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The Impact of Tobacco Smoking on Treatment for Comorbid Depression and Alcohol Misuse

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Abstract

Tobacco use is a major public health concern, and is associated with a number of mental illnesses as well as increased alcohol/other drug (AOD). Research into treatment for individuals experiencing such comorbidities is limited. Participants (n = 447) were those enrolled in the Depression and Alcohol Integrated and Single-focused Interventions project (Baker et al. 2010), and the Self Help for Alcohol/other drugs and DEpression project (Kay-Lambkin et al. Medical Journal of Australia 195:S44–S50, 2011a, Journal of Medical Internet Research 13(1):e11p11, b), who reported current depression and hazardous alcohol use at entry to the study. Smoking cessation was not targeted in, nor a goal of, treatment. After controlling for socioeconomic variables, tobacco use was not associated with higher levels of depressive symptoms at baseline; however heavy smokers (30+ cigarettes per day) consumed significantly more alcohol at baseline than did non-smokers (13 vs. 9 standard drinks per day). Baseline smoking severity did not impact on depression or alcohol use outcomes over a 12-month period. Reductions in tobacco use between baseline and 3-month follow-up were significantly associated with reductions in depression and alcohol consumption over the same time period. The study results suggest that tobacco use does not interfere with treatment for depression and alcohol use problems, and adds weight to the idea of considering specific treatment for tobacco use in the context of treatment for alcohol/other drug use.

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References

  • ABS. (2006). Tobacco smoking in Australia: A snapshot 2004–05. Canberra: Australian Bureau of Statistics, Catalogue Number: 4831.0.55.001 Available at: http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/4831.0.55.001Main%20Features12004-05?opendocument&tabname=Summary&prodno=4831.0.55.001&issue=2004-05&num=&view=.

  • AIHW. (2008). Australia’s health 2008. Canberra: Australian Institute of Health and Welfare (AIHW Cat No. AUS 73).

    Google Scholar 

  • Alati, R., Kinner, S., Najman, J. M., Fowler, G., Watt, K., & Green, D. (2004). Gender differences in the relationships between alcohol, tobacco and mental health in patients attending an emergency department. Alcohol and Alcoholism, 39(5), 463–469.

    Article  PubMed  Google Scholar 

  • APA. (1994). Global assessment of functioning scale diagnostic and statistical manual (4th ed.). Washington: American Psychiatric Association.

    Google Scholar 

  • APA. (1995). Practice guideline for the treatment of patients with substance use disorders: alcohol, cocaine, opiods. The American Journal of Psychiatry, 152(11 Supplement), 1–59.

    Google Scholar 

  • APA. (1996). Practice guidelines for the treatment of patients with nicotine dependence. The American Journal of Psychiatry, 153(10), S1–S31.

    Google Scholar 

  • APA. (2000). Practice guideline for the treatment of patients with major depressive disorder (Revision). The American Journal of Psychiatry, 157(4 Suppl), 1–45.

    Google Scholar 

  • Baker, A., Richmond, R., Haile, M., Lewin, T. J., Carr, V. J., Taylor, R., et al. (2006a). A randomized controlled trial of a smoking cessation intervention among people with a psychotic disorder. The American Journal of Psychiatry, 163, 1934–1942.

    Article  PubMed  Google Scholar 

  • Baker, A. L., Ivers, R., Bowman, J., Butler, T., Kay-Lambkin, F., Wye, P., et al. (2006b). Where there’s smoke, there’s fire: high prevalence of smoking among some sub-populations and recommendations for intervention. Drug and Alcohol Review, 25(1), 85–96.

    Article  PubMed  Google Scholar 

  • Baker, A. L., Kavanagh, D., Kay-Lambkin, F., Hunt, S., Lewin, T. J., Carr, V. J., et al. (2010). Randomised controlled trial of CBT for co-existing depression and alcohol problems: short-term outcome. Addiction, 105, 87–99.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). The beck depression inventory, second edition: Manual. San Antonio: The Psychological Corporation.

    Google Scholar 

  • Burling, T., Burling, A., & Latini, D. (2001). A controlled smoking cessation trial for substance dependent inpatients. Journal of Consulting and Clinical Psychology, 69(2), 295–304.

    Article  PubMed  CAS  Google Scholar 

  • Cargill, B., Emmons, K., Kahler, C., & Brown, R. (2001). Relationship among alcohol use, depression, smoking behaviour, and motivation to quit smoking with hospitalised smokers. Psychology of Addictive Behaviors, 15(3), 272–275.

    Article  PubMed  CAS  Google Scholar 

  • Cooney, N., Litt, M., Cooney, J., Pilkey, D., Steinberg, H., & Oncken, C. (2007). Concurrent brief versus intensive smoking intervention during alcohol dependence treatment. Psychology of Addictive Behaviors, 21(4), 570–575.

    Article  PubMed  Google Scholar 

  • Darke, S., Hall, W., Wodak, A., Heather, N., & Ward, J. (1992). Development and validation of a multi-dimensional instrument for assessing outcome of treatment among opiate users: the Opiate Treatment Index. British Journal of Addiction, 87, 733–742.

    Article  PubMed  CAS  Google Scholar 

  • Derogatis, L. R., & Melisaratos, N. (1983). The brief symptom inventory: an introductory report. Psychological Medicine, 13, 595–605.

    Article  PubMed  CAS  Google Scholar 

  • Dunn, K., Sigmon, S., Reimann, E., Badger, G., Heil, S., & Higgins, S. (2010). A contingency-management intervention to promote initial smoking cessation among opioid-maintained patients. Experimental and Clinical Psychopharmacology, 18(1), 37–50.

    Article  PubMed  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., Williams, J. B. W. (2001). Structured clinical interview for DSM-IV-TR axis i disorders, research version, patient edition. New York: Biometrics Research, New York State Psychiatric Institute.

  • Grant, B., Hasin, B., Chou, P., Stinson, F., & Dawson, D. (2004). Nicotine dependence and psychiatric disorders in the United States: results from the National Epidemiological Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61, 1107–1115.

    Article  PubMed  Google Scholar 

  • Hitsman, B., Abrams, D., Shadel, W., Niaura, R., Borrelli, B., & Emmons, K. (2002). Depressive symptoms and readiness to quit smoking among cigarette smokers in outpatient alcohol treatment. Psychology of Addictive Behaviors, 16(3), 264–268.

    Article  PubMed  Google Scholar 

  • Jane-Llopis, E., & Matytsina, I. (2006). Mental health and alcohol, drugs and tobacco: a review of the comorbidity between mental disorders and the use of alcohol, tobacco and illicit drugs. Drug and Alcohol Review, 25, 515–536.

    Article  PubMed  Google Scholar 

  • Kahler, C., Metrik, J., LaChance, H., Ramsey, S., Abrams, D., & Monti, P. (2008). Addressing heavy drinking in smoking cessation treatment: a randomised clinical trial. Journal of Consulting and Clinical Psychology, 76(5), 852–862.

    Article  PubMed  Google Scholar 

  • Kalman, D., Kim, S., DiGirolamo, G., Smelson, D., & Ziedoni, D. (2010). Addressing tobacco use disorder in smokers in early remission from alcohol dependence: the case for integrating smoking cessation services in substance use disorder treatment programs. Clinical Psychology Review, 30, 12–24.

    Article  PubMed  Google Scholar 

  • Kay-Lambkin, F., Baker, A., Kelly, B., & Lewin, T. J. (2011a). Clinician-assisted computerised versus therapist-delivered treatment for depressive and addictive disorders: results of a randomised controlled trial. Medical Journal of Australia, 195, S44–S50.

    PubMed  Google Scholar 

  • Kay-Lambkin, F., Baker, A. L., Lewin, T. J., & Carr, V. J. (2011b). Acceptability of a clinician-assisted computerized psychological intervention for comorbid mental health and substance use problems: treatment adherence data from a randomized controlled trial. Journal of Medical Internet Research, 13(1), e11p11.

    Article  Google Scholar 

  • Massak, A., & Graham, K. (2008). Is the smoking-depression relationship confounded by alcohol consumption? An analysis by gender. Nicotine & Tobacco Research, 10(7), 1231–1243.

    Article  Google Scholar 

  • NHMRC. (2009). National Health and Medical Research Council of Australia Guidelines to reduce health risks from drinking. Commonwealth of Australia: National Health and Medical Research Council ISBN Online: 1864963808 (available at http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/ds10-alcohol.pdf).

  • Shelef, K., Diamond, G., Diamond, G., & Myers, M. (2009). Changes in tobacco use among adolescent smokers in substance abuse treatment. Psychology of Addictive Behaviors, 23(2), 355–361.

    Article  PubMed  Google Scholar 

  • Wilhelm, K., Mitchell, P., Slade, T., Brownhill, S., & Andrews, G. (2003). Prevalence and correlates of DSM-IV major depression in an Australian national survey. Journal of Affective Disorders, 75, 155–162.

    Article  PubMed  Google Scholar 

  • Wilhelm, K., Wedgewood, L., Niven, H., & Kay-Lambkin, F. J. (2006). Smoking cessation and depression: current knowledge and future directions. Drug and Alcohol Review, 25(1), 97–107.

    Article  PubMed  Google Scholar 

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Acknowledgments

The DAISI project was funded by the National Health and Medical Research Council of Australia. The SHADE study was funded by the Alcohol Education and Rehabilitation Foundation.

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Authors and Affiliations

  1. National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia

    Frances Kay-Lambkin

  2. Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, New South Wales, Australia

    Frances Kay-Lambkin, Sarah Edwards, Amanda Baker, Brian Kelly & Terry Lewin

  3. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia

    David Kavanagh

  4. School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia

    Jenny Bowman

  5. Calvary Mater Hospital, Level 5, McAuley Centre, Waratah, NSW, 2289, Australia

    Frances Kay-Lambkin

Authors
  1. Frances Kay-Lambkin
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  2. Sarah Edwards
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  3. Amanda Baker
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  4. David Kavanagh
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  5. Brian Kelly
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  6. Jenny Bowman
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  7. Terry Lewin
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Correspondence to Frances Kay-Lambkin.

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Kay-Lambkin, F., Edwards, S., Baker, A. et al. The Impact of Tobacco Smoking on Treatment for Comorbid Depression and Alcohol Misuse. Int J Ment Health Addiction 11, 619–633 (2013). https://doi.org/10.1007/s11469-013-9437-2

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  • DOI: https://doi.org/10.1007/s11469-013-9437-2

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