Aims

Among people with cancer, dual alcohol and tobacco use increases risk for morbidity and mortality. Most smoking cessation clinical trials with this patient population have excluded individuals with problematic alcohol use. This investigation examined whether problematic alcohol use affects smoking cessation in cancer patients.

Methods

Mixed-methods secondary analysis of data from the Smokefree Support Study, a randomized-controlled trial examining the efficacy of Intensive (IT; n = 153) vs. Standard Treatment (ST; n = 150) for smoking cessation in newly diagnosed cancer patients. Problematic alcohol use was assessed at enrollment using the Cut-Down-Annoyed-Guilty-Eye-Opener (CAGE), weekly frequency of alcohol use and binge drinking measures. Alcohol use was categorized as: no current alcohol use, moderate and problematic use. The primary outcome was biochemically-confirmed cigarette abstinence at 6-months. A subset of patients (n = 72) completed qualitative exit-interviews.

Results

Among all participants, biochemically-confirmed cigarette abstinence rates were 25% (n = 32), 28% (n = 27), and 36% (n = 20) for participants reporting no current alcohol use, moderate use, and problematic use, respectively (p = 0.33). In logistic regression analysis, neither problematic alcohol use (AOR = 0.96, 95% CI = 0.35–2.67, p = .94) nor the problematic use by study arm interaction (AOR = 2.22, 95% CI = 0.59–8.39, p = .24) were associated with biochemically-confirmed 6-month abstinence. Qualitatively, participants reported that drinking alcohol triggers urges to smoke.

Conclusion

Newly diagnosed cancer patients reporting problematic alcohol use were not less likely to quit smoking than those without. Additional research is needed to investigate whether problematic alcohol users may benefit from smoking and alcohol behavior change interventions at the time of cancer diagnosis.

中文翻译：

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检查有问题的酒精使用对参加戒烟试验的最近诊断出的癌症患者戒烟的影响：二次分析

目标

在癌症患者中，酒精和烟草的双重使用会增加发病率和死亡率的风险。大多数针对该患者群体的戒烟临床试验都排除了酗酒问题的个体。这项调查研究了有问题的酒精使用是否会影响癌症患者的戒烟。

方法

对无烟支持研究的数据进行混合方法二次分析，这是一项随机对照试验，检查强化（IT；n = 153）与标准治疗（ST；n = 150）对新诊断癌症患者戒烟的疗效。有问题的酒精使用在注册时使用 Cut-Down-Annoyed-Guilty-Eye-Opener (CAGE)、每周饮酒频率和酗酒措施进行评估。酒精使用被分类为：当前未使用酒精、中度和有问题的使用。主要结果是生化证实在 6 个月时戒烟。一部分患者（n = 72）完成了定性退出访谈。

结果

在所有参与者中，生化证实的戒烟率分别为 25% (n = 32)、28% (n = 27) 和 36% (n = 20)，参与者报告当前未使用酒精、适度使用和有问题的使用，分别（p = 0.33）。在逻辑回归分析中，既没有酒精使用问题（AOR = 0.96, 95% CI = 0.35–2.67, p = .94），也没有研究组相互作用的问题使用（AOR = 2.22, 95% CI = 0.59–8.39, p = .24) 与生化证实的 6 个月禁欲有关。定性地，参与者报告说饮酒会引发吸烟的冲动。

结论

报告有酒精使用问题的新诊断癌症患者戒烟的可能性并不比没有吸烟的人低。需要进一步的研究来调查有问题的饮酒者在癌症诊断时是否可以从吸烟和饮酒行为改变干预中受益。