Female smokers have the highest alcohol craving in a residential alcoholism treatment cohort.
BACKGROUND
Cigarette smoking among female and male alcoholics has not been extensively studied as a factor related to intensity of alcohol craving during residential treatment and corresponding sobriety length.


METHODS
This retrospective cohort study assessed self-reported sobriety outcomes in patients with alcohol dependence at 3-month intervals over 12 months after completion of a 30-day residential treatment program. Demographic and clinical variables were collected including smoking status, alcohol craving utilizing the Penn Alcohol Craving Scale (PACS), and alcohol relapse. Statistical analyses included Chi-square, ANOVA, Tukey's test, Kaplan-Meier plots and Cox proportional hazards models as appropriate.


RESULTS
Of the 761 alcohol-dependent study subjects, 355 (47%) were current smokers. Alcohol craving intensity was higher in smoking females compared to nonsmoking females (p=0.0096), smoking males (p<0.0001), and nonsmoking males (p<0.0001). Smoking status-by-sex interaction was not associated with post-treatment relapse. After controlling for other variables, higher PACS scores at admission were associated with higher probability of relapse (p=0.0003).


CONCLUSIONS
In this study, female alcoholic smokers experienced the highest level of alcohol craving in an alcohol treatment setting. Interestingly, this did not translate into higher rates of post-treatment relapse. Further research is warranted to explore the neurobiological basis for sex differences in this highly prevalent comorbidity.
Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA; Mental Health Service, Sotero Del Rio Hospital, Avenida Concha y Toro 3459, Puente Alto, Santiago, Chile.
Mario J
MJ
Hitschfeld
Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA. Electronic address: Schneekloth.Terry@mayo.edu.
Terry D
TD
Schneekloth
Department of Medicine, Nicotine Dependence Center, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Jon O
JO
Ebbert
Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Daniel K
DK
Hall-Flavin
Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Victor M
VM
Karpyak
Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Osama A
OA
Abulseoud
Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Christi A
CA
Patten
Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Jennifer R
JR
Geske
Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Mark A
MA
Frye
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications / Q000523:psychology*; D015331:Cohort Studies; D066249:Craving; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012114:Residential Treatment; D012189:Retrospective Studies; D012737:Sex Factors; D012907:Smoking / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology*; D055815:Young Adult
Alcohol abstinence; Alcoholism; Craving; Recurrence; Residential treatment; Tobacco use disorder