[Smoking cessation during treatment of alcohol dependence in drug and alcohol rehabilitation centres--a review].
OBJECTIVE
Review of the international literature on smoking cessation with smokers having a concurrent alcohol abuse disorder. The three aims are: 1. discussion of the pros and cons of concurrent smoking cessation and treatment of alcohol use disorder, 2. smoking cessation strategies and 3. description of national and international studies evaluating smoking cessation interventions with patients who are at the same time treated for their alcohol abuse disorder.


METHODS
The results are collected on the basis of an extensive literature research in PsychInfo, Science Direct and Medicine.


RESULTS
Considering the pros and cons, it can be concluded that smoking cessation should be offered to this subgroup of high risk smokers. The open question is which kind of interventions are effective. Intervention strategies should consist of a multi-level approach including structural as well as person-specific components. Evaluation studies show that a 12% abstinence rate at one year follow-up can be achieved in case of an intensive intervention in combination with a restrictive tobacco policy. Alcohol abstinence is not jeopardised by a concurrent smoking cessation, when smoking cessation is voluntary.


CONCLUSIONS
On the basis of empiric research the common arguments against smoking cessation within the subgroup of alcohol-addicted smokers cannot be maintained on the basis of empiric research. Rehabilitation centres treating substance abuse disorders provide an excellent setting for the treatment of nicotine dependence. Interventions should include structural as well as subgroup-specific components.
Metz
K
K
IFT Institut für Therapieforschung, München. Metz@ift.de
Kröger
C
C
Bühringer
G
G
D000437:Alcoholism / Q000150:complications / Q000534:rehabilitation*; D002986:Clinical Trials as Topic; D018849:Controlled Clinical Trials as Topic; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012047:Rehabilitation Centers; D012106:Research; D012307:Risk Factors; D016540:Smoking Cessation; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000150:complications / Q000534:rehabilitation*