Combined treatment for at-risk drinking and smoking cessation among Puerto Ricans: A randomized clinical trial.
Tobacco and alcohol use are linked behaviors that individually and synergistically increase the risk for negative health consequences. This study was a two-group, randomized clinical trial evaluating the efficacy of a behavioral intervention, "Motivation And Problem Solving Plus" (MAPS+), designed to concurrently address smoking cessation and the reduction of at-risk drinking. Targeted interventions may promote coaction, the likelihood that changing one behavior (smoking) increases the probability of changing another behavior (alcohol use). Puerto Ricans (N=202) who were smokers and at-risk drinkers were randomized to standard MAPS treatment focused exclusively on smoking cessation (S-MAPS), or MAPS+, focused on cessation and at-risk drinking reduction. Drinking outcomes included: number of at-risk drinking behaviors, heavy drinking, binge drinking, and drinking and driving. MAPS+ did not have a significant main effect on reducing at-risk drinking relative to S-MAPS. Among individuals who quit smoking, MAPS+ reduced the number of drinking behaviors, the likelihood of meeting criteria for heavy drinking relative to S-MAPS, and appeared promising for reducing binge drinking. MAPS+ did not improve drinking outcomes among individuals who were unsuccessful at quitting smoking. MAPS+ showed promise in reducing at-risk drinking among Puerto Rican smokers who successfully quit smoking, consistent with treatment enhanced coaction. Integrating an alcohol intervention into cessation treatment did not reduce engagement in treatment, or hinder cessation outcomes, and positively impacted at-risk drinking among individuals who quit smoking. Findings of coaction between smoking and drinking speak to the promise of multiple health behavior change interventions for substance use treatment and chronic disease prevention.
Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, United States. Electronic address: vcorreaf@central.uh.edu.
Virmarie
V
Correa-Fernández
Division of Cancer Control and Population Sciences, University of Puerto Rico, Comprehensive Cancer Center, PMB 371, PO Box 70344, San Juan, PR 00936-8344, Puerto Rico. Electronic address: elba.diaz@upr.edu.
Elba C
EC
Díaz-Toro
Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, United States. Electronic address: lrreitze@central.uh.edu.
Lorraine R
LR
Reitzel
Department of Psychology, Rice University, 6500 Main St, Bioscience Research Collaborative, Houston, TX 77030, United States. Electronic address: lg40@rice.edu.
Lin
L
Guo
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Unit 1411, P.O. Box 301402, Houston, TX 77230, United States. Electronic address: mchen3@mdanderson.org.
Minxing
M
Chen
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Unit 1411, P.O. Box 301402, Houston, TX 77230, United States. Electronic address: ysli@mdanderson.org.
Yisheng
Y
Li
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1102-F McGavran-Greenberg Bldg, CB 7411, Chapel Hill, NC 27599-7411, United States. Electronic address: wacalo@live.unc.edu.
William A
WA
Calo
Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Unit 1444, P.O. Box 301402, Houston, TX 77230, United States. Electronic address: yashih@mdanderson.org.
Ya-Chen Tina
YT
Shih
Department of Population Health Sciences and The Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84108, United States. Electronic address: david.wetter@hci.utah.edu.
David W
DW
Wetter
D000223:Adaptation, Psychological; D000328:Adult; D000428:Alcohol Drinking / Q000628:therapy; D000437:Alcoholism / Q000150:complications / Q000628:therapy*; D003376:Counseling / Q000379:methods*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009042:Motivation; D011340:Problem Solving; D011647:Puerto Rico; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
At-risk drinking; Coaction; Latinos; Multiple health risk behaviors; Smoking