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Alcohol Use Intensity Decreases in Response to Successful Smoking Cessation Therapy.

ABSTRACT: Smokers frequently drink heavily. However, the effectiveness of smoking cessation therapy for those with comorbid alcohol abuse is unclear, and the content of smoking cessation programs often does not address comorbid alcohol consumption. In order to achieve a better understanding of the relationship between changes in rate of smoking to the change in intensity of alcohol consumption, and the necessity for alcohol-specific programming for dual users, we quantified cigarette and alcohol consumption in 39 subjects undergoing a 3-month contingency management smoking cessation program using recently developed DNA methylation tools. Intake alcohol consumption, as quantified by the Alcohol T Score (ATS), was highly correlated with cg05575921 smoking intensity (adjusted R² = 0.49) with 19 of the 39 subjects having ATS scores indicative of Heavy Alcohol Consumption. After 90 days of smoking cessation therapy, ATS values decreased with the change in ATS score being highly correlated with change in cg05575921 smoking intensity (adjusted R² = 0.60), regardless of whether or not the subject managed to completely quit smoking. We conclude that alcohol consumption significantly decreases in response to successful smoking cessation. Further studies to determine whether targeted therapy focused on comorbid alcohol use increases the success of smoking cessation in those with dual use should be explored.

SUBMITTER: Philibert R

PROVIDER: S-EPMC8775089 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionThe co-use of cannabis and alcohol among tobacco-using youth is common. Alcohol co-use is associated with worse tobacco cessation outcomes, but results are mixed regarding the impact of cannabis on tobacco outcomes and if co-use leads to increased use of non-treated substances. This secondary analysis from a youth smoking cessation trial aimed to (1) evaluate the impact of cannabis or alcohol co-use on smoking cessation, (2) examine changes in co-use during the trial, and (3) explore secondary effects of varenicline on co-use.MethodsThe parent study was a 12-week, randomized clinical trial of varenicline for smoking cessation among youth (ages 14-21, N = 157; Mage = 19, 40% female; 76% White). Daily cigarette, cannabis, and alcohol use data were collected via daily diaries during treatment and Timeline Follow-back for 14 weeks post-treatment.ResultsBaseline cannabis co-users (68%) had double the odds of continued cigarette smoking throughout the trial compared with noncannabis users, which was pronounced in males and frequent cannabis users. Continued smoking during treatment was associated with higher probability of concurrent cannabis use. Baseline alcohol co-users (80%) did not have worse smoking outcomes compared with nonalcohol users, but continued smoking was associated with higher probability of concurrent drinking. Varenicline did not affect co-use.ConclusionsInconsistent with prior literature, results showed that alcohol co-users did not differ in smoking cessation, whereas cannabis co-users had poorer cessation outcomes. Youth tobacco treatment would benefit from added focus on substance co-use, particularly cannabis, but may need to be tailored appropriately to promote cessation.ImplicationsAmong youth cigarette smokers enrolled in a pharmacotherapy evaluation clinical trial, alcohol and/or cannabis co-use was prevalent. The co-use of cannabis affected smoking cessation outcomes, but more so for males and frequent cannabis users, whereas alcohol co-use did not affect smoking cessation. Reductions in smoking were accompanied by concurrent reductions in alcohol or cannabis use. Substance co-use does not appear to affect all youth smokers in the same manner and treatment strategies may need to be tailored appropriately for those with lower odds of smoking cessation.

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Alcohol Use Intensity Decreases in Response to Successful Smoking Cessation Therapy.

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