Association of Current and Lifetime DSM-IV Drug use Disorder Diagnoses to 6-Month Changes in Smoking Behavior in Risky Drinking Smokers: A Pilot Study

ABSTRACT

Background: Alcohol and other drug use disorders co-occur with cigarette smoking and negatively impact cessation outcomes. Objectives: This study examined the differential effects of current and lifetime DSM-IV drug diagnoses on the 6-month smoking outcomes of 84 untreated heavy drinking smokers who were motivated to quit smoking in the next 6-months. Methods: Generalized estimating equations (GEE) assessed changes in nicotine dependence, readiness to quit smoking, and prevalence of heavy smoking from baseline to 6-months as a function of time, baseline drinking severity, and drug diagnosis. Results: GEE models showed that nicotine dependence and prevalence of heavy smoking decreased over 6-months, irrespective of drug diagnosis and baseline alcohol consumption. Several 3-way interactions were found, showing differences in the rate of change over time in readiness to quit smoking and prevalence of heavy smoking as a function of current versus lifetime drug diagnosis and higher versus lower of baseline alcohol consumption. Conclusions/Importance: Drug diagnoses are common in risky drinking smokers, and significantly impede changes in smoking behavior and motivation to quit. Treatment planning for smoking cessation should include a thorough assessment of current and past drug use behavior to determine the impact on readiness to quit and quit success. Mechanisms of change in smokers with multiple substance use diagnoses should be examined.

KEYWORDS:

• Substance use disorders
• drug diagnosis
• cigarettes
• alcohol
• nicotine dependence
• behavior change

Acknowledgments

We would like to acknowledge Dr. Thomas Brandon and Dr. Stephen Armeli, consultants on this funded project and who have provided invaluable feedback on study implementation and dissemination.

Disclosures/declaration of interests

The authors have no conflicts of interest to declare. The authors alone are responsible for the content and writing of this paper.

Funding

This study was funded by R03CA 175870 awarded to the first author from the National Cancer Institute.