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Cinquetti A, Terranova C, Aprile A, Favretto D. Driving license regranting: Hair EtG, serum CDT, and the role of sociodemographic and medicolegal variables. Drug Test Anal 2023; 15:953-961. [PMID: 36525282 DOI: 10.1002/dta.3426] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/11/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Abstract
Driving under the influence (DUI) of alcohol is a road safety problem. Driving license regranting is based on the evaluation of medicolegal and toxicological variables that may include serum carbohydrate-deficient transferrin (CDT) and hair ethyl glucuronide (hEtG). The aim of the study was to compare the diagnostic performance of CDT and hEtG in a population of DUI offenders. Other factors potentially associated with heavy alcohol use were explored. The population included DUI offenders examined during the period of January 1, 2019, through June 30, 2022. Sociodemographic, medicolegal, and toxicological variables were collected. CDT in serum and EtG in head hair were determined in all subjects. Excessive alcohol intake (hEtG ≥30 pg/mg) was considered cause for unfitness to drive. Cohen's kappa coefficient was calculated. Descriptive analyses were performed using chi-square and Mann-Whitney tests. Variables significantly different between the groups were included in a multivariate binary logistic regression model. The sample encompassed 838 subjects (case group: 179, comparison group: 689). CDT exhibited poor agreement (κ = 0.053) with hEtG as the reference test. Lower education, age at DUI, heavy smoking, and GGT levels associated with heavy alcohol consumption differentiated the two groups. For DUI offenders, the use of CDT to assess heavy alcohol consumption is limited, possibly due to the time-window assessed, the time required for normalization, and the different amount of ethanol needed to reach higher CDT levels, in comparison to hEtG; thus, hEtG assessment is strongly recommended for this population. Heavy smoking, GGT, education, and age could be related to heavy alcohol consumption and higher risk of DUI.
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Affiliation(s)
- Alessandro Cinquetti
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Claudio Terranova
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Anna Aprile
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Donata Favretto
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
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Frie JA, Nolan CJ, Murray JE, Khokhar JY. Addiction-Related Outcomes of Nicotine and Alcohol Co-use: New Insights Following the Rise in Vaping. Nicotine Tob Res 2022; 24:1141-1149. [PMID: 34758090 PMCID: PMC9278825 DOI: 10.1093/ntr/ntab231] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/03/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022]
Abstract
PURPOSE Nicotine and alcohol-containing products are some of the most commonly used substances of abuse and are both leading causes of preventable death. These substances also have significant interactions that have additive and, in some cases, multiplicative effects on the health consequences of their use. Thus, to reduce these negative consequences, it is important to understand the abuse liability of nicotine and alcohol in combination, especially in the most relevant use cases among those who are most vulnerable. Specifically, as tobacco cigarette use is continually decreasing, vaping is quickly replacing cigarettes as the primary mode of nicotine use. This pattern is especially true in adolescent populations in which vaping has grown considerably. Particularly concerning is that adolescents are more vulnerable than adults to the negative consequences of substance use. It is therefore imperative to revisit the literature as it relates to the rising state of co-use of vaping products with alcohol. Here, we review the clinical outcomes of nicotine and alcohol co-use as they relate to the abuse liability of each individually. Special attention is paid to adolescent findings, where available, as well as investigations that use nontobacco nicotine products as these may more accurately reflect the more recent trends of co-use. IMPLICATIONS Though nicotine alone has previously been considered a proxy for tobacco and tobacco cigarette use, combustible routes of administration have been decreasing. They are, instead, being replaced by e-cigarettes that do not involve other tobacco constituents and contain additional nonnicotine constituents of their own. Unfortunately, the literature remains limited with regard to e-cigarettes and their interactions with other substances, especially their prevalent co-use with alcohol. This review attempts to discuss the current literature on nicotine and alcohol co-use in the context of the vaping epidemic, predominantly focusing on addiction-related outcomes and why e-cigarette use may be unique.
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Affiliation(s)
- Jude A Frie
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
- Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
| | - Caitlin J Nolan
- Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Jennifer E Murray
- Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
- Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
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Ritchie EV, Fitzpatrick C, Ronksley PE, Leung AA, Seidel S, McGrath DS. The Effect of Alcohol Cue Exposure on Tobacco-Related Cue Reactivity: A Systematic Review. Alcohol Alcohol 2022; 57:104-112. [PMID: 33589917 DOI: 10.1093/alcalc/agab009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS To examine the effect of alcohol cue exposure on tobacco-related cravings, self-administration and other measures of tobacco-related cue reactivity. METHODS We searched Medline, PsycINFO, Embase, CINAHL and Scopus from inception to May 2020 for articles reporting on a combination of cue reactivity (and/or cross-cue reactivity), alcohol use and tobacco consumption. A semi-quantitative analysis and study quality assessment were performed for the included articles. RESULTS A total of 37 articles met our inclusion criteria and were included in the systematic review. Most studies (60%) reported that alcohol cue exposure increased tobacco cravings, but only 18% of studies reported that alcohol cue exposure resulted in an increase in ad libitum smoking. There was also substantial heterogeneity between studies due to differences in methodology related to alcohol cue exposure, measures of tobacco cravings, as well as variable participant and study characteristics. CONCLUSIONS Alcohol cue exposure can increase cravings for tobacco. This has important implications for individuals who use both substances but are trying to quit one or both.
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Affiliation(s)
- Emma V Ritchie
- Department of Psychology, University of Calgary, Administration Building, Room AD255 2500 University Dr NW Calgary, AB T2N 1N4 Canada
- York University Faculty of Health Department of Psychology, Room 101 Behavioural Sciences Building, 4700 Keele Street Toronto, Ontario M3J 1P3 Canada
| | - Chelsea Fitzpatrick
- Department of Psychology, University of Calgary, Administration Building, Room AD255 2500 University Dr NW Calgary, AB T2N 1N4 Canada
| | - Paul E Ronksley
- Department of Community Health Sciences, University of Calgary, 3D10, 3280 Hospital Drive NW Calgary, AB T2N 4Z6 Canada
| | - Alexander A Leung
- Department of Community Health Sciences, University of Calgary, 3D10, 3280 Hospital Drive NW Calgary, AB T2N 4Z6 Canada
- Department of Medicine, Health Sciences Centre Foothills Campus, University of Calgary, 3330 Hospital Drive NW Calgary, Alberta T2N 4N1 Canada
| | - Sydney Seidel
- Department of Psychology, University of Calgary, Administration Building, Room AD255 2500 University Dr NW Calgary, AB T2N 1N4 Canada
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, Administration Building, Room AD255 2500 University Dr NW Calgary, AB T2N 1N4 Canada
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Hershberger AR, Studebaker A, Whitt ZT, Fillmore M, Kahler CW, Cyders MA. An Experimental Test of the Relationship between Electronic Nicotine Delivery System Use and Alcohol Consumption. Alcohol Clin Exp Res 2021; 45:808-818. [PMID: 33547653 PMCID: PMC8076069 DOI: 10.1111/acer.14566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Increasing research shows that the use of electronic nicotine delivery systems (ENDS) is associated with a higher rate and quantity of alcohol consumption. METHODS The present study used a 2-session, within-subjects design to experimentally examine the relationship between ENDS use and laboratory ad libitum alcohol consumption. A total of N = 31 (mean age = 28.71, SD = 11.17; 45.2% women; 54.8% White/Caucasian) healthy adults from the community who use ENDS and endorsed liking beer completed the study, which included a beer consumption taste-test task that assessed the volume of beer consumed by the participants across 2 counterbalanced sessions: 1 in which concurrent ENDS use was allowed and 1 in which it was not. All analyses controlled for age, race, and gender. RESULTS The effect of ENDS condition on the volume of beer consumed was not statistically significant, F(1, 30) = 0.03, p = 0.86). Results of linear mixed modeling showed that ENDS puffs were significantly related to alcohol sips (estimate = 0.23, SE = 0.07, p = 0.002) across the ad libitum session. CONCLUSIONS Overall, ENDS use did not increase alcohol consumption; however, the data suggest that ENDS puffs might act as a prime for beer sips or that these 2 behaviors are linked through habit. Future studies should more fully measure and compare global and event-level data on ENDS and alcohol use as they might show disparate patterns of relationships.
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Affiliation(s)
| | - Amanda Studebaker
- Department of Psychology, Indiana University Purdue University Indianapolis
| | - Zachary T. Whitt
- Department of Psychology, Indiana University Purdue University Indianapolis
| | - Mark Fillmore
- Departmet of Psychology, University of Kentucky, Lexington, KY
| | - Christopher W. Kahler
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Melissa A. Cyders
- Department of Psychology, Indiana University Purdue University Indianapolis
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Nguyen N, McQuoid J, Neilands TB, Dermody SS, Holmes LM, Ling PM, Thrul J. Same-day use of cigarettes, alcohol, and cannabis among sexual minority and heterosexual young adult smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:215-223. [PMID: 32804517 PMCID: PMC7887119 DOI: 10.1037/adb0000678] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Sexual minority (SM) young adults have higher rates of substance use than heterosexuals, but little is known about daily use of multiple substances, which confer numerous health risks for this population. Using daily diary data from a smartphone-based study, we examined the associations between sexual identity (i.e., SM vs. heterosexual) and patterns of same-day multiple substance use (i.e., cigarettes and alcohol, cigarettes and cannabis, alcohol and cannabis, and all 3 substances). METHOD Young adult smokers (N = 147, aged 18-26, 51.7% female, 41.5% SM, 40.8% White) reported consecutive daily assessments on substance use over 30 days. We used generalized estimating equations to examine associations between sexual identity and patterns of same-day multiple substance use, controlling for demographic factors and psychological distress. RESULTS Of 2,891 daily assessments, 16.7% reported same-day use of cigarettes and alcohol, 18.1% cigarettes and cannabis, 1.5% alcohol and cannabis, and 15.0% use of all 3 substances. SM participants (vs. heterosexuals) had significantly greater odds of reporting days with use of cigarettes and cannabis [Adjusted Odds Ratio (AOR) = 2.05, 95% Confidence Interval (CI) [1.04, 4.01]] and use of all three substances (AOR = 2.79, 95% CI [1.51, 5.14]) than days with single substance use or no use. CONCLUSIONS These findings warrant tailored interventions addressing multiple substance use among SM young adults and temporally accurate measures of multiple substance use patterns. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Nhung Nguyen
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA
| | - Julia McQuoid
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA
| | - Torsten B. Neilands
- Center for AIDS Prevention Studies, Division of Prevention Science, University of California, San Francisco, San Francisco, CA
| | - Sarah S. Dermody
- School of Psychological Science, Oregon State University, Corvallis, OR
| | - Louisa M. Holmes
- Social Science Research Institute, Penn State University, University Park, PA
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA
| | - Johannes Thrul
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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Dermody SS, Tessier KM, Meier E, al'Absi M, Denlinger-Apte RL, Drobes DJ, Jensen J, Koopmeiners JS, Pacek LR, Tidey JW, Vandrey R, Donny E, Hatsukami D. An Evaluation of Potential Unintended Consequences of a Nicotine Product Standard: A Focus on Drinking History and Outcomes. Nicotine Tob Res 2020; 23:1168-1175. [PMID: 33220047 DOI: 10.1093/ntr/ntaa236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/16/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION A nicotine product standard reducing the nicotine content in cigarettes could improve public health by reducing smoking. This study evaluated the potential unintended consequences of a reduced nicotine product standard by examining its effects on (1) smoking behaviors based on drinking history; (2) drinking behavior; and (3) daily associations between smoking and drinking. METHODS Adults who smoke daily (n = 752) in the United States were randomly assigned to smoke very low nicotine content (VLNC) cigarettes versus normal nicotine content (NNC; control) cigarettes for 20 weeks. Linear mixed models determined if baseline drinking moderated the effects of VLNC versus NNC cigarettes on Week 20 smoking outcomes. Time-varying effect models estimated the daily association between smoking VLNC cigarettes and drinking outcomes. RESULTS Higher baseline alcohol use (vs no use or lower use) was associated with a smaller effect of VLNC on Week 20 urinary total nicotine equivalents (ps < .05). No additional moderation was supported (ps > .05). In the subsample who drank (n = 415), in the VLNC versus NNC condition, daily alcohol use was significantly reduced from Weeks 17 to 20 and odds of binge drinking were significantly reduced from Weeks 9 to 17. By Week 7, in the VLNC cigarette condition (n = 272), smoking no longer predicted alcohol use but remained associated with binge drinking. CONCLUSIONS We did not support negative unintended consequences of a nicotine product standard. Nicotine reduction in cigarettes generally affected smoking behavior for individuals who do not drink or drink light-to-moderate amounts in similar ways. Extended VLNC cigarette use may improve public health by reducing drinking behavior. IMPLICATIONS There was no evidence that a VLNC product standard would result in unintended consequences based on drinking history or when considering alcohol outcomes. Specifically, we found that a very low nicotine standard in cigarettes generally reduces smoking outcomes for those who do not drink and those who drink light-to-moderate amounts. Furthermore, an added public health benefit of a very low nicotine standard for cigarettes could be a reduction in alcohol use and binge drinking over time. Finally, smoking VLNC cigarettes may result in a decoupling of the daily associations between smoking and drinking.
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Affiliation(s)
- Sarah S Dermody
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | | | - Ellen Meier
- Department of Psychology, University of Wisconsin-Stevens Point, USA
| | - Mustafa al'Absi
- Masonic Cancer Center, University of Minnesota, Duluth, MN, USA
| | - Rachel L Denlinger-Apte
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - David J Drobes
- Tobacco Research and Intervention Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Joni Jensen
- Masonic Cancer Center, University of Minnesota, Duluth, MN, USA
| | | | - Lauren R Pacek
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jennifer W Tidey
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA.,Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Ryan Vandrey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Eric Donny
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Dermody SS, Hendershot CS, Andrade AK, Novalen M, Tyndale RF. Changes in Nicotine Metabolite Ratio Among Daily Smokers Receiving Treatment for Alcohol Use Disorder. Nicotine Tob Res 2020; 22:256-263. [PMID: 30561731 DOI: 10.1093/ntr/nty265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/13/2018] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Alcohol may influence the nicotine metabolite ratio (NMR), an index of the rate of nicotine metabolism that is associated smoking level and lapses. We examined if NMR changes during alcohol use disorder (AUD) treatment and how changes in NMR relate to reductions in drinking. METHODS Using an observational design, 22 daily smokers [63.64% male, Mage = 46.77 (11.37)] receiving AUD treatment completed baseline and follow-up appointments 3 weeks apart. At each appointment, daily alcohol and cigarette use, salivary and urinary NMR, nicotine exposure via urinary total nicotine equivalents, and carbon monoxide were assessed. Multilevel models examined the change over time in NMR and its within-person relations with changes in drinks per week. Sex differences were evaluated. RESULTS There were significant reductions in both salivary and urinary NMR over time for men (p = .02; p = .01, respectively) but not for women (p = .54; p = .90, respectively). There were no changes over time in total nicotine equivalents (p = .09), carbon monoxide (p = .44), or cigarette use (p = .44) in either sex. Drinks per week were significantly reduced for men (29.12 drink reduction, p < .001) but not for women (2.28 drink reduction, p = .80); however, within-person changes in drinking were not associated with changes in salivary or urinary NMR (p = .99; p = .19). CONCLUSIONS The reduction in alcohol use and NMR in men provides indirect support for alcohol increasing NMR. In contrast, the low baseline drinking and lack of alcohol reduction likely underlie the lack of change in NMR in females. Reasons for NMR reductions during AUD treatment and its effects on smoking require further study. IMPLICATIONS Three weeks of alcohol use disorder treatment among daily smokers coincided with a significant reduction in both alcohol use and NMR for men; however, neither drinking level nor NMR changed for women. The findings indirectly support that heavy drinking increases NMR, which is reversed with reduced drinking. Additional research is needed to establish if these changes in NMR correlate with smoking and cessation outcomes.
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Affiliation(s)
- Sarah S Dermody
- School of Psychological Science, Oregon State University, Corvallis, OR
| | - Christian S Hendershot
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Allyson K Andrade
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Maria Novalen
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
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8
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Changes in behavioral and neuronal parameters by alcohol, cigarette, or their combined use in rats. Behav Pharmacol 2020; 30:490-499. [PMID: 30724798 DOI: 10.1097/fbp.0000000000000476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Few studies have explored the effects of the combined use of alcohol and cigarette in humans, despite its prevalence. Here we evaluated the effect of isolated and combined use on behaviors and neuronal parameters in rats. Male adult rats were divided into alcohol (AL, 2 g/kg, by oral gavage), cigarette smoke (TB, six cigarettes, by inhalation), combined use (ALTB), or control (CT, water by oral gavage and environmental air) groups, treated twice a day (09.00 and 14.00 h). After 4 weeks, the rats were tested in the open field for behavioral analysis and euthanized for brain volume estimation and counting of neurons in the hippocampus. All treatments increased locomotion, and this behavior was higher in the ALTB than TB group. Latency to exit from the central area was lower in the ALTB than in the AL or CT groups. Rearing behavior increased in TB and decreased in AL and ALTB rats. Combined ALTB rats significantly increased their grooming behavior. Only the AL group showed decreased neuron counts and increased brain volume. Our results show that the isolated and combined uses of alcohol and cigarette smoke have diverse effects on behavioral and neuronal parameters in rats after long-term treatment.
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9
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Dermody SS, Shiffman S. The time-varying effect of alcohol use on cigarette smoking relapse risk. Addict Behav 2020; 102:106192. [PMID: 31726424 DOI: 10.1016/j.addbeh.2019.106192] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/27/2019] [Accepted: 10/23/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Alcohol consumption promotes lapses to smoking among smokers trying to quit, perhaps particularly among smokers with lower dependence. We assessed how the role of alcohol in lapses varies over time. METHODS This is a secondary analysis of ecological momentary assessment data collected from 159 daily smokers (mean age = 43.90 (SD = 10.41), 56.60% female) who drink alcohol. During the 4 weeks following initial cessation (quit >24 h), a logistic time-varying effect model (TVEM) modeled momentary assessments of lapses and temptations to smoke compared to randomly-selected moments as a function of concurrently-assessed recent alcohol use (past 15 min). Time was examined continuously. RESULTS Recent alcohol use was associated with smoking lapses, particularly for less nicotine dependent individuals, and the association varied across time. For individuals who did not smoke within 5 min of waking, alcohol use became a significant predictor of lapse on Day 1 post-quit, increased in strength until Day 7, then decreased such that alcohol use was no longer associated with lapse by Day 25. For this subgroup, the associations between alcohol use and temptations were relatively stable and significant from Day 1 to 22 post-quit. Results were similar when dependence was assessed by the Nicotine Dependence Symptom Scale. CONCLUSIONS The association between drinking and smoking lapse and temptations varies over time, peaking early in smoking abstinence and declining thereafter. This could reflect progressive relapse of most vulnerable individuals or habituation to alcohol as a smoking cue. Interventions to prevent alcohol-related lapses are essential early in the quit period.
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Weinberger AH, Pacek LR, Giovenco D, Galea S, Zvolensky MJ, Gbedemah M, Goodwin RD. Cigarette Use Among Individuals with Alcohol Use Disorders in the United States, 2002 to 2016: Trends Overall and by Race/Ethnicity. Alcohol Clin Exp Res 2018; 43:79-90. [PMID: 30408209 DOI: 10.1111/acer.13922] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/12/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Individuals with alcohol use disorders (AUDs) who smoke cigarettes experience greater health risks than those using either substance alone. Further, disparities exist in AUDs and smoking by race/ethnicity. Although smoking has declined in the general population, it is not known whether the smoking prevalence has changed over time for individuals with AUDs. The current study used representative U.S. data to estimate the prevalence of current cigarette use from 2002 to 2016 by AUD status and severity overall and by race/ethnicity. METHODS Data were drawn from the National Survey on Drug Use and Health, an annual cross-sectional study of U.S. individuals, from 2002 to 2016 (total analytic sample n = 837,326). Cigarette smoking prevalence was calculated annually among those with and without past-year AUD and by AUD severity level (mild, moderate, severe AUD). Time trends in smoking prevalence by AUD status and severity were tested using logistic regression for the overall sample and significant interactions were subsequently stratified by race/ethnicity (non-Hispanic [NH] White, NH Black, Hispanic, NH Other). RESULTS Cigarette use was persistently over twice as common among those with AUDs compared to without AUDs (2016: 37.84% vs. 16.29%). Cigarette use was also more common among those at each level of AUD severity criteria (2016: mild AUD 34.59%; moderate AUD 35.35%; severe AUD 52.23%). Approximately half of NH Black respondents with AUDs, and three-quarters of NH Black respondents with severe AUDs, reported smoking in 2016. The prevalence of smoking decreased significantly over time among respondents with and without AUDs; however, there were differences by race. There was no decline in smoking prevalence among NH Black respondents with AUDs over time in contrast to a significant decrease for every other racial/ethnic group with and without AUDs. CONCLUSIONS Individuals with AUDs may need additional resources and interventions to quit smoking, especially NH Black individuals.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology , Yeshiva University, Bronx, New York.,Department of Epidemiology & Population Health , Albert Einstein College of Medicine, Bronx, New York
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences , Duke University School of Medicine, Durham, North Carolina
| | - Daniel Giovenco
- Department of Sociomedical Sciences , Mailman School of Public Health, Columbia University, New York, New York
| | - Sandro Galea
- Department of Epidemiology , Boston University School of Public Health, Boston, Massachusetts
| | | | - Misato Gbedemah
- Department of Epidemiology and Biostatistics , Graduate School of Public Health and Health Policy, The City University of New York, New York, New York.,Institute for Implementation Science in Population Health , The City University of New York, New York, New York
| | - Renee D Goodwin
- Department of Epidemiology and Biostatistics , Graduate School of Public Health and Health Policy, The City University of New York, New York, New York.,Institute for Implementation Science in Population Health , The City University of New York, New York, New York.,Department of Epidemiology , Mailman School of Public Health, Columbia University, New York, New York
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Roberts W, Moore K, Peltier MR, Verplaetse TL, Oberleitner L, Hacker R, McKee SA. Electronic Cigarette Use and Risk of Harmful Alcohol Consumption in the U.S. Population. Alcohol Clin Exp Res 2018; 42:2385-2393. [PMID: 30222189 PMCID: PMC6286236 DOI: 10.1111/acer.13889] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 09/05/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Electronic cigarette (e-cigarette) use is an increasingly common method of nicotine delivery in the general population. It is well-established that tobacco users are at increased risk to engage in hazardous drinking and meet criteria for alcohol use disorder (AUD) relative to nonusers. Less is known, however, about the risk of harmful alcohol use among people who use e-cigarettes. The current study reports on the association between e-cigarette and alcohol use in the U.S. population using a nationally representative sample. METHODS Data from 36,309 adults who participated in the National Epidemiologic Survey on Alcohol and Related Conditions-Wave III were included in the study. The Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS) measured past-year e-cigarette and alcohol use outcomes. Based on past-year e-cigarette use, respondents were categorized as nonusers, nondaily users, or daily users. Alcohol use outcomes were drinking quantity/frequency, binge drinking frequency, AUD diagnostic status, and National Institute on Alcohol Abuse and Alcoholism-defined hazardous drinking status. RESULTS Controlling for demographic characteristics, daily and nondaily e-cigarette users showed increased risk of harmful alcohol use compared to e-cigarette nonusers, including hazardous drinking (adjusted odds ratios [AORs] = 1.69; 2.48), AUD (AORs = 1.89; 2.44), and binge drinking frequency (AORs = 1.30 to 3.30). Nondaily e-cigarette use was associated with higher levels of risk than was daily use. Secondary analyses examined alcohol use outcomes according to participants' patterns of dual tobacco cigarette/e-cigarette use. These analyses confirmed that e-cigarette use alongside tobacco cigarette use is associated with additive risk of harmful alcohol consumption, particularly among nondaily users. CONCLUSIONS E-cigarette users, particularly those who engage in nondaily and dual use, show elevated rates of harmful alcohol use. Heavy drinking may constitute a source of health risk among e-cigarette users.
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Affiliation(s)
- Walter Roberts
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
| | - Kelly Moore
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
| | - MacKenzie R. Peltier
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
| | - Terril L. Verplaetse
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
| | - Lindsay Oberleitner
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
| | - Robyn Hacker
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
| | - Sherry A. McKee
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven CT, 06519
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Implicit Alcohol and Smoking Associations among Young Adult Heavy Drinkers: Associations with Smoking Status and Alcohol-Cigarette Co-Use. MOTIVATION AND EMOTION 2018; 42:682-690. [PMID: 31598024 DOI: 10.1007/s11031-018-9701-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Implicit memory associations may play a role in motivation to use alcohol and cigarettes, but the relationship between implicit associations and co-use of alcohol and cigarettes is currently unknown. This study provided an initial examination of alcohol and smoking implicit associations among young adult drinkers who were either nonsmokers or relatively light smokers (i.e., 10 or fewer cigarettes per day) as a function of smoking frequency and daily-level alcohol-cigarette co-use. Drinkers (N = 129) completed alcohol-arousal and smoking-valence variants of the Implicit Association Test as well as a daily-level assessment of past 90-day alcohol and cigarette use. Smokers were grouped according to whether they reported daily or nondaily smoking frequency. Results showed that although implicit alcohol-arousal associations did not differ between smokers and nonsmokers, stronger implicit alcohol-arousal associations were observed for nondaily smokers relative to daily smokers after controlling for drinking frequency. Further, implicit positive-smoking associations were stronger for smokers relative to nonsmokers. Within the subgroup of nondaily smokers, more frequent co-use of alcohol and cigarettes was associated with stronger implicit positive-smoking associations when controlling for total drinking and smoking frequency. The findings suggest that implicit alcohol and smoking associations may be linked with smoking patterns (daily vs. nondaily) and co-use of alcohol and cigarettes among young adult drinkers who are not heavy smokers, highlighting the need for more research on the role of implicit associations in the co-use of cigarettes and alcohol.
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13
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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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14
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Weinberger AH, Gbedemah M, Goodwin RD. Cigarette smoking quit rates among adults with and without alcohol use disorders and heavy alcohol use, 2002-2015: A representative sample of the United States population. Drug Alcohol Depend 2017; 180:204-207. [PMID: 28918239 PMCID: PMC5693304 DOI: 10.1016/j.drugalcdep.2017.07.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/09/2017] [Accepted: 07/15/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND While the overall smoking quit rate has increased over time, it is not known whether the quit rate has also increased among persons with alcohol use disorders (AUDs) or heavy alcohol use (HAU). The current study examined quit rates among adults with and without AUDs and HAU over a 12-year period in a representative sample of US adults. METHODS Data were drawn from the National Household Survey on Drug Use, an annual cross-sectional study of US persons. Quit rate (i.e., the rate of former smokers to ever smokers) was calculated annually from 2002 to 2014 (for HAU) and 2015 (for AUD). Time trends in quit rates by AUD/HAU status were tested using linear regression. RESULTS The prevalence of past-month cigarette smoking was much higher for persons with, compared to without, AUDs (38% vs. 18%) and HAU (49% vs. 19%). In the most recent data year, the quit rate for persons with AUDs was approximately half that of persons without AUDs (26% versus 49%) and for persons with HAU was less than half that of persons without HAU (22% versus 48%). Over time, the smoking quit rate increased for persons with and without AUDs/HAU and the rate of increase was greater for persons with AUDs/HAU. Yet, quit rates for persons with AUDs and HAU remained much lower than persons without AUDs and HAU. CONCLUSIONS It may be beneficial for public health and clinical efforts to incorporate screenings and treatment for tobacco use into programs for adults with AUDs and HAU.
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Affiliation(s)
- Andrea H. Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY 10461 USA,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461 USA
| | - Misato Gbedemah
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA.
| | - Renee D. Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY USA,Institute for Implementation Science and Population Health, CUNY School of Public Health and Health Policy, New York, NY USA,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
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