Concurrent Alcohol and Tobacco Treatment: Effect on Daily Process Measures of Alcohol Relapse Risk

• Published in: Journal of consulting and clinical psychology Vol. 83; no. 2; pp. 346 - 358
• Main Authors: Cooney, Ned L., Litt, Mark D., Sevarino, Kevin A., Levy, Lucienne, Kranitz, Linda S., Sackler, Helen, Cooney, Judith L.
• Format: Journal Article
• Language: English
• Published: United States American Psychological Association 01-04-2015
• Subjects: Adult; Alcohol Treatment; Alcohol use; Alcoholism; Alcoholism - therapy; Ambulatory Care; Comparative analysis; Female; Human; Humans; Intervention; Male; Middle Aged; Outcome Expectancies; Outpatient; Outpatients; Readiness to Change; Recurrence; Relapse (Disorders); Risk; Risk Assessment; Risk Factors; Self Efficacy; Smoking - therapy; Smoking Cessation; Smoking Cessation - methods; Smoking Cessation - psychology; Substance abuse treatment; Substance Use Treatment; Time Factors; Tobacco Smoking; Treatment Outcome; Treatment Outcomes; alcohol; outcome expectancies; craving; smoking cessation; negative mood
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/a0038633

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. Method: 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.
What is the public health significance of this article?
Study results support conveying a message to alcohol dependent smokers that smoking abstinence is accompanied by favorable changes in alcohol use, craving, mood, confidence, and motivation.