Recovery from alcohol dependence: Do smoking indicators predict abstinence?
Recovery from alcohol dependence: Do smoking indicators predict abstinence?
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DOI：
10.1111/ajad.12535
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发表时间：
2017-06-01
影响因子：
3.7
通讯作者：
Wodarz, Norbert
中科院分区：
文献类型：
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作者：
Hufnagel, Anna;Frick, Ulrich;Wodarz, Norbert
背景与目的关于吸烟对酒精依赖恢复的潜在影响的证据并不一致。我们的研究旨在评估吸烟行为对酒精使用障碍（AUD）患者戒毒后12个月随访期间复发的影响。方法从德国两所精神病院戒毒中心招募300例AUD患者（吸烟74.9%），对其饮酒情况进行为期1年的前瞻性随访。收集了有关吸烟行为不同指标的数据。采用Cox回归模型评价酒精消费复发时间的潜在危险因素。279名参与者（n=279）被纳入最终分析。结果吸烟增加酒精复发的风险（风险比=3.962,95% CI = 1.582-9.921）。然而，随着每天吸烟数量的增加，这种增加的风险略有降低（每支香烟的风险比= 0.986,95% CI = 0.976 - 0.995）。结论吸烟显著降低了酒精依赖患者维持戒酒的可能性，而每天吸烟数量的增加则降低了酒精依赖患者酒精复发的风险。科学意义对急性期后不同亚组AUD患者进行协调的精神病学和药物滥用干预是必要的。个体化的治疗计划对于容易复发饮酒和躯体并发症的吸烟AUD患者尤为重要。我们的发现可能支持个体化治疗方案。（Am J Addict 2017;26:36 -373）
Background and ObjectivesThere is inconsistent evidence about the potential influence of smoking on recovery from alcohol dependence. Our study aimed at assessing the impact of smoking-behavior on relapse during a 12 months follow-up period following a detoxification in patients with Alcohol Use Disorder (AUD).MethodsThree hundred Patients with AUD (74.9% smoking) were recruited from two inpatient detoxification units in psychiatric hospitals in Germany and their alcohol consumption was prospectively followed for 1 year. Data on different indicators of smoking behavior was gathered. Cox regression model was used to evaluate potential risk factors on time to relapse of alcohol consumption. Two hundred seventy-nine participants (n=279) were included in the final analysis.ResultsSmoking increased the risk for alcohol relapse (hazard ratio=3.962, 95% CI 1.582-9.921). However, this increased risk is slightly reduced with higher numbers of daily consumed cigarettes (hazard ratio per cigarette=.986, 95% CI .976-.995).ConclusionSmoking reduced the probability of maintaining alcohol abstinence significantly, whereas higher number of cigarettes smoked daily diminished the increased risk of alcohol relapse in alcohol-dependent patients.Scientific SignificanceCoordinated psychiatric and substance abuse interventions for different subgroups of patients with AUD in the post-acute treatment phase are necessary. Individualized treatment planning is especially important in smoking patients with AUD who are vulnerable for a relapse to alcohol drinking and for somatic complications. Our findings might support individualized treatment plans. (Am J Addict 2017;26:366-373)