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Are smokers with alcohol disorders less likely to quit?

N Breslau, E Peterson, L Schultz, P Andreski and H Chilcoat

Department of Psychiatry, Henry Ford Health Sciences Center, Detroit, Mich 48202, USA.

OBJECTIVES. This study examined the likelihood of smoking cessation in smokers with a prior history of alcoholism. METHODS. Data came from an epidemiologic study of 1007 young adults, randomly selected from those insured in a large health maintenance organization (HMO) in southeast Michigan. Cox proportional hazards models with time-dependent covariates were used to estimate the hazards ratios of quitting in smokers with current and past alcoholism, with smokers with no history of alcoholism as a reference. Sex, race, and education were controlled. RESULTS. Smokers with active alcoholism in the preceding year were 60% less likely to quit than were smokers with no history of alcoholism. In contrast, smokers whose alcoholism had remitted were at least as likely to quit as smokers with no history of alcoholism. Compared with persistent alcoholism, remission of alcoholism was associated with more than a threefold increase in the likelihood of subsequent smoking cessation. CONCLUSIONS. The findings suggest that discontinuation of alcoholism might increase the potential for successful smoking cessation.

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