Female smokers have the highest alcohol craving in a residential alcoholism treatment cohort

Mario J Hitschfeld; Terry D Schneekloth; Jon O Ebbert; Daniel K Hall-Flavin; Victor M Karpyak; Osama A Abulseoud; Christi A Patten; Jennifer R Geske; Mark A Frye

doi:10.1016/j.drugalcdep.2015.02.016

Female smokers have the highest alcohol craving in a residential alcoholism treatment cohort

Drug Alcohol Depend. 2015 May 1:150:179-82. doi: 10.1016/j.drugalcdep.2015.02.016. Epub 2015 Feb 25.

Authors

Mario J Hitschfeld¹, Terry D Schneekloth², Jon O Ebbert³, Daniel K Hall-Flavin⁴, Victor M Karpyak⁴, Osama A Abulseoud⁴, Christi A Patten⁴, Jennifer R Geske⁵, Mark A Frye⁴

Affiliations

¹ Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA; Mental Health Service, Sotero Del Rio Hospital, Avenida Concha y Toro 3459, Puente Alto, Santiago, Chile.
² Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA. Electronic address: Schneekloth.Terry@mayo.edu.
³ Department of Medicine, Nicotine Dependence Center, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
⁴ Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
⁵ Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

PMID: 25746235
DOI: 10.1016/j.drugalcdep.2015.02.016

Abstract

Background: Cigarette smoking among female and male alcoholics has not been extensively studied as a factor related to intensity of alcohol craving during residential treatment and corresponding sobriety length.

Methods: This retrospective cohort study assessed self-reported sobriety outcomes in patients with alcohol dependence at 3-month intervals over 12 months after completion of a 30-day residential treatment program. Demographic and clinical variables were collected including smoking status, alcohol craving utilizing the Penn Alcohol Craving Scale (PACS), and alcohol relapse. Statistical analyses included Chi-square, ANOVA, Tukey's test, Kaplan-Meier plots and Cox proportional hazards models as appropriate.

Results: Of the 761 alcohol-dependent study subjects, 355 (47%) were current smokers. Alcohol craving intensity was higher in smoking females compared to nonsmoking females (p=0.0096), smoking males (p<0.0001), and nonsmoking males (p<0.0001). Smoking status-by-sex interaction was not associated with post-treatment relapse. After controlling for other variables, higher PACS scores at admission were associated with higher probability of relapse (p=0.0003).

Conclusions: In this study, female alcoholic smokers experienced the highest level of alcohol craving in an alcohol treatment setting. Interestingly, this did not translate into higher rates of post-treatment relapse. Further research is warranted to explore the neurobiological basis for sex differences in this highly prevalent comorbidity.

Keywords: Alcohol abstinence; Alcoholism; Craving; Recurrence; Residential treatment; Tobacco use disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Alcoholism / complications
Alcoholism / psychology*
Cohort Studies
Craving*
Female
Humans
Male
Middle Aged
Recurrence
Residential Treatment
Retrospective Studies
Sex Factors
Smoking / psychology*
Tobacco Use Disorder / complications
Tobacco Use Disorder / psychology*
Young Adult