1. Predictors of reduced smoking quantity among recovering alcohol dependent men in a smoking cessation trial
- Author
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Worley, Matthew J, Isgro, Melodie, Heffner, Jaimee L, Lee, Soo Yong, Daniel, Belinda E, and Anthenelli, Robert M
- Subjects
Biological Psychology ,Psychology ,Neurosciences ,Tobacco Smoke and Health ,Behavioral and Social Science ,Alcoholism ,Alcohol Use and Health ,Brain Disorders ,Clinical Research ,Tobacco ,Substance Misuse ,Prevention ,Cancer ,Clinical Trials and Supportive Activities ,6.1 Pharmaceuticals ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Respiratory ,Cardiovascular ,Stroke ,Good Health and Well Being ,Adult ,Adult Survivors of Child Abuse ,Alcohol Abstinence ,Alcoholism ,Cognition ,Depression ,Humans ,Impulsive Behavior ,Male ,Middle Aged ,Motivation ,Prognosis ,Randomized Controlled Trials as Topic ,Smoking ,Smoking Cessation ,Smoking Reduction ,Tobacco Use Disorder ,Topiramate ,Smoking cessation ,Nicotine ,Alcohol dependence ,Public Health and Health Services ,Substance Abuse ,Public health ,Biological psychology ,Clinical and health psychology - Abstract
IntroductionAdults with alcohol dependence (AD) have exceptionally high smoking rates and poor smoking cessation outcomes. Discovery of factors that predict reduced smoking among AD smokers may help improve treatment. This study examined baseline predictors of smoking quantity among AD smokers in a pharmacotherapy trial for smoking cessation.MethodsThe sample includes male, AD smokers (N = 129) with 1-32 months of alcohol abstinence who participated in a 12-week trial of medication (topiramate vs. placebo) and adjunct counseling with 6 months of follow-up. Baseline measures of nicotine dependence, AD severity, psychopathology, motivation to quit smoking, and smoking-related cognitions were used to predict smoking quantity (cigarettes per day) at post-treatment and follow-up.ResultsOverall, the sample had statistically significant reductions in smoking quantity. Greater nicotine dependence (Incidence rate ratios (IRRs) = 0.82-0.90), motivation to quit (IRRs = 0.65-0.85), and intrinsic reasons for quitting (IRRs = 0.96-0.98) predicted fewer cigarettes/day. Conversely, greater lifetime AD severity (IRR = 1.02), depression severity (IRRs = 1.05-1.07), impulsivity (IRRs = 1.01-1.03), weight-control expectancies (IRRs = 1.10-1.15), and childhood sexual abuse (IRRs = 1.03-1.07) predicted more cigarettes/day.ConclusionsSmokers with AD can achieve large reductions in smoking quantity during treatment, and factors that predict smoking outcomes in the general population also predict greater smoking reductions in AD smokers. Treatment providers can use severity of nicotine dependence and AD, motivation to quit, smoking-related cognitions, and severity of depression to guide treatment and improve outcomes among AD smokers.
- Published
- 2018