Pattern and Determinants of Alcohol and Tobacco Co-Use and its Relationship with Smoking Cessation in Hong Kong

ABSTRACT

Introduction:
Alcohol and tobacco are often used together. Studies have shown that some biological factors contribute to the concurrent use of alcohol and nicotine. There have been comparatively few studies that document the concurrent prevalence and correlates of alcohol and tobacco use among adults. A better understanding of the smokers who also drink is needed to help them to quit smoking.

Methods:
A retrospective case review study on smokers who voluntarily joined our service in 2014–2017 was conducted. Characteristics of tobacco users only, and alcohol and tobacco co-users were reviewed. The quit rate of smoking related to alcohol use was analyzed. Participants were contacted by phone at week 26 and 52 to ascertain smoking status and abstinence.

Results:
There were 4602 alcohol and tobacco co-users and 2732 tobacco only users. Co-users had higher education level and better income than tobacco only users. In all, 52.24% of co-users were aged 21–40 years. For the alcohol users, their mean AUDIT score was only 6.17 (SD: 5.67). Multivariate analysis showed that age and gender were associated with co-use while high personal income had lower odds of co-use. Quit rate decreased as the AUDIT score increased. Those who had binge drinking more than once a month had lower quit rate compared with binge drinking less than once a month at week 26 (34.2% vs 43.19%, p<0.0001).

Conclusions:
Alcohol and tobacco co-users should acknowledge alcohol–tobacco interactions to reduce alcohol use and prevent smoking relapse. Healthcare providers should screen for alcohol use in smoking cessation interventions.