Implicit Alcohol and Smoking Associations among Young Adult Heavy Drinkers: Associations with Smoking Status and Alcohol-Cigarette Co-Use

Impact of alcohol and drug use on smoking and cessation in socioeconomically disadvantaged young adults

INTRODUCTION

Population studies highlight that alcohol and marijuana use are correlated with cigarette smoking and other tobacco use. The aim of our study was to describe the ways in which alcohol and drug use may affect cigarette smoking and cessation in socioeconomically-disadvantaged young adult (SDYA) smokers.

METHODS

Thirty-six SDYA smokers aged 18-29 participated in eight focus groups and two individual interviews in Burlington, Vermont in 2018. Structured focus groups addressed poly-tobacco use, other substance use and co-use with tobacco, and the contexts and facilitators that cue SDYA smoking. Participants were also asked their reasons for smoking, barriers to cessation, and messages or modalities that would make smoking cessation more novel or relevant. Three coders implemented the Framework Method to systematically code focus group transcripts.

RESULTS

In this sample of SDYA smokers, four key themes emerged around the relationships between alcohol and drug use and smoking: 1) frequent co-use of tobacco and other substances, 2) changes in frequency of smoking when using other substances, including chain smoking when drinking and substituting cigarettes with marijuana, 3) cigarettes as a last remaining addiction for those in recovery from other substance use and, 4) fears that quitting smoking would cause relapse to other substances.

DISCUSSION

Co-use of other substances emerged as a reason for smoking and a barrier to quitting, including a concern that quitting smoking would trigger drug or alcohol relapse. Findings support demand for interventions that address substance co-use to improve smoking cessation in SDYA smokers.

Trend in the Prevalence of Non-Daily Smoking and Their Relationship with Mental Health Using the Korea Health and Nutrition Examination Survey

Introduction: Non-Daily Smoking (NDS), which is increasingly prevalent worldwide, has not yet attracted as much attention as has daily smoking in Asia. The aims of this study were to identify trends in the prevalence of NDS and to compare characteristics by age, gender, and mental health indicators such as depression, suicidality, and alcohol consumption in South Korea. Methods: We included 33,806 adults (aged ≥ 19 years) who participated in the Korean National Health and Nutrition Examination Survey (KNHNES) from 2010 to 2015. The dataset includes self-reported medical history and questionnaires that explore depression, suicidality, and alcohol use, which are known to be highly related to smoking. We divided the respondents into four groups according to smoking status: Never Smoking (NS, N = 20,270); Past Smoking (PS = 6835); Daily Smoking (DS = 5927), who reported smoking every day; and Non-Daily Smoking (NDS = 774), who reported that they sometimes smoke. Results: Increased NDS prevalence is observed in most age groups in both male and female adults despite the prevalence of total smoking and daily smoking gradually decreasing. Depression and suicidality were significantly more prevalent in the NDS than the NS group (Depression Odds ratio, OR = 1.72, 95% Confidence interval, CI = 1.31–2.26; Suicidality OR = 3.14, 95% CI = 1.40–7.02). NDS is also associated with a higher frequency of binge drinking and alcohol use disorder than NS (OR = 4.17, 95% CI = 3.49–4.99). Conclusions: This study suggests that more concern is warranted for NDS given the increasing prevalence and characteristics of poor mental health in NDS respondents.