alcohol is an important risk factor in the relationship between HTS and poly-tobacco use, particularly among younger cigarette smokers. The links between alcohol, HTS, and poly-tobacco use should be considered when developing HTS education and prevention materials directed toward younger cigarette smokers. Findings provide information relevant to FDA's interest in the addiction potential of HTS and its link to poly-tobacco use.
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Affiliation(s)
- Amy M Cohn
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street NW, 4th Floor, Washington, DC, USA; Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, 3970 Reservoir Road NW, Washington, DC, USA.
| | - Sarah J Ehlke
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street NW, 4th Floor, Washington, DC, USA
| | - Caroline O Cobb
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Eric K Soule
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
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Cohn A, Ehlke S, Cobb CO. Relationship of nicotine deprivation and indices of alcohol use behavior to implicit alcohol and cigarette approach cognitions in smokers. Addict Behav 2017; 67:58-65. [PMID: 28038363 PMCID: PMC5250545 DOI: 10.1016/j.addbeh.2016.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 11/21/2016] [Accepted: 12/06/2016] [Indexed: 01/05/2023]
Abstract
Alcohol and smoking frequently co-occur and alcohol is a primary trigger for smoking behavior and relapse back to smoking. This study examined whether several indices of alcohol use behavior and consequences of use would be associated with changes in implicit alcohol-approach versus implicit cigarette-approach cognitions under cigarette deprived and non-deprived cognitions in 109 smokers who drank at risky or non-risky levels. An Implicit Association Task (IAT) measured how quickly respondents paired alcohol and cigarette pictures with approach and avoid words. Regression analyses examined the associations of quantity/frequency, proportion heavy drinking days, number of DSM-IV alcohol use disorder (AUD) symptoms, and risky drinking status to IAT scores under deprived conditions, controlling for IAT order effects, non-deprived IAT score, and deprived cigarette craving and withdrawal. Interactions with craving and withdrawal intensity were also examined. Results showed a significant positive association between proportion of heavy drinking days and stronger alcohol-approach than cigarette-approach motivations when deprived. There was also a conditional association of AUD symptoms to alcohol-approach motivations among respondents reporting more intense withdrawal when deprived. Alcohol quantity and frequency, as well as risky drinking status were unrelated to change in IAT scores. Findings suggest that cigarette deprivation may magnify motivation to drink, rather than smoke, among smokers who engage in more frequent bouts of heavy drinking and who report more alcohol-related problems. Results also show relative momentary and unconscious "preference" or choice for alcohol over cigarettes in some high-risk smokers, when cigarette craving and withdrawal are high.
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Affiliation(s)
- Amy Cohn
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA; Department of Oncology, Georgetown University Medical Center, USA.
| | - Sarah Ehlke
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA; Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Caroline O Cobb
- Department of Psychology & Center for Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
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Cross SJ, Lotfipour S, Leslie FM. Mechanisms and genetic factors underlying co-use of nicotine and alcohol or other drugs of abuse. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:171-185. [PMID: 27532746 DOI: 10.1080/00952990.2016.1209512] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Concurrent use of tobacco and alcohol or psychostimulants represents a major public health concern, with use of one substance influencing consumption of the other. Co-abuse of these drugs leads to substantial negative health outcomes, reduced cessation, and high economic costs, but the underlying mechanisms are poorly understood. Epidemiological data suggest that tobacco use during adolescence plays a particularly significant role. Adolescence is a sensitive period of development marked by major neurobiological maturation of brain regions critical for reward processing, learning and memory, and executive function. Nicotine exposure during this time produces a unique and long-lasting vulnerability to subsequent substance use, likely via actions at cholinergic, dopaminergic, and serotonergic systems. In this review, we discuss recent clinical and preclinical data examining the genetic factors and mechanisms underlying co-use of nicotine and alcohol or cocaine and amphetamines. We evaluate the critical role of nicotinic acetylcholine receptors throughout, and emphasize the dearth of preclinical studies assessing concurrent drug exposure. We stress important age and sex differences in drug responses, and highlight a brief, low-dose nicotine exposure paradigm that may better model early use of tobacco products. The escalating use of e-cigarettes among youth necessitates a closer look at the consequences of early adolescent nicotine exposure on subsequent alcohol and drug abuse.
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Affiliation(s)
- Sarah J Cross
- a Department of Anatomy & Neurobiology , School of Medicine, University of California , Irvine , CA , USA
| | - Shahrdad Lotfipour
- b Department of Emergency Medicine , School of Medicine, University of California , Irvine , CA , USA.,c Department of Pharmacology , School of Medicine, University of California , Irvine , CA , USA
| | - Frances M Leslie
- a Department of Anatomy & Neurobiology , School of Medicine, University of California , Irvine , CA , USA.,c Department of Pharmacology , School of Medicine, University of California , Irvine , CA , USA
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Was it the drink? The conditioned association of alcohol and desire to quit smoking on the dual use of little cigars/cigarillos and cigarettes among men and women. Addict Behav 2016; 59:48-51. [PMID: 27070096 DOI: 10.1016/j.addbeh.2016.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 03/15/2016] [Accepted: 03/17/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Dual use of little cigars/cigarillos (LCCs) with cigarettes is becoming more popular; especially among men, but infrequently studied. Dual tobacco users show a higher prevalence of health-risk behaviors such as drug and alcohol use, are likely exposed to higher levels of nicotine and tobacco-related toxicants, and have greater difficulty quitting and maintaining abstinence. This study examined the effects of alcohol use, and desire to quit smoking on dual use of LCCs and cigarettes among men and women. METHODS Data utilized responses from a screening survey of 571 adult smokers. Basic demographic information, current cigarette use, desire to quit smoking, frequency of current LCC use, and alcohol and drug use were collected. RESULTS Dual users were more likely to be male and younger, report drug use in the past 90-days, and have a lower desire to quit smoking. Regression analyses showed a 3-way interaction of gender, alcohol use frequency, and desire to quit smoking, such that men who drank alcohol more frequently who had a higher desire to quit smoking used LCCs more frequently than men with a lower desire to quit. DISCUSSION Alcohol use may be a risk factor for men's dual use of LCCs and cigarettes among those who want to quit smoking. Implications for prevention and treatment are discussed.
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Lechner WV, Knopik VS, McGeary JE, Spillane NS, Tidey JW, McKee SA, Metrik J, Leventhal AM, Rohsenow DJ, Kahler CW. Influence of the A118G Polymorphism of the OPRM1 Gene and Exon 3 VNTR Polymorphism of the DRD4 Gene on Cigarette Craving After Alcohol Administration. Nicotine Tob Res 2016; 18:632-6. [PMID: 26092968 PMCID: PMC5896808 DOI: 10.1093/ntr/ntv136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 06/10/2015] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The current study examined whether the presence of the G allele of the A118G polymorphism of the OPRM1 gene (rs1799971) and the long allele of exon 3 VNTR polymorphism of the DRD4 gene moderate the effect of alcohol administration on urge to smoke. These polymorphisms have been associated with greater alcohol induced-urge to drink. Urge to drink and alcohol consumption increase urge to smoke. Therefore, these polymorphisms may also sensitize urge to smoke after alcohol consumption. METHODS Individuals smoking 10-30 cigarettes per day and reporting heavy drinking were recruited from the community. Caucasians (n = 62), 57.3% male, mean age 39.2, took part in a three-session, within-subjects, repeated-measures design study. Participants were administered a placebo, 0.4 g/kg, or 0.8 g/kg dose of alcohol. A118G genotype, exon 3 VNTR genotype, and urge to smoke (baseline and three times after receiving alcohol) were assessed. RESULTS G allele carriers showed greater urge to smoke across all assessments. Additionally, a significant interaction indicated that G carriers, compared to homozygotes (AA), evinced a significantly greater increase in urge to smoke after high dose alcohol relative to placebo. The interaction between condition, DRD4 polymorphism, and time was not significant. CONCLUSIONS Presence of G allele of the A118G polymorphism of the OPRM1 gene may lead to greater increases in urge to smoke after a high dose of alcohol. Pharmacotherapies targeted to opiate receptors (eg, naltrexone) may be especially helpful in aiding smoking cessation among G carriers who are heavy drinkers.
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Affiliation(s)
- William V Lechner
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI;
| | - Valerie S Knopik
- Division of Behavioral Genetics, Rhode Island Hospital, Providence, RI; Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
| | - John E McGeary
- Division of Behavioral Genetics, Rhode Island Hospital, Providence, RI; Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
| | - Nichea S Spillane
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI
| | | | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI; Providence Veterans Affairs Medical Center, Providence, RI
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA
| | - Damaris J Rohsenow
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI; Providence Veterans Affairs Medical Center, Providence, RI
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI
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Twyman L, Bonevski B, Paul C, Bryant J, West R, Siahpush M, D'Este C, Oldmeadow C, Palazzi K. Factors Associated With Concurrent Tobacco Smoking and Heavy Alcohol Consumption Within a Socioeconomically Disadvantaged Australian Sample. Subst Use Misuse 2016; 51:459-70. [PMID: 26942661 DOI: 10.3109/10826084.2015.1122065] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Tobacco use and heavy alcohol consumption occur more frequently in socioeconomically disadvantaged groups. Little is known about the sociodemographic and psychosocial factors associated with use of alcohol and tobacco in disadvantaged groups in comparison to low-risk users. OBJECTIVES This study aimed to compare the characteristics of low-risk users with: disadvantaged smokers only; disadvantaged heavy drinkers only; and disadvantaged concurrent smokers and heavy drinkers. METHODS A cross-sectional survey of socioeconomically disadvantaged adult clients attending a community welfare agency assessed tobacco use, alcohol use, demographic, and psychosocial variables. Multivariable analysis using multinomial logistic regression was carried out. RESULTS The sample consisted of 835 participants; 40% (n = 331) were concurrent users, 31% were smokers only (n = 252), 11% were heavy drinkers only (n = 93), and 18% were low-risk users (n = 149). Compared with those who neither smoked nor consumed alcohol heavily, concurrent users were more likely to be younger, have only some contact with family, have more friends and family who were smokers, have no fixed home address, live alone, and have higher levels of financial stress. Most of these factors were shared by individuals who were smokers only. Factors associated with heavy drinkers only were frequent contact with family and having more friends and family who were smokers. CONCLUSION Among those Australians who suffer severe economic hardship, being a concurrent smoker and heavy drinker appears to be associated with more isolated living conditions and financial stress but some contact with family.
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Affiliation(s)
- Laura Twyman
- a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia
| | - Billie Bonevski
- a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia
| | - Christine Paul
- a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia.,b Hunter Medical Research Institute , Newcastle , Australia
| | - Jamie Bryant
- c Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute , Newcastle , Australia
| | - Robert West
- d Department of Epidemiology and Public Health , University College London , London , United Kingdom
| | - Mohammad Siahpush
- e Department of Health Promotion, Social and Behavioral Health , University of Nebraska Medical Center , Omaha , Nebraska , USA
| | - Catherine D'Este
- f National Centre for Epidemiology and Population Health, Australian National University , Canberra , Australia
| | - Christopher Oldmeadow
- a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia.,b Hunter Medical Research Institute , Newcastle , Australia
| | - Kerrin Palazzi
- b Hunter Medical Research Institute , Newcastle , Australia
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Bold KW, McCarthy DE, Minami H, Yeh VM, Chapman GB, Waters AJ. Independent and interactive effects of real-time risk factors on later temptations and lapses among smokers trying to quit. Drug Alcohol Depend 2016; 158:30-7. [PMID: 26585613 PMCID: PMC4698113 DOI: 10.1016/j.drugalcdep.2015.10.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 10/01/2015] [Accepted: 10/26/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE The current study sought to expand our understanding of relapse mechanisms by identifying the independent and interactive effects of real-time risk factors on temptations and the ability to resist temptations in smokers during a quit attempt. PROCEDURES This study was a secondary analysis of data from 109 adult, treatment-seeking daily smokers. Ecological momentary assessment data was collected 4 times a day for 21 days following a quit attempt and was used to assess affect, urge, impulsiveness, recent cigarette exposure, and alcohol use as predictors of temptations to smoke and smoking up to 8h later. All smokers received nicotine replacement therapy and smoking cessation counseling. FINDINGS In multinomial hierarchical linear models, there were significant main (agitation odds ratio (OR)=1.22, 95% CI=1.02-1.48; urge OR=1.60, 95% CI=1.35-1.92; nicotine dependence measured by WISDM OR=1.04, 95% CI=1.01-1.08) and interactive effects (agitation×urge OR=1.12, 95% CI=1.01-1.27; urge×cigarette exposure OR=1.38, 95% CI=1.10-1.76; positive affect×impulsiveness OR=2.44, 95% CI=1.02-5.86) on the odds of temptations occurring, relative to abstinence without temptation. In contrast, prior smoking (OR=3.46, 95% CI=2.58-4.63), higher distress (OR=1.30, 95% CI=1.06-1.60), and recent alcohol use (OR=3.71, 95% CI=1.40-9.89) predicted smoking versus resisting temptation, and momentary impulsiveness was related to smoking for individuals with higher baseline impulsiveness (OR=1.12, 95% CI=1.04-1.22). CONCLUSIONS The risk factors and combinations of factors associated with temptations and smoking lapses differ, suggesting a need for separate models of temptation and lapse.
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Affiliation(s)
- Krysten W Bold
- Rutgers, The State University of New Jersey, Department of Psychology, 152 Frelinghuysen Road, Piscataway, NJ 08854-8020, USA; Institute for Health, Health Care Policy, and Aging Research, 112 Paterson Street, New Brunswick, NJ 08901-1293, USA; Yale School of Medicine, Department of Psychiatry, CMHC, 34 Park Street, New Haven, CT 06519, USA.
| | - Danielle E McCarthy
- Rutgers, The State University of New Jersey, Department of Psychology, 152 Frelinghuysen Road, Piscataway, NJ 08854-8020, USA; Institute for Health, Health Care Policy, and Aging Research, 112 Paterson Street, New Brunswick, NJ 08901-1293, USA
| | - Haruka Minami
- Rutgers, The State University of New Jersey, Department of Psychology, 152 Frelinghuysen Road, Piscataway, NJ 08854-8020, USA; Institute for Health, Health Care Policy, and Aging Research, 112 Paterson Street, New Brunswick, NJ 08901-1293, USA; Fordham University, Department of Psychology, 441 E. Fordham Road, Bronx, NY 10458, USA
| | - Vivan M Yeh
- Rutgers, The State University of New Jersey, Department of Psychology, 152 Frelinghuysen Road, Piscataway, NJ 08854-8020, USA; Institute for Health, Health Care Policy, and Aging Research, 112 Paterson Street, New Brunswick, NJ 08901-1293, USA; Deloitte Consulting LLP, 25 Broadway, New York, NY 10004, USA
| | - Gretchen B Chapman
- Rutgers, The State University of New Jersey, Department of Psychology, 152 Frelinghuysen Road, Piscataway, NJ 08854-8020, USA; Institute for Health, Health Care Policy, and Aging Research, 112 Paterson Street, New Brunswick, NJ 08901-1293, USA
| | - Andrew J Waters
- Uniformed Services University of the Health Sciences, Medical and Clinical Psychology, 4301 Jones Bridge Road, Bethesda, MD 20814-4799, USA
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Ojo-Fati O, John F, Thomas J, Joseph AM, Raymond NC, Cooney NL, Pratt R, Rogers CR, Everson-Rose SA, Luo X, Okuyemi KS. Integrating smoking cessation and alcohol use treatment in homeless populations: study protocol for a randomized controlled trial. Trials 2015; 16:385. [PMID: 26320081 PMCID: PMC4552980 DOI: 10.1186/s13063-015-0858-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/10/2015] [Indexed: 12/02/2022] Open
Abstract
Background Despite progress in reducing cigarette smoking in the general U.S. population, smoking rates, cancer morbidity and related heart disease remain strikingly high among the poor and underserved. Homeless individuals’ cigarette smoking rate remains an alarming 70 % or greater, and this population is generally untreated with smoking cessation interventions. Furthermore, the majority of homeless smokers also abuse alcohol and other drugs, which makes quitting more difficult and magnifies the health consequences of tobacco use. Methods/Design Participants will be randomized to one of three groups, including (1) an integrated intensive smoking plus alcohol intervention using cognitive behavioral therapy (CBT), (2) intensive smoking intervention using CBT or (3) usual care (i.e., brief smoking cessation and brief alcohol counseling). All participants will receive 12-week treatment with a nicotine patch plus nicotine gum or lozenge. Counseling will include weekly individual sessions for 3 months, followed by monthly booster group sessions for 3 months. The primary smoking outcome is cotinine-verified 7-day smoking abstinence at follow-up week 52, and the primary alcohol outcome will be breathalyzer-verified 90-day alcohol abstinence at week 52. Discussion This study protocol describes the design of the first community-based controlled trial (n = 645) designed to examine the efficacy of integrating alcohol abuse treatment with smoking cessation among homeless smokers. To further address the gap in effectiveness of evidence-based smoking cessation interventions in the homeless population, we are conducting a renewed smoking cessation clinical trial called Power to Quit among smokers experiencing homelessness. Trial registration ClinicalTrials.gov Identifier: NCT01932996. Date of registration: 20 November 2014.
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Affiliation(s)
- Olamide Ojo-Fati
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Florence John
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Janet Thomas
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Department of Medicine, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Anne M Joseph
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Department of Medicine, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Nancy C Raymond
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Department of Psychiatry, University of Minnesota Medical School, Medical School, Academic Affairs, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
| | - Ned L Cooney
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT, 06511, USA.
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Charles R Rogers
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Susan A Everson-Rose
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Department of Medicine, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Xianghua Luo
- Division of Biostatistics, School of Public Health, University of Minnesota, A460 Mayo Building, MMC 303, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
| | - Kolawole S Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
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Fucito LM, Hanrahan TH. Heavy-Drinking Smokers' Treatment Needs and Preferences: A Mixed-Methods Study. J Subst Abuse Treat 2015; 59:38-44. [PMID: 26297324 DOI: 10.1016/j.jsat.2015.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/12/2015] [Accepted: 07/06/2015] [Indexed: 02/07/2023]
Abstract
The purpose of this mixed methods study was to describe the smoking and psychological characteristics of heavy-drinking smokers, their perceptions of smoking and drinking, and their smoking and alcohol treatment preferences to inform an integrated smoking and alcohol intervention. Heavy-drinking smokers (N=26) completed standardized surveys and participated in semi-structured focus group interviews. Participants reported a strong association between their smoking and drinking. Participants were more motivated to quit smoking than to reduce their drinking but perceived greater barriers to smoking cessation. Stress/negative affect was closely linked with both behaviors. They expressed overall enthusiasm for a smoking and alcohol intervention but had specific format and content preferences. Half preferred an integrated treatment format whereas others preferred a sequential treatment model. The most preferred content included personalized health feedback and a way to monitor health gains after behavior changes.
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Affiliation(s)
- Lisa M Fucito
- Yale School of Medicine, Department of Psychiatry, 1 Long Wharf Drive, Box 18, New Haven, CT 06511, USA; Smilow Cancer Hospital at Yale-New Haven, 20 York Street, New Haven, CT 06519, USA; Yale Cancer Center, 333 Cedar Street, New Haven, CT, 06510, USA.
| | - Tess H Hanrahan
- Yale School of Medicine, Department of Psychiatry, 1 Long Wharf Drive, Box 18, New Haven, CT 06511, USA
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Toll BA, Martino S, O'Malley SS, Fucito LM, McKee SA, Kahler CW, Rojewski AM, Mahoney MC, Wu R, Celestino P, Seshadri S, Koutsky J, Hyland A, Cummings KM. A randomized trial for hazardous drinking and smoking cessation for callers to a quitline. J Consult Clin Psychol 2015; 83:445-54. [PMID: 25419583 PMCID: PMC5996380 DOI: 10.1037/a0038183] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study evaluated whether tobacco quitline telephone coaches can be trained to counsel hazardous-drinking smokers to improve smoking cessation success and to limit or abstain from alcohol use. METHOD Smokers (N = 1,948) who called the New York State Smokers' Quitline and reported hazardous drinking (exceeding sex-specific weekly limits [14 drinks for men, 7 drinks for women] or meeting/exceeding daily drinking limits [5 drinks for men, 4 drinks for women] at least once in the past year) were randomized to receive either brief motivational counseling to limit or abstain from alcohol plus an alcohol reduction booklet added to standard care (Alcohol + Tobacco Counseling; ATC), or only smoking cessation counseling plus a smoking cessation booklet added to standard care (Tobacco-Only Counseling; TOC). RESULTS Acceptable coach adherence was achieved. The intention-to-treat (ITT) analysis showed that ATC was associated with a significantly higher rate of smoking abstinence at 7-month follow-up (13.5%) compared with TOC (10.3%; p = .03). The respondent analysis (ATC= 26.2%; TOC = 20.4%) paralleled the ITT findings. When controlling for treatment condition, participants who did not report any heavy drinking were significantly more likely to quit smoking than those who reported any heavy drinking (OR = 1.87, 95% CI [1.29, 2.71]; p = .001). CONCLUSIONS A brief alcohol intervention plus standard care via a telephone quitline resulted in significantly higher smoking cessation rates for hazardous-drinking callers. Given that quitline coaches were trained to provide the intervention with acceptable adherence, the potential to extend this intervention for wide-scale implementation and impact is promising.
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Affiliation(s)
| | - Steve Martino
- Department of Psychiatry, Yale University School of Medicine, VA Connecticut Healthcare Center
| | | | | | | | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Department of Behavior and Social Sciences, Brown University School of Public Health
| | | | | | | | - Paula Celestino
- Department of Health Behavior, Roswell Park Cancer Institute
| | | | - James Koutsky
- Department of Health Behavior, Roswell Park Cancer Institute
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Cancer Institute
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina
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Pengpid S, Peltzer K, Puckpinyo A, Viripiromgool S, Thamma-Aphiphol K, Suthisukhon K, Dumee D, Kongtapan T. Screening and concurrent brief intervention of conjoint hazardous or harmful alcohol and tobacco use in hospital out-patients in Thailand: a randomized controlled trial. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2015; 10:22. [PMID: 26013537 PMCID: PMC4448213 DOI: 10.1186/s13011-015-0018-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 05/20/2015] [Indexed: 11/14/2022]
Abstract
Background The aim of this study was to conduct a cluster randomized control trial to assess the efficacy of screening and brief intervention (SBI) for conjoint alcohol and tobacco use among hospital out-patients. Method In all 620 hospital out-patients who screened positive for both tobacco and alcohol moderate risk in four hospitals were randomized into 2 control and 1 intervention condition using the hospital as a unit of randomization (2 intervention and 2 control hospitals) to 405 patients in the two control groups (tobacco only intervention, n = 199, and alcohol only intervention, n = 206) and 215 in the intervention group. The intervention or control consisted of three counselling sessions. Results Results of the interaction (Group × Time) effects using GEE indicated that there were statistically significant differences between the three study groups over the 6-month follow-up on the ASSIST tobacco score (Wald χ2 = 8.43, P = 0.004), and past week tobacco use abstinence (Wald χ2 = 7.34, P = 0.007). Although there were no significant interaction effects on the other outcomes (Alcohol ASSIST score, low alcohol risk score, past week tobacco abstinence or low alcohol risk score, and past week tobacco abstinence and low alcohol risk score), the scores in all of the six outcome measures showed consistent improvements. For past week tobacco abstinence the tobacco only intervention was more effective than the alcohol only intervention and the integrated alcohol and tobacco intervention. For the outcome of low alcohol risk, the alcohol only intervention and the integrated alcohol and tobacco intervention was more effective than the tobacco only or alcohol only intervention. Conclusions The study found that for past week tobacco abstinence the tobacco only intervention was more effective than the alcohol only intervention and the polydrug use (alcohol and tobacco) integrated intervention.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya Phutthamonthon, Nakhonpathom, Thailand. .,University of Limpopo, Turfloop Campus, Turfloop, South Africa.
| | - Karl Peltzer
- ASEAN Institute for Health Development, Mahidol University, Salaya Phutthamonthon, Nakhonpathom, Thailand. .,University of Limpopo, Turfloop Campus, Turfloop, South Africa. .,HIV/AIDS/STIs/and TB (HAST), Human Sciences Research Council, Pretoria, South Africa.
| | - Apa Puckpinyo
- ASEAN Institute for Health Development, Mahidol University, Salaya Phutthamonthon, Nakhonpathom, Thailand.
| | - Somchai Viripiromgool
- ASEAN Institute for Health Development, Mahidol University, Salaya Phutthamonthon, Nakhonpathom, Thailand.
| | - Kriengsak Thamma-Aphiphol
- ASEAN Institute for Health Development, Mahidol University, Salaya Phutthamonthon, Nakhonpathom, Thailand.
| | - Kawinarat Suthisukhon
- ASEAN Institute for Health Development, Mahidol University, Salaya Phutthamonthon, Nakhonpathom, Thailand.
| | - Dussanee Dumee
- ASEAN Institute for Health Development, Mahidol University, Salaya Phutthamonthon, Nakhonpathom, Thailand.
| | - Thiprada Kongtapan
- ASEAN Institute for Health Development, Mahidol University, Salaya Phutthamonthon, Nakhonpathom, Thailand.
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Gilchrist G, Davidson S, Middleton A, Herrman H, Hegarty K, Gunn J. Factors associated with smoking and smoking cessation among primary care patients with depression: a naturalistic cohort study. ADVANCES IN DUAL DIAGNOSIS 2015. [DOI: 10.1108/add-10-2014-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– People with a history of depression are more likely to smoke and less likely to achieve abstinence from smoking long term. The purpose of this paper is to understand the factors associated with smoking and smoking cessation among patients with depression.
Design/methodology/approach
– This paper reports on smoking prevalence and cessation in a cohort of 789 primary care attendees with depressive symptoms (Centre for Epidemiologic Studies Depression Scale score of=16) recruited from 30 randomly selected Primary Care Practices in Victoria, Australia in 2005.
Findings
– At baseline, 32 per cent of participants smoked. Smokers were more likely to be male, unmarried, receive government benefits, have difficulty managing on available income, have emphysema, a chronic illness, poor self-rated health, to have more severe depressive and anxiety symptoms, to be taking anti-depressants, to be hazardous drinkers, to report suicidal ideation and to have experienced childhood physical or sexual abuse. At 12 months, 20 participants reported quitting. Females and people with good or better self-rated health were significantly more likely to have quit, while people with a chronic illness or suicidal ideation were less likely to quit. Smoking cessation was not associated with increases in depression or anxiety symptoms. Only six participants remained quit over four years.
Practical implications
– Rates of smoking were high, and long-term cessation was low among primary care patients with depressive symptoms. Primary care physicians should provide additional monitoring and support to assist smokers with depression quit and remain quit.
Originality/value
– This is the first naturalistic study of smoking patterns among primary care attendees with depressive symptoms.
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Allan NP, Albanese BJ, Norr AM, Zvolensky MJ, Schmidt NB. Effects of anxiety sensitivity on alcohol problems: evaluating chained mediation through generalized anxiety, depression and drinking motives. Addiction 2015; 110:260-8. [PMID: 25220033 PMCID: PMC4302006 DOI: 10.1111/add.12739] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 04/22/2014] [Accepted: 09/03/2014] [Indexed: 11/26/2022]
Abstract
AIMS To test whether the relations between anxiety sensitivity (AS), a transdiagnostic risk factor, and alcohol problems are explained by chained mediation models, from AS through anxiety or depressive symptoms then drinking motives in an at-risk sample. It was hypothesized that AS would influence alcohol problems through generalized anxiety or depression symptoms and then through negatively reinforced drinking motives (i.e. drinking to cope with negative affect and drinking to conform). DESIGN Cross-sectional single- and chained-mediation models were tested. SETTING Self-report measures were completed in clinics at Florida State University and the University of Vermont, USA. PARTICIPANTS Participants consisted of 523 adult daily cigarette smokers [mean age = 37.23, standard deviation (SD) = 13.53; 48.6% female]. MEASUREMENTS As part of a larger battery of self-report measures, participants completed self-report measures of AS, generalized anxiety, depression, drinking motives and alcohol problems. FINDINGS Chained mediation was found from AS to alcohol problems through generalized anxiety then through drinking to cope with negative affect [B = 0.04, 90% confidence interval (CI) = 0.004, 0.10)]. Chained mediation was also found from AS to alcohol problems through depression then through drinking to cope with negative affect (B = 0.11, 90% CI = 0.05, 0.21) and, separately, through socially motivated drinking (B = 0.05, 90% CI = 0.003, 0.11). CONCLUSIONS Anxiety sensitivity and alcohol problems are indirectly related through several intervening variables, such as through generalized anxiety or depression and then through drinking to cope with negative affect.
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Affiliation(s)
- Nicholas P. Allan
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
| | - Brian J. Albanese
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
| | - Aaron M. Norr
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
| | | | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
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Kahler CW, Metrik J, Spillane NS, Day A, Leventhal AM, McKee SA, Tidey JW, McGeary JE, Knopik VS, Rohsenow DJ. Acute effects of low and high dose alcohol on smoking lapse behavior in a laboratory analogue task. Psychopharmacology (Berl) 2014; 231:4649-57. [PMID: 24858377 PMCID: PMC4232980 DOI: 10.1007/s00213-014-3613-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 05/01/2014] [Indexed: 11/26/2022]
Abstract
RATIONALE Smoking lapses (i.e., returns to smoking after quitting) often occur following alcohol consumption with observational data suggesting greater quantities of alcohol lead to greater risk. However, a causal dose-dependent effect of alcohol consumption on smoking lapse behavior has not been established, and the mechanisms that might account for such an effect have not been tested. OBJECTIVES In a within-subjects design, we examined the effects of low- (0.4 g/kg) and high-dose (0.8 g/kg) alcohol, relative to placebo, on smokers' ability to resist initiating smoking after acute smoking abstinence. METHODS Participants were 100 heavy alcohol drinkers, smoking 10-30 cigarettes per day. Across three separate days, participants consumed placebo, low-dose, or high-dose alcohol following 3 h of smoking abstinence and, 35 min later, were offered the opportunity to smoke while resisting smoking was monetarily reinforced proportional to the amount of time delayed. RESULTS Consistent with a dose-response effect, participants smoked 3.35 min (95 % confidence intervals (CI) [-7.09, 0.40], p = .08) earlier following low-dose alcohol and 6.36 min (95 % CI [-9.99, -2.73], p = .0006) earlier following high-dose alcohol compared to drinking a placebo beverage. Effects of dose on smoking behavior were partially mediated by increases in urge to smoke. There was no evidence that alcohol's effects on urge to smoke or ability to resist smoking were mediated through its stimulating or sedating effects. CONCLUSIONS Alcohol can reduce the ability to resist smoking in a dose-dependent fashion, in part, due to its effect on increasing the intensity of smoking urges.
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Affiliation(s)
- Christopher W Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, USA,
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Pulvers K, Hayes RB, Scheuermann TS, Romero DR, Emami AS, Resnicow K, Olendzki E, Person SD, Ahluwalia JS. Tobacco Use, Quitting Behavior, and Health Characteristics Among Current Electronic Cigarette Users in a National Tri-Ethnic Adult Stable Smoker Sample. Nicotine Tob Res 2014; 17:1085-95. [PMID: 25385875 DOI: 10.1093/ntr/ntu241] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 11/03/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The present study characterizes the tobacco use, quitting behaviors, and health characteristics of cigarette smokers who did not change their smoking pattern over the past 6 months and have used electronic cigarettes (ECs) in the past 30 days. This is an important subpopulation to characterize if EC dual use with cigarettes continues to grow. METHODS Participants (N = 2,376) from a research survey panel completed an online cross-sectional survey between June and August 2012. Sampling was stratified to recruit equal numbers of cigarette smoking participants by race/ethnicity (Black, Hispanic, and Caucasian) and smoking frequency (nondaily and daily). All displayed a stable rate of smoking for the past 6 months and were not currently in treatment. Bivariate and multivariate analyses were used to examine correlates of current EC use (any use within the past 30 days). RESULTS Current EC use was reported by 9.2% (n = 219) of the total sample. Of current EC users, 44% reported having used ECs as a quit method. Bivariate and multivariate analyses showed that current EC use was significantly associated with greater nicotine dependence, concurrent poly-tobacco use, more past-year quit attempts, past use of multiple cessation methods, and more depressive symptoms. No demographic variables were significantly associated with current EC use. CONCLUSIONS This study suggests that stable smokers who currently use ECs possess characteristics that are associated with difficulty in achieving smoking cessation. These characteristics should be considered when examining the effectiveness of ECs on cessation and in designing future cessation trials using ECs.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA;
| | - Rashelle B Hayes
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Devan R Romero
- Department of Kinesiology, California State University San Marcos, San Marcos, CA
| | - Ashley S Emami
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Effie Olendzki
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Sharina D Person
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Jasjit S Ahluwalia
- Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN
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Fridberg DJ, Cao D, Grant JE, King AC. Naltrexone improves quit rates, attenuates smoking urge, and reduces alcohol use in heavy drinking smokers attempting to quit smoking. Alcohol Clin Exp Res 2014; 38:2622-9. [PMID: 25335648 DOI: 10.1111/acer.12513] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 07/10/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Heavy drinking smokers (HDS) have more difficulty quitting smoking than lighter drinkers or abstainers. The opioid antagonist naltrexone may improve smoking quit rates and reduce alcohol use in drinker-smokers, but its relative efficacy in smokers with a range of drinking patterns is unknown. The current study tested the hypothesis that HDS would show differential benefit of naltrexone versus placebo relative to moderate-to-light or nondrinking smokers in terms of improving smoking outcomes and reducing alcohol consumption. METHODS Adult smokers (N = 315) enrolled in a 12-week, double-blinded, placebo-controlled trial of 50 mg naltrexone for smoking cessation were categorized into subgroups based upon past 6-month drinking patterns: HDS (n = 69; i.e., averaged ≥2 heavy drinking episodes per month), moderate-to-light drinking smokers (n = 204, i.e., consumed 1 drink up to a maximum of <2 heavy drinking episodes per month on average), or nondrinking smokers (n = 42, no alcohol consumed in the past 6 months). The groups were compared on the main study outcomes of biochemically verified prolonged abstinence quit rates (i.e., no smoking weeks 2 to 12), and smoking urge and alcohol use (drinks/wk) during treatment. RESULTS Naltrexone significantly increased 12-week smoking abstinence rates and decreased smoking urge and alcohol use among HDS, but not moderate-to-light or nondrinking smokers. Mediation analyses in HDS revealed that naltrexone's effect on smoking urge during the first 4 weeks of treatment mediated its effect on quit rates. CONCLUSIONS HDS appear to be particularly sensitive to naltrexone effects on smoking and drinking outcomes. This group may represent an important target for adjunctive treatment with naltrexone to optimize smoking cessation outcomes.
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Affiliation(s)
- Daniel J Fridberg
- Department of Psychiatry & Behavioral Neuroscience , The University of Chicago, Chicago, Illinois
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