在一项戒烟试验中，研究问题性饮酒对近期确诊癌症患者戒烟的影响：一项二次分析。

Examining the effects of problematic alcohol use on cigarette abstinence in recently diagnosed cancer patients enrolled in a cessation trial: A secondary analysis.

作者信息

Streck Joanna M, Hyland Kelly A, Regan Susan, Muzikansky Alona, Rigotti Nancy A, Ponzani Colin J, Perez Giselle K, Kalkhoran Sara, Ostroff Jamie S, Park Elyse R

机构信息

Department of Psychiatry, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Tobacco Research and Treatment Center, Department of Medicine and Health Policy Research Center, The Mongan Institute, MGH, Boston, MA, United States.

Department of Psychology, University of Southern Florida, Tampa, FL, United States.

出版信息

Addict Behav. 2021 Apr;115:106794. doi: 10.1016/j.addbeh.2020.106794. Epub 2020 Dec 29.

DOI:10.1016/j.addbeh.2020.106794

PMID:33385757

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8118391/

Abstract

AIMS

Among people with cancer, dual alcohol and tobacco use increases risk for morbidity and mortality. Most smoking cessation clinical trials with this patient population have excluded individuals with problematic alcohol use. This investigation examined whether problematic alcohol use affects smoking cessation in cancer patients.

METHODS

Mixed-methods secondary analysis of data from the Smokefree Support Study, a randomized-controlled trial examining the efficacy of Intensive (IT; n = 153) vs. Standard Treatment (ST; n = 150) for smoking cessation in newly diagnosed cancer patients. Problematic alcohol use was assessed at enrollment using the Cut-Down-Annoyed-Guilty-Eye-Opener (CAGE), weekly frequency of alcohol use and binge drinking measures. Alcohol use was categorized as: no current alcohol use, moderate and problematic use. The primary outcome was biochemically-confirmed cigarette abstinence at 6-months. A subset of patients (n = 72) completed qualitative exit-interviews.

RESULTS

Among all participants, biochemically-confirmed cigarette abstinence rates were 25% (n = 32), 28% (n = 27), and 36% (n = 20) for participants reporting no current alcohol use, moderate use, and problematic use, respectively (p = 0.33). In logistic regression analysis, neither problematic alcohol use (AOR = 0.96, 95% CI = 0.35-2.67, p = .94) nor the problematic use by study arm interaction (AOR = 2.22, 95% CI = 0.59-8.39, p = .24) were associated with biochemically-confirmed 6-month abstinence. Qualitatively, participants reported that drinking alcohol triggers urges to smoke.

CONCLUSION

Newly diagnosed cancer patients reporting problematic alcohol use were not less likely to quit smoking than those without. Additional research is needed to investigate whether problematic alcohol users may benefit from smoking and alcohol behavior change interventions at the time of cancer diagnosis.

摘要

目的

在癌症患者中，同时饮酒和吸烟会增加发病和死亡风险。大多数针对该患者群体的戒烟临床试验都排除了有酒精使用问题的个体。本研究调查了有酒精使用问题是否会影响癌症患者的戒烟情况。

方法

对无烟支持研究的数据进行混合方法二次分析，该研究是一项随机对照试验，旨在检验强化治疗（IT；n = 153）与标准治疗（ST；n = 150）对新诊断癌症患者戒烟的疗效。在入组时使用减少-烦恼-内疚-眼-开瓶器（CAGE）、饮酒周频率和暴饮措施评估酒精使用问题。酒精使用被分类为：当前不饮酒、适度饮酒和有问题饮酒。主要结局是6个月时经生化确认的戒烟情况。一部分患者（n = 72）完成了定性退出访谈。

结果

在所有参与者中，报告当前不饮酒、适度饮酒和有问题饮酒的参与者经生化确认的戒烟率分别为25%（n = 32）、28%（n = 27）和36%（n = 20）（p = 0.33）。在逻辑回归分析中，有问题饮酒（优势比[AOR]=0.96，95%置信区间[CI]=0.35 - 2.67，p = 0.94）和按研究组交互作用的有问题饮酒（AOR = 2.22，95% CI = 0.59 - 8.39，p = 0.24）均与经生化确认的6个月戒烟无关。定性分析方面，参与者报告饮酒会引发吸烟冲动。