Alcohol abuse and Smoking.

[Psyber]

In another thread somewhere I loosely referred to the incidence of risky drinking and that it was the activity of a minority, and that the level of drinking being discussed in the thread was not normal or the pattern of "everyone". Someone asked me to put up a reference, but I couldn't find the thread again to post it where the request came from. I think from memory the bits in blue were what I had referred to. This is a US study but I would expect similar findings here.


Smoking status is a clinical indicator of alcohol misuse

16 Apr 2007

Patients who smoke should be questioned about their alcohol intake as they are three to five times more likely than non-smokers to be hazardous drinkers and to have an alcohol dependence or abuse disorder, a large study in the United States has concluded.

A national epidemiological survey on alcohol use and related conditions collected information from 42,000 adult participants. Daily or occasional smoking had a sensitivity of 42% for the detection of hazardous drinking, and a specificity of 82%. The positive predictive value was 45%.

"Our data suggest that smoking status provides an added benefit as an indicator of alcohol misuse," the researchers said. "While the sensitivity was low to moderate, information regarding potential alcohol misuse is gained at no additional cost and with no risk, since smoking status is already being assessed." The modest sensitivity was a result of never-smokers accounting for about 40% of the participants with alcohol problems.

Overall, 26% of participants met the criteria for hazardous drinking rising to 45% in smokers. 'Hazardous' drinking equated to more than 21 Australian standard drinks (10 g ethanol) a week for men or ten drinks for women, or a substantial binge in the last 12 months. Similarly, the overall prevalence of an alcohol diagnosis was 8.5%, rising to 17.8% in smokers.

Occasional smokers were once assumed to be people starting or quitting smoking. The survey suggested, though, that many were 'regular intermittent' smokers, often in association with drinking.

Screening for alcohol use and related disorders was widely recommended as a standard clinical procedure, but doctors were much less assiduous in asking about drinking than about smoking. One study found that 81% of primary care patients were asked about smoking but only 30% about drinking. Asking a single brief question about any episodes of binge drinking in the past year had excellent sensitivity for identifying difficulties.

"Brief interventions are particularly suitable for addressing problem drinking," the researchers said. "The spectrum of problem drinking behaviours that are amenable to office-based treatment is expanding from nondependent hazardous drinking to alcohol dependence."

Reference
McKee, S. Falba, T. et al. 2007, 'Smoking status as a clinical indicator for alcohol misuse in US adults.' Archives of Internal Medicine vol. 167, pp. 716-721.

[Dog_ger]

Just give up smoking......

Smoking is no longer the Toughy Status.....!

IT STINKS....!!!

WE all breathe your smoke........

Go Away.....

Dis-appear......

[Sojourner]

Apparently a number of pubs are putting large screen tv's in the beer gardens to get around the new no smoking laws being introduced in the final stage in Oct.

Many people quit, yet then take it back after being out socially at their local, the new laws might well result in less people getting back on the wagon which would give some grief to the ciggarette companies!

[am Bays]

In another thread somewhere I loosely referred to the incidence of risky drinking and that it was the activity of a minority, and that the level of drinking being discussed in the thread was not normal or the pattern of "everyone". Someone asked me to put up a reference, but I couldn't find the thread again to post it where the request came from. I think from memory the bits in blue were what I had referred to. This is a US study but I would expect similar findings here.


Smoking status is a clinical indicator of alcohol misuse

16 Apr 2007

Patients who smoke should be questioned about their alcohol intake as they are three to five times more likely than non-smokers to be hazardous drinkers and to have an alcohol dependence or abuse disorder, a large study in the United States has concluded.

A national epidemiological survey on alcohol use and related conditions collected information from 42,000 adult participants. Daily or occasional smoking had a sensitivity of 42% for the detection of hazardous drinking, and a specificity of 82%. The positive predictive value was 45%.

"Our data suggest that smoking status provides an added benefit as an indicator of alcohol misuse," the researchers said. "While the sensitivity was low to moderate, information regarding potential alcohol misuse is gained at no additional cost and with no risk, since smoking status is already being assessed." The modest sensitivity was a result of never-smokers accounting for about 40% of the participants with alcohol problems.

Overall, 26% of participants met the criteria for hazardous drinking rising to 45% in smokers. 'Hazardous' drinking equated to more than 21 Australian standard drinks (10 g ethanol) a week for men or ten drinks for women, or a substantial binge in the last 12 months. Similarly, the overall prevalence of an alcohol diagnosis was 8.5%, rising to 17.8% in smokers.

Occasional smokers were once assumed to be people starting or quitting smoking. The survey suggested, though, that many were 'regular intermittent' smokers, often in association with drinking.

Screening for alcohol use and related disorders was widely recommended as a standard clinical procedure, but doctors were much less assiduous in asking about drinking than about smoking. One study found that 81% of primary care patients were asked about smoking but only 30% about drinking. Asking a single brief question about any episodes of binge drinking in the past year had excellent sensitivity for identifying difficulties.

"Brief interventions are particularly suitable for addressing problem drinking," the researchers said. "The spectrum of problem drinking behaviours that are amenable to office-based treatment is expanding from nondependent hazardous drinking to alcohol dependence."

Reference
McKee, S. Falba, T. et al. 2007, 'Smoking status as a clinical indicator for alcohol misuse in US adults.' Archives of Internal Medicine vol. 167, pp. 716-721.

PhilG where are you hiding Psyber captive.....

[Psyber]

As I said - this thread was only a response to a request/demand I backup my earlier statement, but while I am disturbing people in their comfort zones, how about this one!!

Tobacco's natural radiation dose higher than after Chernobyl

17 Jun 2007

If nothing else, this should worry smokers: the radiation dose from radium and polonium found naturally in tobacco can be a thousand times more than that from the caesium-137 taken up by the leaves from the Chernobyl nuclear accident.

Constantin Papastefanou from the Aristotle University of Thessaloniki in Greece measured radioactivity in tobacco leaves from across the country and calculated the average radiation dose that would be received by people smoking 30 cigarettes a day. He found that the dose from natural radionuclides was 251 microsieverts a year, compared with 0.199 from Chernobyl fallout in the leaves (Radiation Protection Dosimetry, vol 123, p 68).

Though the radiation dose from smoking was only 10 per cent of the average dose anyone receives from all natural sources, Papastefanou argues that it is an increased risk. "Many scientists believe that cancer deaths among smokers are due to the radioactive content of tobacco leaves and not to nicotine and tar," he says.

Reproduced from New Scientist, 2nd June 2007

[westcoastpanther]

Smokers are a dying breed, let cancer take it's course and we won't have to worry about them....

[Psyber]

AND JUST TO FINISH OFF - I'll quit this now unless someone wants more.....

Lancet warns: Cannabis use increases risk of psychotic illness later in life.

6 Aug 2007

A Lancet review has warned that there is sufficient evidence to warn young people that cannabis use increases their risk of developing psychotic illness later in life.

Cannabis is a commonly used illicit substance, especially among young adolescents. Studies have shown evidence of cannabis-related psychotic and affective experiences, which are usually mild and transient; however, reports of persistent symptoms that occur independently of intoxication effects are less robust. Indeed, it is unclear if cannabis use increases the incidence of mental disorders such as schizophrenia or depression. Moore et al. conducted a systematic review of the literature to investigate whether cannabis use is linked to the occurrence of psychotic or affective mental health outcomes.

The authors noted that previous reviews in this area have generally not been systematic and have examined broad psychosocial outcomes rather than mental illness, or have included cross-sectional data. In contrast, Moore et al. have systematically reviewed longitudinal and population-based studies of cannabis use and subsequent psychotic or affective mental health outcomes.

The current review included 35 studies from 4804 references. Cohorts of people with existing mental illness or substance-use-related problems, prison populations, and trials of cannabis for medical use were not included in the review.

The authors found a consistent association between cannabis use and psychotic symptoms, including disabling psychotic disorders.

Analyses revealed a consistent increase in the incidence of psychosis outcomes among people who had used cannabis. The pooled analysis revealed an increase in risk of psychosis of approximately 40% among people who had ever used cannabis (adjusted odds ratio [OR], 1.41).

Findings were consistent with a dose-response relationship. More frequent use was associated with larger effects with the majority of studies revealing a 50–200% increase in risk for the heaviest users of cannabis (OR, 2.09 for most frequent users).

While only three studies specifically examined psychotic disorders as an outcome, results were consistent with an increased risk of psychotic disorders among cannabis users.

Almost all studies reported an increased risk of affective outcomes in people who used cannabis; however, effect sizes were small and the authors suggested that many of the studies were most likely underpowered.

Interestingly, the authors noted that there existed no robust evidence to support the view that earlier use of cannabis may have more harmful effects.

“Although individual lifetime risk of chronic psychotic disorders such as schizophrenia, even in people who use cannabis regularly, is likely to be low (less than 3%), cannabis use can be expected to have a substantial effect on psychotic disorders at a population level because exposure to this drug is so common,” they concluded.

In a related editorial, Drs Nordentoft and Hjorthøj describe this study as “the most comprehensive meta-analysis to date of possible causal relation between cannabis use and psychotic and affective illness later in life.” They assert that the potential long-term hazardous effects of cannabis with regard to psychosis appear to have been overlooked, and stress the need to warn to public of these dangers.
Reference

Moore, T. Zammit, S. et al. 2007, ‘Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review’ The Lancet; 370: 319–328.