title: Is smoking cessation associated with worse comorbid substance use outcomes among homeless adults?
abstract: OBJECTIVE
  Smoking prevalence among homeless adults is exceedingly high, and high rates of comorbid substance use are among the barriers to abstinence experienced by this group. The extent to which smoking cessation might engender an escalation in comorbid substance use could be a concern prohibiting treatment provision and engagement. This study examined whether smoking abstinence status was associated with alcohol and substance use at 26 weeks post-randomization among homeless smokers in a smoking cessation trial.
  
  
  METHODS
  The current study was a secondary analysis of randomized smoking cessation intervention trial data.
  
  
  METHODS
  The parent study was conducted in the Minneapolis/St Paul area of Minnesota, USA.
  
  
  METHODS
  Participants were 427 homeless adult smokers interested in quitting smoking.
  
  
  METHODS
  Covariates collected at baseline included alcohol, cocaine, marijuana/hashish, heroin and 'any' drug use, age, sex, race/ethnicity, education, tobacco dependence, length of time homeless and treatment group. Biochemically verified smoking abstinence and self-reported alcohol and substance use were collected at 26 weeks post-randomization.
  
  
  RESULTS
  Smoking abstinence was associated with fewer drinking days (P = 0.03), fewer drinks consumed on drinking days (P = 0.01), and lower odds of heavy drinking (P = 0.05), but not with differences in the number of days of cocaine, marijuana/hashish, heroin or any drug use.
  
  
  CONCLUSIONS
  In homeless smokers, achieving smoking abstinence may be associated with a reduction in alcohol consumption but appears not to be associated with a substantial change in other drug use.
authors.affiliation: Department of Educational Psychology, College of Education, University of Houston, Houston, TX, USA.
authors.forename: Lorraine R
authors.initials: LR
authors.lastname: Reitzel
authors.forename: Nga
authors.initials: N
authors.lastname: Nguyen
authors.forename: Sara
authors.initials: S
authors.lastname: Eischen
authors.forename: Janet
authors.initials: J
authors.lastname: Thomas
authors.forename: Kolawole S
authors.initials: KS
authors.lastname: Okuyemi
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology* / Q000534:rehabilitation; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006703:Ill-Housed Persons / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D062405:Motivational Interviewing; D009538:Nicotine / Q000008:administration & dosage; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology* / Q000534:rehabilitation
chemical_list: D013287:Illicit Drugs; D009538:Nicotine
keywords: Alcohol abuse; compensatory substance use; drug abuse; homeless; smoking cessation; substance use treatment