title: Recovery from alcohol dependence: Do smoking indicators predict abstinence?
abstract: OBJECTIVE
  There is inconsistent evidence about the potential influence of smoking on recovery from alcohol dependence. Our study aimed at assessing the impact of smoking-behavior on relapse during a 12 months follow-up period following a detoxification in patients with Alcohol Use Disorder (AUD).
  
  
  METHODS
  Three hundred Patients with AUD (74.9% smoking) were recruited from two inpatient detoxification units in psychiatric hospitals in Germany and their alcohol consumption was prospectively followed for 1 year. Data on different indicators of smoking behavior was gathered. Cox regression model was used to evaluate potential risk factors on time to relapse of alcohol consumption. Two hundred seventy-nine participants (n = 279) were included in the final analysis.
  
  
  RESULTS
  Smoking increased the risk for alcohol relapse (hazard ratio = 3.962, 95% CI 1.582-9.921). However, this increased risk is slightly reduced with higher numbers of daily consumed cigarettes (hazard ratio per cigarette = .986, 95% CI .976-.995).
  
  
  CONCLUSIONS
  Smoking reduced the probability of maintaining alcohol abstinence significantly, whereas higher number of cigarettes smoked daily diminished the increased risk of alcohol relapse in alcohol-dependent patients.
  
  
  CONCLUSIONS
  Coordinated psychiatric and substance abuse interventions for different subgroups of patients with AUD in the post-acute treatment phase are necessary. Individualized treatment planning is especially important in smoking patients with AUD who are vulnerable for a relapse to alcohol drinking and for somatic complications. Our findings might support individualized treatment plans. (Am J Addict 2017;26:366-373).
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
authors.forename: Anna
authors.identifier: http://orcid.org/0000-0002-2850-7351
authors.initials: A
authors.lastname: Hufnagel
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.|Swiss Research Institute on Public Health and Addiction, University of Zurich, Zürich, Switzerland.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Frick
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Ridinger
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Wodarz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064829:Alcohol Abstinence / Q000523:psychology*; D000428:Alcohol Drinking / Q000523:psychology; D000437:Alcoholism / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000523:psychology*; D055815:Young Adult