Alcohol-dependent Smokers Research Articles

Use of salivary liver function markers for the prognosis of deaddiction in alcohol dependent non-smokers and smokers: A before and after study

Alcohol deaddiction improves the liver function markers in blood as well as saliva in both smokers and non-smokers. The study was conducted to observe the changes in liver function markers after deaddiction in both blood as well as saliva. The study included 83 alcohol dependent subjects, among whom 45 were smokers and 38 were non-smokers. They were followed up after deaddiction for 19-21 days. The liver function markers GGT- γ glutamyl transferase, AST- Aspartate transaminase, ALT- Alanine transaminase, TP- Total protein, and Alb-Albumin were measured spectrophotometrically before and after deaddiction in saliva as well as blood. Paired‘t’ test was done to analyse the significance of their changes in before and after deaddiction. There was no difference in NR (normalization rate) of GGT, AST and ALT between alcohol dependent smokers and non-smokers in saliva as well as blood. NR of TP and Alb was better in non-smokers compared to smokers. GGT (p

Salivary Carbohydrate-Deficient Transferrin in Alcohol- and Nicotine-Dependent Males.

Serum carbohydrate-deficient transferrin (CDT), an 80 kDa glycoprotein, is one of the most commonly employed biomarkers to detect alcohol dependence. Some salivary glycoproteins such as α-amylase, clusterin, haptoglobin, light/heavy-chain immunoglobulin, and transferrin, which alter glycosylation in alcohol-dependent persons, have been suggested to be potential alcohol markers. However, their identification is based on indirect analysis of lectin glycosidic bonds and molecular weight. We investigated the CDT content in the saliva of alcohol- and nicotine-dependent men. The CDT concentration (ng/mL, ng/mg protein) was determined by an Enzyme-Linked Immunosorbent Assay (ELISA) commercial kit in 55 men: 20 healthy social drinkers (C), 10 chronic cigarette smokers (S), 10 alcohol-dependent non-smokers (A), and 15 alcohol-dependent smokers (AS). Surprisingly, there were no differences in the concentrations of CDT between the studied groups. Salivary pH was the lowest in the AS and the highest in the A group. Therefore, salivary CDT cannot be used as an alcohol dependence marker as measured by ELISA. We suggest that direct identification of glycoproteins is necessary to search for potential salivary alcohol biomarkers. Molecules smaller than 40 kDa, which easily translocate from blood to the saliva, might be preferred as salivary alcohol markers.

Salivary proteome characterization of alcohol and tobacco dependents

BackgroundAlcohol and substances found in tobacco may alter salivary flow and amount of saliva proteins. This study aimed to compare salivary proteins between alcohol dependent smokers and controls. MethodsThis is a case-control study with men older than 18 years of age, matched by age. The alcohol-dependent group was composed by heavy smokers and alcohol consumers. Unstimulated whole saliva was collected from all subjects. Analysis of digested peptides was performed in mass spectrometer. Data were processed using ProteinLynx GlobalServer software. Results were obtained by searching theHomo sapiens database from the UniProt catalog. The search tool IBI-IMIM was used to identify candidate proteins for biomarkers. ResultsAlcohol-dependent and control groups were composed of nine participants each, with mean age of 36.89 ± 2.57 and 35.78 ± 1.64 years, respectively. 404 salivary proteins were found in both groups; 282 in the alcohol-dependent. Among the 96 proteins presented in both groups, 32 were up-regulated in the alcohol dependents (i.e. “Hemoglobin subunit beta” and “Forkhead box protein P2” were up-regulated at least 10-fold), 23 were down-regulated (i.e. “Statherin” and “RNA-binding protein 25” were down-regulated at least 10-fold), and 41 presented similar expression in both groups. 71 proteins were candidates for biomarkers of disorders 58 presented in alcohol dependents’ saliva. The most common disorders were neoplasms, genetic, cardiovascular, metabolic and glandular diseases. ConclusionsSalivary protein profile undergoes strong changes in alcohol and tobacco dependents. 34% of salivary proteins present in alcohol and tobacco dependents were present in controls; 14.5% of them were expressed in similar quantity.

Varenicline for tobacco-dependence treatment in alcohol-dependent smokers: A randomized controlled trial

BackgroundTobacco use is prevalent among persons with alcohol abuse and dependence. Varenicline has been shown to be the most effective pharmacotherapy for smoking cessation and may decrease alcohol consumption. The purpose of this study was to evaluate the efficacy of 12 weeks of varenicline for increasing smoking abstinence rates in smokers with alcohol abuse or dependence. MethodsParticipants were eligible for enrollment if they were 18 years or older, smoked 10 or more cigarettes per day for at least 6 months, had current alcohol abuse or dependence, and were interested in quitting smoking. Participants were randomly assigned to receive 12 weeks of varenicline 1 mg twice daily or matching placebo. The primary end point was 7-day point prevalence smoking abstinence at week 12. ResultsThe 7-day point prevalence smoking abstinence rate at 12 weeks was significantly higher with varenicline (n = 16) than placebo (n = 17) (43.8% vs 5.9%; P = .01). At 24 weeks, the 7-day point prevalence smoking abstinence rate was still significantly higher with varenicline than placebo (31.3% vs 0%; P = .02). At 12 weeks, mean (SD) drinks per drinking day was significantly lower with varenicline than placebo (5.7 [3.9] vs 9.0 [5.3] drinks; treatment effect estimate, −2.8 [90% CI, −6.6 to −1.0]). Adverse events were minor and comparable to varenicline clinical trials. ConclusionsVarenicline is safe and efficacious for increasing smoking abstinence rates in smokers with alcohol abuse or dependence. Varenicline may decrease alcohol consumption in this population of smokers.

Long-term changes of salivary exoglycosidases and their applicability as chronic alcohol-drinking and dependence markers

Objectives: Investigation of long-term dynamic changes of salivary activity/output of exoglycosidases, deglycosylation processes and their applicability as alcohol markers.Methods: Exoglycosidase (α-fucosidase (FUC), β-galactosidase (GAL), β-glucuronidase (GLU), β-hexosaminidase (HEX, HEX A and HEX B isoenzymes) and α-mannosidase (MAN)) activities were measured in the saliva of healthy social drinking controls (C), alcohol-dependent non-smokers (ANS) and alcohol-dependent smokers (AS) at the 1st, 15th, 30th and 50th day of abstinence after chronic alcohol drinking.Results: The activity of exoglycosidases was 2–3-fold (MAN), 2–6 fold (FUC), 8–25-fold (HEX A) and 19–40-fold (GLU) higher in the ANS and AS groups than in controls, and had good/excellent sensitivity, specificity and accuracy. The higher outputs of exoglycosidases were in the AS and ANS groups than in controls at the 1st day (GLU, HEX A) and at the 50th day (GLU, FUC, MAN) of abstinence. We found numerous correlations between alcohol-drinking days with GLU and HEX A, alcohol amounts with HEX A and duration of alcohol dependence with FUC and MAN activity/output.Conclusions: Salivary exoglycosidases/deglycosylation processes were still very high up to 50 days after the end of alcohol consumption. We found markers of chronic alcohol consumption (HEX A), alcohol dependence (FUC and MAN) and chronic alcohol consumption and dependence (GLU).

The clinical utility of the Medication Adherence Questionnaire (MAQ) in an alcohol pharmacotherapy trial

BackgroundMedication nonadherence is a ubiquitous problem in pharmacology treatment for alcohol use disorders. Unintentional and purposeful nonadherence as measured by the Medication Adherence Questionnaire (MAQ) has been shown to predict problems with medication adherence; however, feedback from the MAQ has never been incorporated into a behavioral intervention to facilitate medication adherence. We assessed the integration of the MAQ into medical management (MM), a counseling approach frequently employed in conjunction with alcohol pharmacotherapy, to determine whether prior patterns of nonadherence could be addressed effectively to promote medication adherence. MethodsWe conducted a post-hoc analysis of data from 131 alcohol dependent smokers who participated in a double blind, placebo controlled study of varenicline for the treatment of alcohol dependence. At baseline, participants completed a single administration of the MAQ, which asks 2 questions about unintentional nonadherence (e.g., forgetting) and 2 questions about purposeful nonadherence (e.g., stopping because feeling good or feeling bad). Based on these responses, participants were divided into 1 of 3 three categories. Adherent (n=60), Unintentional or Purposeful Nonadherent (n=50) and Unintentional and Purposeful Nonadherent (n=21). Over the course of the 16-week treatment period, patients were expected to participate in 12 medical management (MM) sessions; a brief psychosocial treatment. Feedback based on the MAQ responses was integrated into the MM sessions to facilitate medication and treatment adherence. ResultsThe 3 adherence groups were compared on baseline characteristics, medication adherence, treatment attendance and end-of-treatment patient ratings of treatment helpfulness. Baseline demographics and characteristics were not significantly different among the three categories. We found no statistically significant differences among the three groups with respect to pill adherence, treatment attendance, and treatment satisfaction ratings. ConclusionsThe findings suggest that the incorporation of MAQ feedback into the MM approach could be effective in mitigating risks associated with prior patterns of nonadherence suggesting that further testing of the integrated behavioral approach is warranted.

Association of ankyrin repeats & kinase domain containing 1 (ANKK1) gene polymorphism with co-morbid alcohol & nicotine dependence: A pilot study from a tertiary care treatment centre in north India.

Background & objectives:The frequently encountered co-morbidity of alcohol dependence (AD) with nicotine dependence (ND) increases the risk for various diseases. Ankyrin repeats and kinase domain containing 1 (ANKK1) gene polymorphism is reported to be associated with both ND and AD. This study was undertaken to investigate the possible association of alcohol and tobacco use variables with ANKK1 polymorphism in co-morbid alcohol- and nicotine-dependent treatment seekers visiting a tertiary care centre in north India.Methods:Seventy nine male participants (18-65 yr old) fulfilling diagnostic criteria for ND and AD were included in the study. The socio-demographic data, along with alcohol and tobacco use profile, was recorded and ANKK1 profiling was carried out. Both the allele groups, A1 and A2, were compared with respect to demographic and substance dependence profile. Univariate binary logistic regression analysis was performed to determine the risk of high nicotine and alcohol consumption with genotype.Results:The A1 carrier group (n=33) reported a significantly higher amount of alcohol and tobacco consumed per day. The scores on parameters of ND were found to be significantly higher in this group. The logistic regression analysis revealed that participants with A1 genotype were 2.5 times more likely to report higher amount of alcohol and nicotine consumption than A2 carriers.Interpretation & conclusions:The study provides an indication for the association of ANKK1 polymorphism in the form of higher substance consumption among alcohol dependent smokers, who are A1 carriers and thus may require higher attention of the treatment provider.

A Randomized Trial of Contingency Management for Smoking Cessation During Intensive Outpatient Alcohol Treatment

IntroductionThis randomized clinical trial was designed to evaluate the efficacy of contingency management (CM) for smoking cessation for smokers with alcohol abuse or dependence delivered concurrently with intensive outpatient alcohol treatment. The study also explored the indirect effects of CM smoking treatment and smoking cessation on alcohol and drug use outcomes. MethodsAlcohol abuse/dependent smokers were randomized to cognitive behavioral therapy plus nicotine replacement therapy plus contingency management (CBT+NRT+CM) or to cognitive behavior therapy plus nicotine replacement therapy (CBT+NRT) delivered concurrent with a three-week intensive outpatient alcohol treatment program. ResultsParticipants in the CBT+NRT+CM condition were significantly more likely to be cigarette abstinent at the end of treatment (χ2(1)=8.48, p=.004) with approximately double the carbon monoxide confirmed quit rate (60%) compared with the CBT+NRT condition (29%). At the one-month and six-month time-points there were nonsignificant differences in smoking abstinence outcomes by condition. Smoking treatment condition did not directly affect alcohol abstinence outcomes, but we observed an indirect effect of smoking treatment on alcohol and drug abstinence at one-month follow-up that was mediated by smoking cessation at the end of treatment. ConclusionsAdding CM to an evidence-based smoking cessation treatment that included medication and behavioral counseling doubled the quit rate at the end of treatment. This finding provides strong evidence for the efficacy of CM for helping alcohol dependent smokers reach the milestone of initial smoking abstinence.

Cessation of alcohol consumption decreases rate of nicotine metabolism in male alcohol-dependent smokers

BackgroundRate of nicotine metabolism is an important factor influencing cigarette smoking behavior, dependence, and efficacy of nicotine replacement therapy. The current study examined the hypothesis that chronic alcohol abuse can accelerate the rate of nicotine metabolism. Nicotine metabolite ratio (NMR, a biomarker for rate of nicotine metabolism) and patterns of nicotine metabolites were assessed at three time points after alcohol cessation. MethodsParticipants were 22 Caucasian men randomly selected from a sample of 165 smokers entering a 7-week alcohol dependence treatment program in Poland. Data were collected at three time points: baseline (week 1, after acute alcohol detoxification), week 4, and week 7. Urine was analyzed for nicotine and metabolites and used to determine the nicotine metabolite ratio (NMR, a biomarker for rate of nicotine metabolism), and total nicotine equivalents (TNE, a biomarker for total daily nicotine exposure). Results and conclusionsThere was a significant decrease in urine NMR over the 7 weeks after alcohol abstinence (F(2,42)=18.83, p<0.001), indicating a decrease in rate of nicotine metabolism. On average NMR decreased 50.0% from baseline to week 7 (9.6±1.3 vs 4.1±0.6). There was no change in urine TNE across the three sessions, indicating no change daily nicotine intake. The results support the idea that chronic alcohol abuse may increase the rate of nicotine metabolism, which then decreases over time after alcohol cessation. This information may help to inform future smoking cessation interventions in this population.

An Analysis of Variables Discriminating Between Quitter and Non-quitter Groups among Thai Alcohol-dependent Smokers

The purpose of this study was to identify such variables. This study used a cross-sectional research design involving 375 alcohol-dependent smokers who had received smoking cessation intervention from health care providers. The participants were selected using the convenience sampling technique, and a multistage random sampling was used to select two hospitals, and the Thailand National Quit-line for involvement in this study. All participants completed five questionnaires: 1) the Processes of Change Questionnaire (PCQ), 2) the Self-efficacy Questionnaire (SEQ), 3) the Decisional Balance Questionnaire (DBQ), 4) the Severity of Alcohol Dependence Questionnaire (SADQ), and 5) the Fragestrom Test for Nicotine Dependence (FTND). The acquired data was analyzed using percentages, means, standard deviations, and discriminant analysis. The major findings of the study were as follows: the variables that could discriminate between the „quitter‟ and “non-quitter”groups among Thai alcohol-dependent smokers, at the 0.05 significance level were process of behavior change, nicotine dependency, self efficacy and decisional balance. Furthermore, alcohol-dependent smokers in the “quitter” group were found to possess lower levels of nicotine dependence, higher score of process of behavior change, higher levels of self efficacy and higher decision-making abilities than those in the non-quitter group. The findings suggested that smoking cessation intervention strategies for Thai alcohol-dependent smokers should target the process of behavior change, nicotine dependence, self efficacy and decisional balance. However, level of alcohol dependence among alcohol dependent smokers was not significantly able to discriminate between quitter and non-quitter groups. Future studies should consider for develop the effective smoking cessation intervention for this population.

Predictors of Multiple Substance Use in Alcohol Dependence: The Role of Personality

Objective: The simultaneous use of several licit and illicit psychoactive substances is highly common among patients with mental health disorders. Relatively few studies have investigated the role of personality in the different patterns of multiple substance use among alcohol dependents. The authors aimed to access the association of several clinical, socio-demographic and personality predictors of nicotine and multiple substance use in alcohol dependents. Method: A sample of 178 alcohol-dependent patients was eligible for this study. The profiles of 3 groups of alcohol-dependent patients were compared: 1. alcohol dependents without nicotine use or other substances (“pure” alcohol-dependents; PAD); 2. alcohol-dependent smokers (ADS) without substances use and 3. alcohol-dependents with the use of multiple substances (ADMS). Results: Multiple regression analysis showed that age, educational background, occupational status, years of alcoholism and the personality trait of openness to experience were predictors of Multiple Substance Use (MSU) in alcohol dependent outpatients. Results of the mediation analyses/multivariate regression modelling using bootstrapping method confirmed the mediation role of educational level in the relation between openness to experience and substance use. Conclusion: In alcohol dependents, as in the general population, the personality trait openness to experience may constitute a vulnerability factor associated with polydrug use.

Tobacco smoking interferes with GABAA receptor neuroadaptations during prolonged alcohol withdrawal.

Understanding the effects of tobacco smoking on neuroadaptations in GABAA receptor levels over alcohol withdrawal will provide critical insights for the treatment of comorbid alcohol and nicotine dependence. We conducted parallel studies in human subjects and nonhuman primates to investigate the differential effects of tobacco smoking and nicotine on changes in GABAA receptor availability during acute and prolonged alcohol withdrawal. We report that alcohol withdrawal with or without concurrent tobacco smoking/nicotine consumption resulted in significant and robust elevations in GABAA receptor levels over the first week of withdrawal. Over prolonged withdrawal, GABAA receptors returned to control levels in alcohol-dependent nonsmokers, but alcohol-dependent smokers had significant and sustained elevations in GABAA receptors that were associated with craving for alcohol and cigarettes. In nonhuman primates, GABAA receptor levels normalized by 1 mo of abstinence in both groups--that is, those that consumed alcohol alone or the combination of alcohol and nicotine. These data suggest that constituents in tobacco smoke other than nicotine block the recovery of GABAA receptor systems during sustained alcohol abstinence, contributing to alcohol relapse and the perpetuation of smoking.

A preliminary study assessment of the nutritional status of alcohol dependent inpatients – cigarette smokers and non-smokers

IntroductionThe abuse of alcohol as well as smoking affects behaviour related to nutrition and nutritional state. The aim of the research was to assess the nutritional status of alcohol dependent patients, smokers and non-smokers, assigned to subgroups by age and clinical variables. Material and MethodThe examined group was composed of 49 alcohol-dependent males undergoing inpatient treatment aged 27–69 (17 non-smoking and 32 tobacco smokers). A number of socio-demographic and clinical interviews were carried out with the patients, and anthropometric measurements and blood samples were taken for laboratory tests. ResultsThe anthropometric research indicated that the subjects who abused alcohol and smoked cigarettes had BMI (Body Mass Index), FM% (percentage body Fat Mass) and WHR (Waist/Hip Ratio) scores below the norm. The AMC (fat-free Arm Muscle Circumference) variable score was similar for subjects who were both smokers and non-smokers. DiscussionThe metabolic processes that regulate the nutrition status of alcohol dependent subjects are complex. Therefore, besides use of nicotine as a factor of body mass reduction, we could look for other variables such as age, length and intensity of alcohol dependence, quantity of alcohol doses or liver function. However, research results show that nicotine smoking especially leads to decrease of body mass. ConclusionSmoking is an important factor affecting the values of nutrition indicators among alcohol dependent persons.

Reciprocal effects of alcohol and nicotine in smoking cessation treatment studies

ObjectiveSmoking and alcohol use are highly related; as such the present study investigated whether alcohol use is associated with failure in tobacco cessation attempts. We first examined the self-reported drinking behavior and smoking over the course of a year at a basic level. Next, we addressed two hypotheses to characterize this relationship at a deeper level: (Hypothesis 1) Alcohol use would be lower for those who attempted to quit smoking (quit for one or more days) during the year compared to those who never quit, and (Hypothesis 2) for those who relapsed to smoking after a quit increases in alcohol consumption would be positively associated with increases in smoking. MethodSubjects were participants in two smoking cessation programs. One group of participants (N=139) was part of a smoking cessation study in alcohol dependent smokers in early recovery and the other group of participants (N=163) was drawn from a smoking cessation study for HIV positive smokers.H1 was tested using t-tests. For H2, a time series analysis examined relationships between smoking and alcohol use within person over a one year period. For H1 and for H2, the analyses utilized bivariate time series procedures. Timeline follow-back data allowed for detailed daily reports of both tobacco and alcohol use. ResultsIn the overall sample, there was no difference in alcohol use between those who stopped smoking and those who never stopped. However, when broken up by study, a difference was found in the alcohol dependent sample such that mean drinks were higher for those who stopped compared to those who never stopped smoking (H1). The results indicated a high number of positive significant cross-correlations between tobacco and alcohol use such that one substance predicted current, as well as past and future use of the alternate substance. Same-day cross-correlations were the most common, and dissipated with time (H2). ConclusionsThis analysis provided insights into the proximal influence of one substance on the other. Alcohol is related to relapse in smoking cessation attempts. It is important that smoking cessation efforts in alcohol using populations consider alcohol use in treatment.

The Salivaryβ-HEX A% Index as an Excellent Marker of Periodontitis in Smoking Alcohol-Dependent Persons

Background. Severe periodontitis leading to tooth loss is found in 5–15% of most populations worldwide. Aim. The applicability of salivary β-hexosaminidase (β-HEX A%, percentage of β-HEX A isoenzyme to total β-HEX) and β-HEX B% (β-HEX B/β-HEX) indexes was investigated as a possible marker of periodontitis. Methods. Thirty three alcohol-dependent smokers (AS) and 32 healthy controls (C) were enrolled in the study. The activity of β-HEX was measured spectrophotometrically. Results. β-HEX A% was significantly higher and β-HEX B% was lower in AS than in C group. We found a significant correlation between β-HEX A% and gingival index (GI) and an inverse correlation between β-HEX A% and salivary flow (SF), in all groups. Salivary β-HEX A% index in smoking alcoholics at 0.23 had excellent sensitivity (96%) and specificity (91%); the AUC for β-HEX A% was high (0.937). There were no correlations between amount/duration-time of alcohol drinking/smoking and β-HEX A% or β-HEX B%. We found significant correlations between the time period of denture wearing and GI, papilla bleeding index (PBI), and decayed missing filled teeth index (DMFT) and between GI and the amount of smoked cigarettes per day. Conclusion. Bad periodontal state was most likely due to the nicotine dependence. Salivary β-HEX A% is a promising excellent marker for the diagnosis of periodontitis.

The effect of chronic alcohol intoxication and smoking on the activity of oral peroxidase

Peroxidase is the most important antioxidant enzyme in saliva. Through peroxidation of thiocyanate in the presence of H2O2, peroxidase catalyses the formation of bacteriocidic compounds such as hypothiocyanate. The purpose of this study was to evaluate the effect of chronic alcohol intoxication and smoking on the activity of oral peroxidase (OPO). A total of 37 volunteers participated in the study. This cohort consisted of 17 male alcohol-dependent smoking patients after chronic alcohol intoxication (AS group, alcohol + smoking) (mean age: 42 years; range: 26–55) (100–700 g/day of alcohol; 10–20 cigarettes/day) and 20 control male social drinkers (CNS group, control non-smokers) with no history of alcohol abuse or smoking (mean age: 42 years; range: 30–53). Salivary peroxidase activity was measured by the colorimetric method. The differences between groups were evaluated using the Mann–Whitney U test. There was significantly higher activity of OPO (p = 0.00001) and significantly lower salivary flow (SF) (p = 0.007) in alcohol-dependent smokers after chronic alcohol intoxication compared to the control group. OPO activity significantly correlated with the number of days of alcohol intoxication, but not with smoking. Gingival index (GI) was significantly higher in smoking alcohol-dependent persons than in the control group, and correlated with OPO activity. The sensitivity of the OPO test was 70% in smoking alcoholics, while specificity was 95%. The increased activity of OPO suggests chronic oxidative stress is more likely due to ethanol action than to smoking. Smoking alcohol-dependent persons have a worse periodontal status than controls. OPO activity as a marker of chronic alcohol abuse may help in the diagnosis of alcoholism.

The effect of chronic alcohol intoxication and smoking on the activity of oral peroxidase

Peroxidase is the most important antioxidant enzyme in saliva. Through peroxidation of thiocyanate in the presence of H₂O₂, peroxidase catalyses the formation of bacteriocidic compounds such as hypothiocyanate.The purpose of this study was to evaluate the effect of chronic alcohol intoxication and smoking on the activity of oral peroxidase (OPO). A total of 37 volunteers participated in the study. This cohort consisted of 17 male alcohol-dependent smoking patients after chronic alcohol intoxication (AS group, alcohol + smoking) (mean age: 42 years; range: 26-55) (100-700 g/day of alcohol; 10-20 cigarettes/day) and 20 control male social drinkers(CNS group, control non-smokers) with no history of alcohol abuse or smoking (mean age: 42 years; range:30-53). Salivary peroxidase activity was measured by the colorimetric method. The differences between groups were evaluated using the Mann-Whitney U test. There was significantly higher activity of OPO (p = 0.00001)and significantly lower salivary flow (SF) (p = 0.007) in alcohol-dependent smokers after chronic alcohol intoxication compared to the control group. OPO activity significantly correlated with the number of days of alcohol intoxication, but not with smoking. Gingival index (GI) was significantly higher in smoking alcohol-dependent persons than in the control group, and correlated with OPO activity. The sensitivity of the OPO test was 70% in smoking alcoholics, while specificity was 95%. The increased activity of OPO suggests chronic oxidative stress is more likely due to ethanol action than to smoking. Smoking alcohol-dependent persons have a worse periodontal status than controls. OPO activity as a marker of chronic alcohol abuse may help in the diagnosis of alcoholism.

Salivary hexosaminidase in smoking alcoholics with bad periodontal and dental states

BackgroundA sensitive alcohol marker, β-hexosaminidase (HEX), in the saliva of alcoholics, is investigated for the first time. MethodsThe activity, specific-activity and output of total HEX and its isoenzymes HEX A and HEX B were measured in the saliva of healthy controls (C), alcohol-dependent non-smokers (ANS), and alcohol-dependent smokers (AS). ResultsWe observed a significantly increased activity/specific-activity and output of HEX A in the ANS and AS groups, due to the inflammatory state of the oral-cavity/salivary-glands. Significantly increased activity of HEX A contributed to an increase in the salivary activity of the total HEX in the ANS group. A significant decrease in the activity/specific-activity of HEX B in AS seemed to be due to HEX B inactivation by cigarette smoke. We noticed a tendency for deteriorated dental state (lower decayed-missing-filled-teeth index – DMFT), worse periodontal state (higher gingival index – GI and papilla-bleeding index – PBI) in AS, and worse periodontal state (higher GI) in ANS, as compared to the controls. We found no differences in the salivary protein concentrations between all groups and decreased salivary flow in both alcoholic groups as compared to the controls. In alcoholics, the area under the curve (AUC) for HEX A activity/specific-activity was significantly greater than for HEX and HEX B. The salivary HEX A activity/specific-activity had good/excellent sensitivity and specificity in smoking and non-smoking alcoholics, whereas salivary HEX and HEX B had poor/fair sensitivity and specificity. ConclusionsSalivary HEX A may be helpful in the diagnosis of chronic alcohol intoxication, even in smokers.

Anxiety and smoking cessation outcomes in alcohol-dependent smokers

Anxiety-related characteristics, including anxiety sensitivity and trait anxiety, are elevated in individuals with alcohol and nicotine dependence and associated with greater difficulties with quitting smoking. However, little is known about how anxiety-related characteristics are related to smoking cessation outcomes in alcohol-dependent smokers. The present study, part of a larger smoking cessation clinical trial, examined associations between anxiety sensitivity, trait anxiety, nicotine withdrawal symptoms, smoking urges, and smoking cessation outcomes in a sample of 83 alcohol-dependent smokers. Participants were enrolled in concurrent alcohol and tobacco treatment as part of a substance-abuse intensive outpatient program. Smoking cessation treatment was administered in a 3-week cognitive-behavioral format that included 8 weeks of open-label nicotine patch treatment. Information on nicotine withdrawal, smoking urges, and CO-confirmed smoking consumption rates was collected at baseline, quit date, end of behavioral treatment, and at a 1-month follow-up. Higher levels of anxiety sensitivity were associated with more smoking urges due to anticipation of negative affect relief at quit date. Higher levels of trait anxiety were associated with more smoking urges due to positive reinforcement and anticipation of relief of negative affect at quit date, as well as more severe nicotine withdrawal symptoms at the end of treatment. Levels of anxiety sensitivity and trait anxiety were not associated with Cox regression survival times to relapse. These results indicate that for alcohol-dependent smokers, levels of anxiety sensitivity and trait anxiety are important to consider in the assessment and treatment of nicotine dependence.

Cognitive behavioral smoking cessation during alcohol detoxification treatment: A randomized, controlled trial

BackgroundAmong alcohol-dependent subjects tobacco smoking is very common and causes a variety of health risks. Therefore, it is necessary to reach this high-risk population early with appropriate smoking interventions. MethodsSmokers in alcohol detoxification treatment were offered to participate in a smoking cessation study. A total of 103 patients was enrolled and randomly assigned to either the experimental group (EG) receiving a cognitive behavioral smoking cessation treatment (CBT) or the control group (CG) receiving autogenic training. Smoking outcomes were measured by self-report and carbon monoxide levels, directly after intervention and 6 months later, where additionally alcohol outcomes were recorded. ResultsThere were no differences in smoking quit rates directly after intervention. However, patients in the EG were significantly more likely to reduce their daily cigarette use compared to CG (p=.046). Sub-group analyses revealed that heavy smokers (FTND score≥7) seemed to profit most in the EG regarding cigarette reduction. After 6 months, these positive effects had leveled out. No evidence was found that smoking cessation might jeopardize alcohol outcomes. ConclusionsResults suggest that alcohol-dependent smokers are interested in smoking interventions even during alcohol detoxification. CBT is promising in short-term smoking outcomes and in the approach of harm reduction, however, long-term effects are desirable. These findings underline the feasibility and the importance to provide smoking cessation interventions to patients in alcohol detoxification treatments.