Tobacco and alcohol use are leading causes of premature mortality in the US and concurrent use is associated with even greater health risks. A cross-sectional study of 20,310 patients admitted to a Mid-Atlantic acute health care system between July 1, 2018 and June 30, 2019 were categorized according to smoking and alcohol use disorder (AUD) status. Of the total admissions, 1464 (7.2%) were current smokers with an AUD. These patients were younger (52.4 vs. 63.9), more likely to be male (64.1% vs. 38.0%) and covered by Medicaid (46.9% vs. 11.6%), and resided in proximity to higher counts of tobacco (10.3 vs. 4.72) and alcohol (2.24 vs. 1.14) retailers than never smokers without an AUD. Clinically, these patients had higher rates of other substance use disorders (60.4% vs. 6.1%), depression (64.6% vs. 34.8%), HIV/AIDS (3.3% vs. 0.6%), and liver disease (40.7% vs. 13.2%) than never smokers without an AUD. Patients who concurrently smoke and have an AUD face unique and serious health risks. A multimorbidity framework can guide clinical and community-based interventions for individuals with concurrent psychiatric and chronic medical conditions, complex social needs, and adverse environmental exposures.

烟草和酒精的使用是美国过早死亡的主要原因，同时使用会带来更大的健康风险。一项横断面研究对 2018 年 7 月 1 日至 2019 年 6 月 30 日期间入住大西洋中部急性医疗保健系统的 20,310 名患者进行了根据吸烟和酒精使用障碍 (AUD) 状态进行分类。在总入院人数中，1464 人 (7.2%) 是当前吸烟者，且拥有 1 澳元。这些患者更年轻（52.4 对 63.9），更有可能是男性（64.1% 对 38.0%）并且享受医疗补助计划（46.9% 对 11.6%），并且居住在烟草数量较高的地区（10.3 对 38.0%）。 4.72）和酒精（2.24 对 1.14）零售商比没有澳元的从不吸烟者。临床上，这些患者的其他物质使用障碍（60.4% 对 6.1%）、抑郁症（64.6% 对 34.8%）、艾滋病毒/艾滋病（3.3% 对 0.6%）和肝病（40.7% 对. 13.2%) 比没有澳元的从不吸烟者。同时吸烟并拥有 AUD 的患者面临着独特而严重的健康风险。多发病框架可以指导针对同时患有精神疾病和慢性疾病、复杂的社会需求和不利环境暴露的个体的临床和社区干预。