Intensive intervention for alcohol-dependent smokers in early recovery: a randomized trial.
BACKGROUND
The purpose of this study was to investigate the efficacy of an intensive tobacco cessation intervention for alcohol-dependent smokers in early recovery.


METHODS
A total of 162 alcohol-dependent smokers were randomized to either intensive intervention for smoking cessation or usual care. The intensive intervention consisted of 16 sessions of individual cognitive behavior therapy (CBT) and combination nicotine replacement therapy that lasted 26 weeks. Usual care involved referral to a free-standing smoking cessation program that provided smoking cessation counseling of varying duration and guideline-concordant medications. The primary cessation outcome was verified 7-day point prevalence abstinence (PPA) at 12, 26, 38, and 52 weeks.


RESULTS
At 12 and 26 weeks, the verified 7-day point-prevalence quit rate was significantly higher for the intensive intervention group than for the usual care group (both p=0.03). However, the quit rates for the two treatment groups were not significantly different at 38 or 52 weeks. Verified 30-day alcohol abstinence rates were not significantly different for the two treatment groups at any of the follow-up assessments.


CONCLUSIONS
The intensive smoking cessation intervention yielded a higher short-term smoking quit rate without jeopardizing sobriety. A chronic care model might facilitate maintenance of smoking cessation during the first year of alcohol treatment and perhaps for longer periods of time. It is hoped that studies such as this will inform the development of more effective interventions for concurrent alcohol and tobacco use disorders.
Mental Health Service, San Francisco VA Medical Center, CA 94121, USA. Timothy.Carmody@va.gov
Timothy P
TP
Carmody
Kevin
K
Delucchi
Carol L
CL
Duncan
Peter
P
Banys
Joel A
JA
Simon
Sharon N
SN
Solkowitz
Joy
J
Huggins
Sharon K
SK
Lee
Sharon M
SM
Hall
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome