Screening and concurrent brief intervention of conjoint hazardous or harmful alcohol and tobacco use in hospital out-patients in Thailand: a randomized controlled trial.

Supa Pengpid,Kriengsak Thamma-Aphiphol,Thiprada Kongtapan,Karl Peltzer,Somchai Viripiromgool,Apa Puckpinyo,Kawinarat Suthisukhon,Dussanee Dumee

doi:10.1186/s13011-015-0018-1

Abstract

BackgroundThe aim of this study was to conduct a cluster randomized control trial to assess the efficacy of screening and brief intervention (SBI) for conjoint alcohol and tobacco use among hospital out-patients.MethodIn all 620 hospital out-patients who screened positive for both tobacco and alcohol moderate risk in four hospitals were randomized into 2 control and 1 intervention condition using the hospital as a unit of randomization (2 intervention and 2 control hospitals) to 405 patients in the two control groups (tobacco only intervention, n = 199, and alcohol only intervention, n = 206) and 215 in the intervention group. The intervention or control consisted of three counselling sessions.ResultsResults of the interaction (Group × Time) effects using GEE indicated that there were statistically significant differences between the three study groups over the 6-month follow-up on the ASSIST tobacco score (Wald χ2 = 8.43, P = 0.004), and past week tobacco use abstinence (Wald χ2 = 7.34, P = 0.007). Although there were no significant interaction effects on the other outcomes (Alcohol ASSIST score, low alcohol risk score, past week tobacco abstinence or low alcohol risk score, and past week tobacco abstinence and low alcohol risk score), the scores in all of the six outcome measures showed consistent improvements. For past week tobacco abstinence the tobacco only intervention was more effective than the alcohol only intervention and the integrated alcohol and tobacco intervention. For the outcome of low alcohol risk, the alcohol only intervention and the integrated alcohol and tobacco intervention was more effective than the tobacco only or alcohol only intervention.ConclusionsThe study found that for past week tobacco abstinence the tobacco only intervention was more effective than the alcohol only intervention and the polydrug use (alcohol and tobacco) integrated intervention.

Highlights

The aim of this study was to conduct a cluster randomized control trial to assess the efficacy of screening and brief intervention (SBI) for conjoint alcohol and tobacco use among hospital out-patients
The integration of a brief intervention for tobacco use and problem drinking is important because of (1) the prevalence of problem drinking is higher among smokers than non-smokers [1, 11], (2) alcohol consumption has been identified as a trigger for smoking and for relapse to smoking among those who have already quit, and heavy drinkers have significantly lower rates of quitting smoking [11,12,13], and (3) the combined health risks of smoking and problem drinking are higher than the risks of smoking alone [11, 14]
The aim of this study is to conduct a cluster randomized control trial to assess the efficacy of SBI for conjoint alcohol and tobacco use among hospital out-patients

Summary

Introduction

The aim of this study was to conduct a cluster randomized control trial to assess the efficacy of screening and brief intervention (SBI) for conjoint alcohol and tobacco use among hospital out-patients. The integration of a brief intervention for tobacco use and problem drinking is important because of (1) the prevalence of problem drinking is higher among smokers than non-smokers [1, 11], (2) alcohol consumption has been identified as a trigger for smoking and for relapse to smoking among those who have already quit, and heavy drinkers have significantly lower rates of quitting smoking [11,12,13], and (3) the combined health risks of smoking and problem drinking are higher than the risks of smoking alone [11, 14]. The existing literature [11, 15,16,17,18,19] on the concurrent treatment of smoking and drinking indicates that there may be some benefit to combining services for these addictive behaviours Given this demonstrated overlap in smoking and drinking, the present study explores a brief intervention for conjoint alcohol problem and tobacco users using Kahler’s model [17]

Objectives

Results

Conclusion