Tobacco use treatment for alcoholics: myopia or negligence?
DOI:
https://doi.org/10.20882/adicciones.366Keywords:
smoker-alcoholics, smoking, alcohol, addictionAbstract
Smoking and alcohol drinking are the most common addictions in our society. In an alcohol-dependant population, tobacco use is present in a high percentage of cases. The health consequences of concurrent consumption are devastating. Research into mortality rates has identified tobacco use as the leading cause of death among abstinent alcoholics. Surprisingly, the tobacco dependence of these patients has not received the attention it merits from health professionals working in drug abuse centres in our country. This article endeavours to show the importance of the role of health professionals in changing this situation and in improving the quality of life of these patients. Traditionally, treating tobacco use was delayed until after several years of alcohol abstinence. However, the latest evidence shows that a lapse of three months after the last drink is enough to commence smoking cessation intervention without jeopardizing alcohol abstinence. Moreover, there are effective treatments in facilitating smoking cessation in these patients.References
Banegas JR, Díez Gañán L, González Enríquez J, Villar Alvarez F, Rodríguez-Artalejo F. La mortalidad atribuible al tabaquismo comienza a descender en España. Med Clin 2005; 124: 769-71.
Portella E, Ridao M, Carrillo E, Ribas E, Ribó C, Salvat M. El alcohol y su abuso: impacto socioeconómico. Madrid:Ed. Médica Panamericana; 1998.
Alcohol Alert, 39, National Institute on Alcohol Abuse and Alcoholism; 1998.
Daeppen JB, Smith TL, Danko GP, Gordon L, Landi NA, Nurnberger JI Jr, Bucholz KK, Raimo E, Schuckit MA. Clinical correlates of cigarette smoking and nicotine dependence in alcohol-dependent men and women. The Collaborative Study Group on the Genetics of
Alcoholism. Alcohol Alcohol. 2000; 35: 171-5.
DiFranza JR, Guerrera MP. Alcoholism and smoking [resumen]. J Stud Alcohol 1990; 51:130-5.
Hurt RD, Offord KP, Croghan IT, Gomez-Dahl L, Kottke TE, Morse RM, Melton LJ 3rd. Mortality following inpatient addictions treatment. Role of tobacco use in a community-based cohort. JAMA 1996; 275: 1097-1103.
Gual A, Lligoña A, Costa S, Segura L, Colom J. El tratamiento del alcoholismo y su impacto a largo plaxo. Resultados a 10 años de un estudio longitudinal prospectivo de 850 alcohólicos tratados en la red pública de Cataluña. Med Clin 2004; 124: 769-71.
Hughes JR, Callas PW. Past alcohol problems do not predict worse smoking cessation outcomes. Drug Alcohol Depend 2003; 10;71: 269-73.
Friend KB, Pagano ME. Smoking cessation and alcohol consumption in indivuduals in treatment for alcohol use disorders. J Addict Dis 2005; 24: 61-75.
Bobo JK, McIlvain HE, Lando HA, Walker RD, Leed-Kelly A. Effect of smoking cessation counseling on recovery from alcoholism: findings from a randomized community tintervention trial. Addiction 1998; 93:877-87.
Martin JE, Clafas KJ, PattenCA, Polarek M, Hofstetter CR, Noto J Beach D. Prospective evaluation of three smoking interventions in 205 recovering alcoholics: one year resluts of Project SCRAP-Tobacco. J Consult Clin Psychol 1997; 65:190-4.
Hughes JR, Novy P, Hatsukami DK, Jensen J, Callas PW. Efficacy of nicotine patch in smokers with a history of alcoholism. Alcohol Clin Exp Res 2003; 27: 946-54.
Hayford KE, PattenCA, RummansTA, Schroeder DR, Offord KP, Croghan IT et al. Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism. Br J Psychiatry 1999; 174: 173-8.
Johnson BA. Topiramate-induced reuromodulation of cortico-mesolimbic dopamine function: A new vista for the treatment of comorbid alcohol and nicotine dependence? Addictive Behaviors 2004; 29: 1465-79.


