title: Concurrent alcohol and tobacco treatment: Effect on daily process measures of alcohol relapse risk.
abstract: OBJECTIVE
  The aim of this study was to compare the effects of alcohol treatment along with concurrent smoking treatment or delayed smoking treatment on process measures related to alcohol relapse risk.
  
  
  METHODS
  Alcohol dependent smokers (N = 151) who were enrolled in an intensive outpatient alcohol treatment program and were interested in smoking cessation were randomized to a concurrent smoking cessation (CSC) intervention or to a waiting list for delayed smoking cessation (DSC) intervention scheduled to begin 3 months later. Daily assessments of relapse process measures were obtained using an Interactive Voice Response (IVR) system for 12 weeks after the onset of smoking treatment in the CSC condition, and before beginning smoking treatment in the DSC condition. Smoking outcomes were assessed at 2 and 13 weeks after starting treatment.
  
  
  RESULTS
  Seven-day carbon monoxide (CO) verified smoking abstinence in the CSC condition was 50.5% at 2 weeks and 19.0% at 13 weeks compared with 2.2% abstinence at 2 weeks and 0% abstinence at 13 weeks for those in the DSC condition. Drinking outcomes were not significantly different for CSC versus DSC treatment conditions. On daily IVR assessments, CSC participants had significantly lower positive alcohol outcome expectancies relative to DSC participants. Multilevel modeling (MLM) analyses of within-person effects across the 12 weeks of daily monitoring showed that daily smoking abstinence was significantly associated with same day reports of lower alcohol consumption, lower urge to drink, lower negative affect, lower positive alcohol outcome expectancies, greater alcohol abstinence self-efficacy, greater alcohol abstinence readiness to change, and greater perceived self-control demands.
  
  
  CONCLUSIONS
  Analyses of process measures provide support for recommending smoking intervention concurrent with intensive outpatient alcohol treatment. (PsycINFO Database Record
authors.affiliation: VA Connecticut Healthcare System.
authors.forename: Ned L
authors.initials: NL
authors.lastname: Cooney
authors.affiliation: Division of Behavioral Sciences and Community Health, University of Connecticut Health Center.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Litt
authors.affiliation: VA Connecticut Healthcare System.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Sevarino
authors.affiliation: Department of Psychiatry, Yale University School of Medicine.
authors.forename: Lucienne
authors.initials: L
authors.lastname: Levy
authors.affiliation: Department of Psychiatry, Yale University School of Medicine.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Kranitz
authors.affiliation: Department of Psychiatry, Yale University School of Medicine.
authors.forename: Helen
authors.initials: H
authors.lastname: Sackler
authors.affiliation: VA Connecticut Healthcare System.
authors.forename: Judith L
authors.initials: JL
authors.lastname: Cooney
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000628:therapy*; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012008:Recurrence; D012306:Risk; D018570:Risk Assessment; D020377:Self Efficacy; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome