Alcohol use and initial smoking lapses among heavy drinkers in smoking cessation treatment
Alcohol use and initial smoking lapses among heavy drinkers in smoking cessation treatment
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DOI：
10.1093/ntr/ntq083
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发表时间：
2010-07-01
影响因子：
4.7
通讯作者：
Metrik, Jane
中科院分区：
文献类型：
--
作者：
Kahler, Christopher W.;Spillane, Nichea S.;Metrik, Jane
前言：本研究考察了戒烟治疗中重度非依赖型饮酒者的酒精使用情况及其与初次吸烟行为的关系。方法：在一项随机临床试验中，236名大量饮酒的吸烟者在戒烟治疗中加入了短暂的酒精干预措施。结果：在178名报告戒烟行为的参与者中，41.5%的人在饮酒时发生了行为失误。那些有酒精相关失误的人比那些没有酒精参与的失误的人烟草依赖严重程度低得多，每周喝更多的酒。大多数与酒精有关的失误发生在酒吧或餐馆里，与其他人在一起，当他们心情愉快/好的时候。在以饮酒为时变协变量的生存分析中，适度饮酒与吸烟失误的风险几乎是非饮酒日的四倍，而大量饮酒使吸烟失误的风险比适度饮酒增加一倍。讨论：结果表明，与酒精相关的失误与不与酒精有关的失误在性质上是不同的。此外，在戒酒治疗中大量饮酒的人，即使适度饮酒也会增加吸烟的风险，大量饮酒会进一步增加风险。对大量饮酒者进行戒烟治疗应该强调与任何饮酒和戒烟期间大量饮酒相关的失效风险。
Introduction: This study examined alcohol use and its association with initial smoking lapses among heavy nondependent drinkers in smoking cessation treatment.Methods: Participants were 236 heavy drinking smokers in a randomized clinical trial testing the efficacy of incorporating brief alcohol intervention into smoking cessation treatment.Results: Of the 178 participants who reported a smoking lapse, 41.5% lapsed when drinking alcohol. Those who had alcohol-involved lapses had significantly lower tobacco dependence severity and drank more drinks per week than those who had non-alcohol-involved lapses. The majority of alcohol-involved lapses were in a bar/restaurant, with other people, and when they were in a happy/good mood. In survival analyses with alcohol consumption as a time-varying covariate, moderate drinking days were associated with almost four times greater risk of smoking lapse than non-drinking days, and heavy drinking doubled the risk of lapsing compared with moderate drinking.Discussion: Results suggest that alcohol-related lapses are qualitatively different from lapses that do not involve alcohol. Furthermore, among heavy drinkers in cessation treatment, even moderate alcohol use is associated with increased risk of smoking, with heavy drinking further increasing the risk. Smoking cessation treatments for heavy alcohol drinkers should highlight the lapse risk associated with any alcohol consumption and with heavy drinking during a quit smoking attempt.