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The co-occurrence of smoking and alcohol use disorder in a hospital-based population: Applying a multimorbidity
Scott D Siegel1, Madeline Brooks2, Heather E Ragozine-Bush3
1Value Institute, Christiana Care Health System, USA; Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, USA.
Insights
Concurrent tobacco and alcohol use disorder (AUD) significantly elevates health risks and mortality. This study highlights the unique clinical and social challenges faced by patients with both conditions, emphasizing the need for targeted interventions.
Area of Science:
- Public Health
- Clinical Medicine
- Epidemiology
Background:
- Tobacco and alcohol use are leading causes of premature death in the US.
- Concurrent use of tobacco and alcohol exacerbates health risks.
- Understanding the characteristics of individuals with co-occurring substance use disorders is crucial for public health.
Purpose of the Study:
- To identify the demographic, social, and clinical profiles of patients with concurrent smoking and alcohol use disorder (AUD).
- To compare these profiles with never smokers without AUD.
- To inform the development of targeted interventions for this high-risk population.
Main Methods:
- Cross-sectional study of 20,310 patients admitted to a Mid-Atlantic health care system.
- Patients categorized by smoking status and AUD.
- Demographic, socioeconomic, environmental, and clinical data analyzed.
Main Results:
- 7.2% of admissions (1464 patients) had concurrent smoking and AUD.
- These patients were younger, more likely male, and had Medicaid coverage.
- Higher rates of other substance use disorders, depression, HIV/AIDS, and liver disease were observed.
- Proximity to higher counts of tobacco and alcohol retailers was noted.
Conclusions:
- Patients with concurrent smoking and AUD face unique and severe health risks.
- A multimorbidity framework is recommended for clinical and community interventions.
- Interventions should address psychiatric conditions, chronic medical issues, social needs, and environmental exposures.
Abstract:
Tobacco and alcohol use are leading causes of premature mortality in the US and concurrent use is associated with even greater health risks. A cross-sectional study of 20,310 patients admitted to a Mid-Atlantic acute health care system between July 1, 2018 and June 30, 2019 were categorized according to smoking and alcohol use disorder (AUD) status. Of the total admissions, 1464 (7.2%) were current smokers with an AUD. These patients were younger (52.4 vs. 63.9), more likely to be male (64.1% vs. 38.0%) and covered by Medicaid (46.9% vs. 11.6%), and resided in proximity to higher counts of tobacco (10.3 vs. 4.72) and alcohol (2.24 vs. 1.14) retailers than never smokers without an AUD. Clinically, these patients had higher rates of other substance use disorders (60.4% vs. 6.1%), depression (64.6% vs. 34.8%), HIV/AIDS (3.3% vs. 0.6%), and liver disease (40.7% vs. 13.2%) than never smokers without an AUD. Patients who concurrently smoke and have an AUD face unique and serious health risks. A multimorbidity framework can guide clinical and community-based interventions for individuals with concurrent psychiatric and chronic medical conditions, complex social needs, and adverse environmental exposures.
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