TIMING OF SMOKING INTERVENTION IN ALCOHOL TREATMENT

酗酒者中吸烟的比例为80- 90%， 吸烟和酗酒者的发病率和死亡率增加 与不吸烟者相比。 数据显示， 戒烟，即使是在酒精治疗的时候。 有 越来越多的人认为尼古丁依赖应该得到解决 在这个人群中，但缺乏有效的知识， 战略和最佳干预时机。 烟草 一般被排除在酒精和药物混合治疗之外 由于担心危及治疗结果，无论如何， 新的证据表明，吸烟干预可能会改善酒精 治疗结果。 我们建议随机审判 吸烟干预的有效性， 强化酒精治疗与延迟的吸烟干预 直到酒精治疗后6个月，以比较1）短， 长期戒烟率和2）酒精治疗 结果。 我们将招募500名患有酒精使用障碍的患者 他们也在明尼阿波利斯的四个治疗项目中吸烟 （Fairview滨江医疗中心，Hazelden，Minneapolis VA， 和马约诊所），并将其随机分配至同时或 延迟吸烟干预 吸烟干预将 包括行为成分和透皮尼古丁 替代疗法，并且在两种治疗中相同 除了交货的时间。 主 终点是参与吸烟干预，持续 戒烟3个月和12个月后， 吸烟干预，减少酒精消费， 饮酒后6、12和18个月的酒精依赖严重程度 干预 标准方法包括时间线跟踪 背部，酒精依赖量表，贝克抑郁量表， 治疗服务审查，呼气测醉器测试，附带报告， 尼古丁依赖性、唾液可替宁和 过期的一氧化碳将用于收集数据和验证 结果。 将使用多变量方法比较ndpoints 在两个吸烟治疗组中， 吸烟干预对酒精治疗结果的影响。 结果 该项目将提供有关最佳时机的可靠指导 对酗酒患者进行吸烟干预 治疗，并最终证明是否同时发生 干预对酒精有积极、消极或中性的影响 治疗结果。

The prevalence of smoking in alcoholics is 80-90 percent, andsmoking alcoholics suffer increased morbidity and mortality compared to nonsmokers. Data show considerable interest in quitting smoking, even at the time of alcohol treatment. There is growing consensus that nicotine dependence should be addressed in this population, but a lack of knowledge about effective strategies and optimal timing for intervention. Tobacco has generally been excluded from mixed alcohol and drug treatment because fear of jeopardizing treatment outcomes, however there is new evidence that smoking intervention may improve alcohol treatment outcomes. We propose a radomized trial of the effectiveness of smoking intervention delivered concurrently with intensive alcohol treatment vs smoking intervention that is delayed until 6 months after alcohol treatment to compare 1) short and long-term smoking cessation rates and 2) alcohol treatment outcomes. We will recruit 500 patients with alochol use disorder who also smoke from four treatment programs in Minneasota (Fairview Riverside Medical Center, Hazelden, Minneapolis VA, and thhe Mayo Clinic), and randomize them to concurrent or delayed smoking intervention. The smoking intervention will include a behavioral component and transdermal nicotine replacement therapy , and will be the same in both treatment groups with exception of the timing of delivery. The primary endpoints are participation in the smoking intervention, continuous and point prevalent smoking abstinence 3 and 12 months after smoking intervention, and reduction in alcohol consumption and severity of alcohol dependence 6, 12, and 18 months after alcohol intervention. Standard methods including the Time Line Follow Back, Alcohol Dependence Scale, Beck Depression Inventory, Treatment Services Review, breathalyzer tests, collateral reports, Fagerstrom Test for Nicotine Dependence, saliva cotinine, and expired carbon monoxide will be used to collect data and validate outcomes. Multivariate methods will be used to compare ndpoints in the two smoking treatment groups and to measure the effect of smoking intervention on alcohol treatment outcomes. Results from this project will provide reliable guidance about the optimal timing for smoking intervention for patients who undergo alcohol treatment, and conclusively demonstrate whether concurrent intervention has a positive, negative, or neutral effect on alcohol treatment outcomes.