Longitudinal trajectories of tobacco and alcohol use following first or consecutive admissions for respiratory diseases.

Abstract

Background: Smoking and alcohol use worsen Chronic Respiratory Diseases (CRD). Smoking cessation is a cornerstone of treatment. We aim to describe the trajectories of alcohol and tobacco use in patients admitted due to first (FE) or consecutive episodes (CE) of CRD.

Methods: This prospective study assessed tobacco and alcohol use in 219 patients upon admission for CRD and one year later. Generalized multilevel mixed-effect models analyzed changes within and between groups.

Results: Significant differences between groups were observed in tobacco use prevalence (p = 0.001) and quantity (p = 0.009). Although overall tobacco use prevalence remained stable over time (p = 0.08) and no significant group-by-time interaction was found, weekly cigarette consumption decreased over time (from 32.1 to 19.7 in FE, 15.5 to 4.9 in CE) (p = 0.009). Alcohol use prevalence remained at approximately 50% in both groups and time points. The number of standard drink units per week (SDU)/week showed significant group effects (p = 0.03).

Conclusions: Admission for a respiratory event alone is not sufficient to induce smoking cessation in many patients. Alcohol use prevalence remains high without significant changes. This gap could be reversed by implementing integrated brief interventions based on motivational interviewing for these patients.