Pagano Anna, Le Thao, Fong Timothy, Reid Rory, Delucchi Kevin, Guydish Joseph
Institute for Health Policy Studies, University of California, San Francisco, California, USA.
Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA.
Am J Addict. 2023 Nov;32(6):563-573. doi: 10.1111/ajad.13458. Epub 2023 Aug 6.
Gambling is highly comorbid with disordered use of tobacco and other drugs, and may increase relapse risk among substance use disorder (SUD) patients. We investigated associations between gambling and tobacco use behaviors among SUD patients to inform clinical care.
Patients (N = 651, 170 female) from 25 residential SUD treatment programs in California completed surveys about tobacco use, health, and gambling. Using multivariate regression, we examined associations between gambling, tobacco use behaviors, and mental and physical health.
Past-year gamblers were more likely than non-gamblers to be current smokers (adjusted odds ratio [AOR] = 1.44, 95% confidence interval [CI] = 1.03, 2.01). Smokers who gambled had higher mean Heaviness of Smoking Index (HSI) scores (mean difference = +0.32, 95% CI = 0.04, 0.60), and more often reported smokeless tobacco use (AOR = 1.73, 95% CI = 1.16, 2.58), compared to non-gambling smokers. Past-year problem gamblers were more likely than all others (non-gamblers and non-problem gamblers) to be current smokers (AOR = 1.44, 95% CI = 1.08, 1.90) and to report high psychosocial stress (AOR = 1.87, 95% CI = 1.34, 2.61). Smokers with problem gambling also had higher HSI scores (mean difference = +0.54, 95% CI = 0.14, 0.95) compared to smokers without problem gambling.
Gambling and problem gambling were associated with tobacco use and heavier smoking. SUD patients with gambling comorbidity may be heavier smokers and may need concurrent treatment for tobacco use and problem gambling.
This study provides novel data regarding gambling and tobacco use behaviors among SUD patients.
赌博与烟草及其他药物的紊乱使用高度共病，且可能增加物质使用障碍（SUD）患者的复发风险。我们调查了SUD患者中赌博与烟草使用行为之间的关联，以为临床护理提供参考。
来自加利福尼亚州25个住院SUD治疗项目的患者（N = 651，170名女性）完成了关于烟草使用、健康状况和赌博的调查。我们使用多变量回归分析了赌博、烟草使用行为以及心理和身体健康之间的关联。
过去一年中有赌博行为的人比无赌博行为的人更有可能成为当前吸烟者（调整后的优势比[AOR]=1.44，95%置信区间[CI]=1.03，2.01）。与不赌博的吸烟者相比，有赌博行为的吸烟者的平均吸烟严重程度指数（HSI）得分更高（平均差异=+0.32，95%CI=0.04，0.60），且更常报告使用无烟烟草（AOR=1.73，95%CI=1.16，2.58）。过去一年中有问题赌博行为的人比其他所有人（无赌博行为者和无问题赌博行为者）更有可能成为当前吸烟者（AOR=1.44，95%CI=1.08，1.90），且报告有较高的心理社会压力（AOR=1.87，95%CI=1.34，2.61）。与无问题赌博行为的吸烟者相比，有问题赌博行为的吸烟者的HSI得分也更高（平均差异=+0.54，95%CI=0.14，0.95）。
赌博和问题赌博与烟草使用及更严重的吸烟情况相关。患有赌博共病的SUD患者可能吸烟更严重，可能需要同时接受烟草使用和问题赌博的治疗。
本研究提供了关于SUD患者中赌博和烟草使用行为的新数据。
