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Concurrent Alcohol Use and Smoking Among US Adults with Hepatitis C.
Mohammad Alabbas1, Yuqi Guo2,3, Jingyi Shi4
1Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio, USA.
Journal of Dual Diagnosis
|June 11, 2026
Summary
Concurrent alcohol and smoking use remains high among US adults with Hepatitis C (HCV), increasing liver injury risk. Factors like marijuana use, substance history, depression, and cancer history are linked to this dangerous combination.
Area of Science:
- Hepatology and Viral Hepatitis Research
- Public Health and Epidemiology
- Substance Use and Comorbidity Studies
Background:
- Concurrent alcohol use and smoking significantly accelerate hepatic injury in individuals with Hepatitis C Virus (HCV) infection.
- Understanding the prevalence and trends of these co-occurring behaviors is crucial for mitigating HCV-related liver disease progression.
Purpose of the Study:
- To estimate the population-level prevalence of concurrent alcohol use and active smoking among US adults with HCV over the past decade.
- To examine temporal trends in the prevalence of concurrent alcohol use and active smoking.
- To identify risk factors associated with concurrent alcohol use and active smoking in this population.
Main Methods:
- A repeated cross-sectional analysis was performed using six cycles of the National Health and Nutrition Examination Survey (NHANES) data from 2007-2018.
- The study included US adults aged 20 years and older with confirmed current HCV infection and complete data on alcohol and smoking status.
- Complex survey design methods and design-adjusted multinomial logistic regression were used to analyze prevalence, trends, and associated risk factors.
Main Results:
- The pooled prevalence of concurrent alcohol use and active smoking among US adults with HCV from 2007-2018 was 39.5%.
- Prevalence rates did not decrease over the 11-year study period, remaining consistently high.
- Positive associations with concurrent alcohol and smoking were observed for current marijuana use (aOR=2.88), lifetime substance use (aOR=5.98), depression (aOR=2.59), and a history of cancer (aOR=1.50).
Conclusions:
- The persistently high prevalence of concurrent alcohol and smoking among individuals with HCV poses a significant public health concern.
- These high rates may contribute to an increased incidence of HCV-related morbidity and mortality in the near future.
- Identifying and addressing associated risk factors is critical for developing targeted interventions.
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