[Medical care requested by smokers and at-risk alcohol consumers: results of a representative population survey].
OBJECTIVE
Due to difficult availability of subjects with substance-related disorders (especially nicotine and alcohol) via the existing specialised treatment services, the impact of proactive early interventions in hospitals and general practitioners is increasingly acknowledged. Only little is known as to known many persons with substance-related disorders are not attainable via this pathway and where such persons could be contacted. In the present study, we analysed the prevalence of substance-related disorders and the motivation to change in subjects drawn from a representative population survey with and without use of medical services during the preceding year.


METHODS
The present analysis is based on data from the TACOS ("Transitions in Alcohol Consumption and Smoking") Study (N = 4075) conducted in the town of Luebeck and its environs in Northern Germany. Utilisation of medical services was differentiated in non-utilization (NI), hospital admission during the previous year (KH), at least one visit to a general practitioner (HA), specialist only (FA) and dentist only (ZA).


RESULTS
75% of the population had been to a hospital or their general practitioner in the previous year, a further 18.3% visited a specialist or a dentist only and 4.8% did not contact medical services. Analysis revealed a higher prevalence of smoking and increasing alcohol consumption combined with a higher unemployment rate in NI, followed by KH, HA, FA and ZA.


CONCLUSIONS
The majority of smokers and subjects with at-risk alcohol consumption can be attained via medical services. Additionally, early interventions in dentist practices and employment offices might include further substantial groups of smokers and at-risk drinkers.
Klinik für Psychiatrie und Psychotherapie der Universität zu Lübeck, Luebeck. gallus.bischof@ukl.mu-luebeck.de
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Hapke
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John
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D000437:Alcoholism / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003752:Dental Health Services / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006295:Health Resources / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D011159:Population Surveillance; D012306:Risk; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D013038:Specialization; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014600:Utilization Review / Q000706:statistics & numerical data