Alcohol and tobacco co‐use in nondaily smokers: An inevitable phenomenon?

Introduction and Aims. Alcohol use has consistently been associated with smoking among nondaily smokers. However, this may not be an inevitable relationship that extends across all drinking sessions and/or all nondaily smokers. Recently, distinct subgroups of nondaily smokers have been identified, with one subgroup maintaining a stable pattern of nondaily smoking (long‐term occasional smokers; LOS), and others transitioning to nondaily smoking either from a non‐smoking status (early occasional smokers; EOS) or from a daily smoking status (former daily smokers; FDS). However, little is known about the extent to which these subgroups differ in their alcohol–tobacco co‐administration patterns. Design and Methods. 183 nondaily smokers (74 LOS; 55 EOS; 54 FDS) completed face‐to‐face interviews during which they provided details about their lifetime and past‐week tobacco and alcohol administration patterns. Results. EOS were more likely to report having used alcohol at the time of their first‐ever cigarette relative to the other subgroups (P ≤ 0.001), but there were no differences in past‐week co‐administration patterns between the subgroups. Overall, less than one‐third of all smoking sessions occurred when drinking, but these accounted for more than half of all cigarettes consumed during the previous week. Moreover, while only 42% of drinking sessions involved tobacco co‐administration, when drinking and smoking did co‐occur, significantly greater amounts of alcohol were consumed relative to drinking sessions where no tobacco was used (P < 0.01). Discussion and Conclusions. Findings suggest that alcohol use is not invariably related to smoking in EOS, FDS or LOS, but when it is, across all subgroups co‐administration is associated with mutual dose escalation.[Campbell ML, Bozec LJ, McGrath D, Barrett SP. Alcohol and tobacco co‐use in nondaily smokers: An inevitable phenomenon? Drug Alcohol Rev 2012;31:447–450]     

A problematic drinker in the family: Variations in the level of negative impact experienced by sex,relationship and living status

A national survey on harms experienced from others’ drinking was administered by telephone to 2649 randomly selected adults (18–98 years) in Australia. This article is about responses from participants concerning the family member whose drinking had the most negative impact on them (referred to as the problematic drinker). Respondents were asked about their relationship with the drinker, if they shared a household, and the level of negative impact they experienced. Of the 1494 family members identified as ‘fairly heavy drinkers’/‘drinking a lot sometimes’, the drinking of 592 (39.6%) had negatively affected 415 respondents in the previous 12 months. The problematic drinker was usually male (72.0%) and a partner (22.2%), child (18.2%), or sibling (16.3%). Most problematic drinkers in the home were partners (45.9%) or children (23.5%); there was no significant difference between problematic drinking sons living at home (62.0%) compared with problematic drinking daughters (45.2%). One-third of the respondents (35.8%) were affected ‘a lot’ by the problematic drinker; of those affected a lot, 52.6% lived with the problematic drinker. Severity of impact was significantly associated with the living status of the drinker but not with the sex of the drinker. This population-based study shows negative effects are often experienced when people have a family member who drinks a lot. While partners are often involved, a substantial proportion of problematic drinkers are adult children or siblings.     

The impact of deportation policies on the substance using behaviors of US-citizen Latinos

BackgroundScant data has found that the deportation of a migrant family member has adverse health consequences for their US-citizen family members. However, no study has investigated how the detention or deportations of others (e.g., family, friends) relate to the alcohol and drug-using behaviors of US-citizen Latinos.MethodsFrom April to May 2019, 3,446 adult participants of White, Black, and Latino racial/ethnic descent were recruited to complete a self-administered, structured, online questionnaire. Analyses were restricted to US-citizens only (n = 3,282). Using the Alcohol Use Disorders Identification Test-Concise and the Substance Use Brief Screen scale, the two dependent outcome variables were hazardous drinking and symptoms of a drug use disorder (DUD). Three separate multivariable logistic regression models were conducted to explore how Latinos who personally knew a detained or deported migrant, and their relationship to the detainee/deportee (e.g., family, friend), related to each outcome, relative to other racial/ethnic groups.ResultsOverall 39% of Latinos reported personally knowing a detained or deported migrant. In multivariable analyses, Latinos who knew a detained or deported migrant had significantly higher odds of reporting hazardous drinking and DUD symptoms relative to Whites. Latinos who had a family member detained or deported had 3.91 times the odds of reporting symptoms of DUD, respectively, than Whites. Latinos who had a friend detained or deported had also greater odds of reporting hazardous drinking and DUD symptoms than Whites. Importantly, Latinos who did not personally know a detainee or deportee were not any more likely than Whites to report hazardous drinking and DUD symptoms.ConclusionFindings underscore that detentions and deportations may be influencing the substance using behaviors of US-citizen Latinos and may potentially exacerbate or perpetuate substance abuse-related disparities. Public health and policy implications are discussed.     

Methamphetamine use among young adults: health and social consequences

The current research analyzed the relationship between methamphetamine use and health and social outcomes. Interviews were conducted with a sample of 106 respondents. Virtually all of the respondents experienced negative consequences of methamphetamine use. The most serious, but least prevalent, methamphetamine-related health problem was seizures and convulsions. The most prevalent health effect was weight lose. A substantial number of respondents experienced severe psychological symptoms: depression, hallucinations, and paranoia. Of the 106 respondents, 34.9% had committed violence while under the influence of methamphetamine. The data suggest that methamphetamine-based violence was more likely to occur within private domestic contexts, both family and acquaintance relationships. It is apparent from the findings that methamphetamine use heightens the risk for negative health, psychological, and social outcomes. Having said this, it is crucial to acknowledge that there was no evidence of a single, uniform career path that all chronic methamphetamine users follow. Furthermore, a significant number of sample members experienced limited or no serious social, psychological, or physical dysfunction as a result of their methamphetamine use.     

Nicotine replacement therapy use among a cohort of smokers

BACKGROUND: Nicotine replacement therapy (NRT) has been shown to assist smokers to stop smoking in randomized trials, but little is known about its use in the general population. METHODS: As part of ongoing follow-up of a cohort established in 1989 in Washington County, Maryland, a questionnaire mailed in 1998 included a question about ever use of the two NRT products then available over-the-counter: nicotine gum and nicotine patch. This study reports on ever use of NRT among the 1,954 respondents who were current smokers in 1989 and subsequently provided data on NRT use and smoking habits in 1998. RESULTS: Overall, 36% of the smokers in 1989 had ever used NRT in some form by 1998; 10% used gum only, 16% used patch only, and 10% used both gum and patch. Number of cigarettes smoked per day at baseline was the strongest predictor of ever use of NRT (ptrend < 0.001). Compared to nonusers, ever users of NRT were more likely to have more than 12 years of education (p < 0.01) and be 25-54 years old at baseline (p < 0.001). When NRT use was assessed in relation to smoking status in 1998, 30% of NRT ever users compared to 39% of nonusers had quit smoking (p < 0.01). Among persistent smokers, the likelihood of reducing the number of cigarettes smoked per day was similar between NRT ever users (40%) and nonusers (41%). CONCLUSIONS: Ever use of NRT was common among this cohort of smokers, particularly among heavy smokers. Compared to nonusers, ever users of NRT were less likely to have stopped smoking and equally likely to cut down the frequency of smoking. This may reflect a tendency to turn to NRT for help after failing to quit by other means.     

How are lifetime polytobacco users different than current cigarette-only users? Results from a Canadian young adult population

Current cigarette smoking combined with ever use of other tobacco products (lifetime polytobacco use) is important to examine as users may be at greater risk for illicit drug use, nicotine addiction, and adverse health outcomes. We determined estimates and patterns of lifetime polytobacco use and conducted multivariable analyses to determine demographic, family and friend, psychosocial, and lifestyle factors associated with use among a sample of Canadian young adults. Overall prevalence was 36.3% for current cigarette use; 10.1% for current cigarette use only and 26.2% for lifetime polytobacco use. Among polytobacco users, current cigarette use and ever cigar use was most frequent (67.2%). For males, the final model contained demographic, family and friends, and lifestyle factors. For females, the final model also included psychosocial factors. Illicit drug use was the strongest significant predictor for lifetime polytobacco use among males. We found gender specific differences when comparing lifetime polytobacco users to current cigarette-only users, in particular; male lifetime polytobacco users were more likely to use drugs and alcohol. Interventions focusing on individual substances should consider addressing combinations of use.     

Detection of and intervention for excessive alcohol and tobacco use among adult hospital in-patients

Early detection and intervention for alcohol problems have been shown to reduce subsequent health consequences. However, the extent to which these practices have been implemented is unclear. The study assessed among hospital in-patients (1) the prevalence of at-risk drinking and smoking, (2) current practice in detection and intervention for at-risk drinking and smoking and (3) self-reported effect of any intervention. A brief self-administered questionnaire was administered to adult in-patients addressing alcohol use [Alcohol Use Disorders Identification Test (AUDIT) questionnaire], smoking and self-reported effect of any recent intervention for drinking or smoking. The participant's smoking status and alcohol use as recorded by medical and nursing staff was compared to self-reports. Of 448 in-patients, 50% (226) participated in the study; 38% (170) were ineligible and 12% (52) refused. Participants were aged 61.3 (+/-18.9) years. A higher number of problem drinkers (11.9% vs. 3.5%, p < 0.0001) and current smokers (17.3% vs. 9.3%, p < 0.0001) were identified by the questionnaire compared to the medical records. Hospital staff quantified smoking more consistently than alcohol (54% vs. 42%, p = 0.02). Of those who recalled an intervention, 19% of drinkers and 27% of smokers said they had stopped drinking or smoking for a period since that intervention. Further improvement is required in the rates of detection and interventions for alcohol use disorders and smoking in the hospital setting.     

The relationship between alcohol use and attempts and success at smoking cessation

This study assessed the relationships between alcohol use and smoking cessation in a general population sample (N = 2115) of adults living in a county in north Florida. Nearly half of the sample had ever smoked. Of these, 44% had successfully quit; 34% had tried unsuccessfully to quit; 21% reported never having tried to quit. In multivariate analyses which controlled for background factors, heavy drinkers were found to be less likely to attempt to quit smoking. And, if they had attempted to quit, they were less likely to succeed. Having quit drinking was very strongly related to success at smoking cessation, and slightly negatively related to attempts to quit smoking. Individuals who enjoyed smoking with alcohol were more likely to attempt to quit smoking and to be successful at quitting than those who did not enjoy smoking and drinking concurrently. Those who enjoyed smoking at stressful times were less likely to have tried to quit than those not using smoking to cope with stress. The authors suggest social-situational and stress perspectives as conceptual frameworks for future research.     

Attitudes and Practices of Hookah Smokers in the San Francisco Bay Area

Abstract

As many as 10 million people will die annually by the year 2030 due to tobacco-related causes. While much research has focused on cigarettes, the increasing popularity of smoking hookah (water pipe) has received much less attention. Epidemiological studies have been carried out in India, Pakistan, Syria, Kuwait, and Lebanon, but there are few in the United States. Hookah smoking is typically a social activity and there are many myths and rumors about the relative safety of smoking hookah compared to cigarettes. The aim of this study was to identify the knowledge, attitudes, and practices of hookah smokers in the San Francisco Bay Area. We sampled 50 participants (25 male and 25 female) who were mostly college students at the University of California, Berkeley. Hookah smoking was occasional among those sampled, with only six participants (12%) reporting weekly hookah smoking. The majority of respondents considered hookah smoking to be harmful to their health (88%), yet 52% had no intention of quitting. More definitive studies conveying the possible harm of hookah smoking are necessary to serve as a basis for health education programs and policy changes towards this potentially harmful activity.     

Young people's awareness of illicit drug use in the family

A sample of Scottish schoolchildren aged 14–15 (N = 1240) were asked a series of questions regarding their knowledge and experience of illicit drugs. They were asked to report on personal lifetime drug use and whether they knew of any family member who had ever used drugs. More than four in ten respondents admitted to having used an illegal drug, with a similar number admitting to awareness of drug use by another family member. There was a strong statistical relationship between respondents’ own use and drug use by all types of family members. However, although respondents who reported using drugs themselves were more likely to nominate other drug users in their family, only a small minority of respondents stated that a family member initiated them into drug use and few stated that they were aware of any problematic use. Although prior drug use by family members may not directly lead to use by young people, these data indicate that illegal drug use tends to cluster within families.     

Cigarette use and smoking beliefs among older Americans: findings from a nationally representative survey*

Background: Between 2005 and 2015, the prevalence of smoking among US adults has decreased for all age subgroups, except those aged 65 and older.

Aim: In order to identify potential correlates of smoking behaviors in older adults, this research examined associations between age, smoking beliefs, and quitline utilization.

Methods: Self-reported, nationally representative data from the Health Information National Trends Survey 2015 cycle (HINTS-FDA) were used (n?=?3738). Multivariable logistic regression analyses examined associations between sociodemographic characteristics and beliefs about smoking behaviors. All analyses were conducted with jackknife estimation using sampling weights.

Results: Among all survey respondents, 10.5% of those aged 65+ were current smokers (smoked 100 lifetime cigarettes and currently smoked every day or some days). These older adults, compared to those aged 18–29 years, had significantly higher odds of agreeing that smoking behavior is something one can do little to change (AOR?=?1.89, 95% CI =1.08, 3.28) and agreeing that nicotine is the substance that causes cancer (AOR?=?3.93, 95% CI?=?2.17, 7.12). Post hoc analyses compared midlife adults (ages 50–64) with older adults (ages 65+), and indicated older adults had lower odds of having used a quitline/smoking cessation website (AOR?=?0.36, 95% CI?=?0.14, 0.94, p?=?0.04) compared to their midlife peers.

Discussion: US adults aged 65 and older hold erroneous beliefs about cigarette smoking behaviors and are less likely to utilize quitline supports. This may be contributing to the stagnant smoking rates among older adults. Smoking cessation efforts targeting older adult Americans are critical in order to stem tobacco use among all Americans.     

Prevalence of hazardous-harmful drinking in a southern Thai community

The objective of this study was to identify the prevalence and characteristics of hazardous - harmful drinkers in a Thai community population using a cross-sectional survey in two urban and five rural areas in Southern Thailand. Face-to-face interviews were conducted with 1005 subjects, aged ≥ 35, at the community centres to collect data on demographic characteristics and smoking and drinking patterns. The Alcohol Use Identification Test (AUDIT) was used to classify the subjects into three groups: hazardous - harmful drinkers (AUDIT ≥ 8), non-problem drinkers (AUDIT= 1 - 7) and non-drinkers (AUDIT= 0). Blood samples were drawn from 200 randomly selected subjects to determine the gamma glutamyltransferease (GGT) level. The analysis was performed on 898 respondents, 325 males and 573 females. Age-adjusted prevalence of hazardous - harmful drinkers was 10% (27%in males and 1% in females). Adjusted for other variables, men were seven times (95% CI = 4.2 - 11.5) more likely to be non-problem drinkers and 42 times (95% CI =18.1 - 99.0) more likely to be hazardous - harmful drinkers than women. Median intensity of drinking was 43 g and 25 g per drinking day in the hazardous - harmful and non-problem drinkers, respectively. Of all the subjects, 48%, 25% and 15% of the hazardous - harmful, non-problem and non-drinkers had abnormal GGT. Hazardous - harmful drinking is a prevalent problem in male general population in Thailand. [Assanangkornchai S, Pinkaew P, Apakupakul P. Prevalence of hazardous - harmful drinking in a southern Thai community. Drug Alcohol Rev 2003;22:287 - 293]     

Parent, sibling and peer influences on smoking initiation, regular smoking and nicotine dependence. Results from a genetically informative design

We sought to determine whether parenting, sibling and peer influences are associated with offspring ever smoking, regular smoking and nicotine dependence (ND) after controlling for familial factors. We used a twin-family design and data from structured diagnostic surveys of 1919 biological offspring (ages 12-32 years), 1107 twin fathers, and 1023 mothers. Offspring were classified into one of four familial risk groups based on twin fathers' and their co-twins' history of DSM-III-R nicotine dependence. Multivariate multinomial logistic regression was used to model familial risk, paternal and maternal parenting behavior and substance use, sibling substance use, and friend and school peer smoking, alcohol and drug use. Ever smoking was associated with increasing offspring age, white race, high maternal pressure to succeed in school, sibling drug use, and friend smoking, alcohol and drug use. Offspring regular smoking was associated with these same factors with additional contribution from maternal ND. Offspring ND was associated with increasing offspring age, male gender, biological parents divorce, high genetic risk from father and mother ND, maternal problem drinking, maternal rule inconsistency and sibling drug use, and friend smoking, alcohol and drug use. Friend smoking had the largest magnitude of association with offspring smoking. This effect remains after accounting for familial liability and numerous parent and sibling level effects. Smoking interventions may have greatest impact by targeting smoking prevention among peer groups in adolescent and young adult populations.     

Associations between adolescent drinking and driving involvement and self-reported risk and protective factors in students in public schools in Washington State

OBJECTIVE: This study examines associations between self-reported drinking and driving or being a passenger of a drinking driver and risk and protective factors in a general population of adolescents. METHOD: We used a two-staged sampling procedure to survey 2,955 students in Washington State public schools in Grades 9-12. Students were asked if they were a passenger of, or had been, a drinking driver in the previous month. They were also asked about individual, parent, school and community risk and protective factors. Comparisons were made using hierarchical polychotomous logistic regression, entering age and gender and parent, school and community protective factors at the first step and individual risk factors at the second step. RESULTS: Driving after drinking in the previous month was reported by 12.1% of respondents and riding with a drinking driver was reported by an additional 17.6% of respondents. At the first step, driving after drinking was more likely and riding with a drinking driver was less likely among youth who were age 16 or older, and male students were more likely than female students to report driving after drinking. Parent, school and community support were each significantly associated with less driving after drinking, and school support was significantly associated with less riding with drinking drivers. At the second step, higher quantity and frequency of drinking, more smoking cigarettes and drug use and less seat belt use were each associated with both drinking and driving and riding with drinking drivers. Gun carrying was also associated with driving after drinking. CONCLUSIONS: Drinking and driving behaviors were associated with risk and protective factors in the community, school, family and individual. Pilot prevention programs should test the effectiveness of reducing drinking and driving involvement by addressing such factors.     

Mike Agar: "The Story of Crack"

Two hundred and forty-four 16 to 35 year olds were recruited from a variety of clinical and community sources. One hundred and sixty-four were offspring of parents with drinking problems; eighty were comparison respondents of similar ages and from similar sources. Each was interviewed at length using a semi-structured interview which focussed on, among other things, carefully reconstructed recollections of childhood family environments. The present paper shows that the children of problem drinkers reported very much more disharmonious family environments, and much higher levels of childhood difficulties, than did the comparisons.

The degree of disharmony reported by both offspring and comparison respondents ranged from negligible to extreme; thus allowing a test of whether family disharmony or parental problem drinking was a more harmful influence on the incidence of childhood difficulties. It is shown, using path analysis, that all the covariance of childhood difficulties and parental problem drinking can be explained in terms of the effects of family disharmony.     

Feasibility and Efficacy of an Addiction Treatment Program in Patients With Upper Aerodigestive Tract Cancer

Background: Continuing to smoke or to drink after the treatment of an upper aerodigestive tract (UADT) cancer is known to worsen the prognosis. We assessed the feasibility and efficacy of an addiction treatment program integrated into the cancer treatment. Method: In four units devoted to UADT tumors, we proposed an addiction treatment to all patients still drinking or smoking at the end of the cancer treatment; the abstinence rate was assessed 6 and 12 months later. Results: One hundred and sixteen patients were included. Among the 73 patients still drinking and/or smoking at the end of the cancer treatment, 46.6% accepted an addiction treatment. In the latter, abstinence rate was increased, 52.2% versus 31.03% (?p = .07) at M12. In patients both drinking and smoking, addiction treatment doubled the rate of abstinence of both products (31% vs. 14%). Conclusion: Offering addiction treatment to patients with UADT cancer improves abstinence rate and helps maintain long-term withdrawal.     

Anabolic steroid use in high school students

A total of 1351 high school students (52.3% males, 47.7% females) with mean age 17.5 years (SD = 2.2) from randomized school classes in Hordaland County, Norway, participated in an Internet survey conducted in 2004 about the lifetime use of anabolic steroids and personal acquaintance with at least one user of anabolic steroids. In addition to questions about anabolic steroids the participants completed the Hospital Anxiety and Depression Scale and the Alcohol Use Disorders Identification Test. They also answered questions about demography, smoking, and narcotic use. The lifetime prevalence for use of anabolic steroids was 3.6% for males and 0.6% for females. In all, 27.9% of the respondents reported having at least one acquaintance that used or had used anabolic steroids. Use of anabolic steroids and having acquaintances using such drugs were strongly related to use of other drugs such as alcohol, nicotine, and narcotics. Implications for prevention are discussed and the study's limitations are noted.