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. 2022 Jun 9:18:100418.
doi: 10.1016/j.lanepe.2022.100418. eCollection 2022 Jul.

Characterising smoking and smoking cessation attempts by risk of alcohol dependence: A representative, cross-sectional study of adults in England between 2014-2021

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Characterising smoking and smoking cessation attempts by risk of alcohol dependence: A representative, cross-sectional study of adults in England between 2014-2021

Claire Garnett et al. Lancet Reg Health Eur. .

Abstract

Background: There is a strong shared association between smoking tobacco and drinking alcohol. This study aimed to compare smoking prevalence and smoking characteristics in drinkers who were versus were not at risk of alcohol dependence in England.

Methods: We used cross-sectional data from a monthly, nationally representative survey of adults in England (weighted n=144,583) collected between 2014-2021. Smoking and smoking cessation attempt characteristics were regressed on to alcohol dependence (drinkers at risk versus not at risk), adjusting for survey year.

Findings: Past-year smoking prevalence was 63·3% (95% CI=59·7-66·8) among drinkers at risk of alcohol dependence compared with 18·7% (95% CI=18·4-18·9) among those not at risk, and 19·2% (95% CI=18·8-19·7) among non-drinkers. Among past-year smokers, drinkers at risk of alcohol dependence (versus not at risk) smoked more cigarettes per day (B=3·0, 95% CI=2·3-3·8) and were more likely to smoke their first cigarette within 5 (versus >60) minutes of waking (OR=2·81, 95% CI=2·25-3·51).

Interpretation: In a representative sample of adults in England, a graded effect was observed where smoking prevalence increased with level of alcohol consumption. Past-year smokers at risk of alcohol dependence had higher levels of cigarette dependence than drinkers not at risk. Therefore, smokers at risk of alcohol dependence are a high priority group to target to reduce smoking prevalence as part of the NHS long-term plan.

Funding: Cancer Research UK and the National Institute for Health Research.

Keywords: Alcohol dependence; Cessation; Classifications; Comorbidities; Health policy; Public health; Smoking; Tobacco; Treatment.

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Conflict of interest statement

CG and MO are paid scientific consultants for the behaviour change and lifestyle organisation ‘One Year No Beer’. SC and HTB have no conflicts to declare. LS is a HEFCE funded member of staff at University College London. He has received honoraria for talks, an unrestricted research grant and travel expenses to attend meetings and workshops from Pfizer and an honorarium to sit on advisory panel from Johnson&Johnson, both pharmaceutical companies that make smoking cessation products. He has acted as paid reviewer for grant awarding bodies and as a paid consultant for health care companies. Other research has been funded by the government, a community-interested company (National Centre for Smoking Cessation) and charitable sources. He has never received personal fees or research funding of any kind from alcohol, electronic cigarette or tobacco companies.

Figures

Fig 1
Figure 1
Smoking prevalence by AUDIT score among drinkers (adjusted for survey year, holding it constant at 2020 for purposes of prediction). a. Past-year smoking prevalence. b. Current smoking prevalence.

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