Hobden Breanne, Bryant Jamie, Forshaw Kristy, Oldmeadow Christopher, Evans Tiffany-Jane, Sanson-Fisher Rob
Health Behaviour Research Collaborative, HMRI Building, University of Newcastle, Callaghan, NSW 2308, Australia. Email: ;
Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, NSW 2308, Australia. Email:.
Aust Health Rev. 2020 Feb;44(1):125-131. doi: 10.1071/AH18126.
Objectives This study sought to determine, among a large sample of Australian general practice patients: (1) the prevalence of smoking among different levels of alcohol misuse; and (2) whether the associations between demographic characteristics and alcohol use differ according to smoking status. Methods A cross-sectional survey was administered from 2010 to 2011 to 3559 patients from 12 Australian urban general practices. Patients reported their demographic details, smoking status and their alcohol intake. Results The overall prevalence of reported concurrent smoking and alcohol misuse was 7.8%. Smokers were 3.81-fold more likely to have a higher level of alcohol consumption than non-smokers (95% confidence interval 3.13-4.63; P<0.0001). There was evidence that smoking was an effect modifier of the relationship between alcohol misuse and chronic illness. Conclusions There was an increasing prevalence of smoking with increasing level of alcohol consumption. In addition, those with chronic conditions who smoked had greater odds of higher levels of alcohol consumption. Preventative interventions for these substances are needed to reduce the burden associated with concurrent smoking and alcohol misuse. What is known about the topic? Tobacco and alcohol are the most commonly used substances and contribute to over 10million deaths annually. The risk of disease is high when using either of these substances, however, concurrent use is associated with a greatly compounded risk. Australian data is limited regarding the prevalence of concurrent tobacco and alcohol misuse, however, international studies suggest variation in prevalence rates between different clinical settings. What does this paper add? This study examined the prevalence of concurrent smoking and alcohol misuse among different levels of alcohol misuse severity within an Australian general practice setting. Additionally it explored whether the associations between demographic characteristics and alcohol use differ according to smoking status. What are the implications for practitioners? This study has important implications for disease prevention and the delivery of preventive health services by general practitioners. Considering one in 100 clinical treatments provided in general practice relate to preventative smoking or alcohol counselling, it is critical that efforts are made to ascertain risk factors such as smoking and alcohol misuse to increase treatment rates. General practitioners should consider screening for smoking and alcohol misuse opportunistically during routine clinical encounters, as well as screening for smoking or alcohol misuse if one or the other is present.
目的 本研究旨在确定大量澳大利亚全科医疗患者中的：（1）不同程度酒精滥用人群中的吸烟率；（2）人口统计学特征与酒精使用之间的关联是否因吸烟状况而异。方法 2010年至2011年对来自澳大利亚12个城市全科医疗诊所的3559名患者进行了横断面调查。患者报告了他们的人口统计学细节、吸烟状况和酒精摄入量。结果 报告的同时吸烟和酒精滥用的总体患病率为7.8%。吸烟者酒精消费量较高的可能性是非吸烟者的3.81倍（95%置信区间3.13 - 4.63；P<0.0001）。有证据表明吸烟是酒精滥用与慢性病之间关系的效应修饰因素。结论 随着酒精消费量增加，吸烟率也在上升。此外，患有慢性病且吸烟的人酒精消费量较高的几率更大。需要针对这些物质采取预防干预措施，以减轻同时吸烟和酒精滥用带来的负担。关于该主题已知的情况是什么？烟草和酒精是最常用的物质，每年导致超过1000万人死亡。单独使用这两种物质时疾病风险都很高，然而，同时使用会使风险大幅增加。澳大利亚关于同时烟草和酒精滥用患病率的数据有限，不过，国际研究表明不同临床环境中的患病率存在差异。本文补充了什么？本研究调查了澳大利亚全科医疗环境中不同程度酒精滥用严重程度下同时吸烟和酒精滥用的患病率。此外，还探讨了人口统计学特征与酒精使用之间的关联是否因吸烟状况而异。对从业者有何启示？本研究对疾病预防以及全科医生提供预防性健康服务具有重要意义。考虑到全科医疗中每100次临床治疗中有1次与预防性吸烟或酒精咨询相关，努力确定吸烟和酒精滥用等风险因素以提高治疗率至关重要。全科医生应在常规临床问诊时机会性地筛查吸烟和酒精滥用情况，以及在存在其中一项时筛查另一项的滥用情况。
