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An integrated behavioural intervention combined with varenicline for heavy-drinking smokers: a randomized pilot study

Published online by Cambridge University Press:  18 March 2020

Lisa M. Fucito Open the ORCID record for Lisa M. Fucito [Opens in a new window] ,
Ran Wu ,
Stephanie S. O'Malley ,
Tess H. Hanrahan ,
Jolomi T. Ikomi ,
Srinivas Muvvala ,
Kathleen M. Carroll  and
Ralitza Gueorguieva
Lisa M. Fucito*
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, USA Yale Cancer Centre, New Haven, USA Smilow Cancer Hospital at Yale-New Haven, New Haven, USA
Ran Wu
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, USA
Stephanie S. O'Malley
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, USA Yale Cancer Centre, New Haven, USA
Tess H. Hanrahan
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, USA
Jolomi T. Ikomi
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, USA
Srinivas Muvvala
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, USA
Kathleen M. Carroll
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, USA
Ralitza Gueorguieva
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, USA Yale School of Public Health, New Haven, USA
*
Author for correspondence: Lisa M. Fucito, E-mail: [email protected]
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Abstract

Objectives

Combined smoking and heavy drinking is a significant health burden. Varenicline, an efficacious tobacco pharmacotherapy that also shows promise for drinking, has yielded mixed results among heavy-drinking smokers. This pilot study investigated integrated tobacco and alcohol counselling plus varenicline for this vulnerable group.

Design

Twelve-week parallel, randomized controlled pilot trial of two behavioural interventions in combination with open-label varenicline. Participants were randomized using computer-generated tables, stratified by sex.

Setting

Outpatient academic medical centre research clinic.

Participants

Volunteers who reported smoking and heavy drinking and sought tobacco or alcohol treatment (N = 26).

Intervention

(1) Integrated tobacco + alcohol counselling (INT; n = 13) or (2) counselling focused on their presenting concern (i.e., tobacco or alcohol) (SINGLE; n = 13), plus varenicline (2 mg) for 12 weeks.

Main outcomes

Feasibility/acceptability, smoking quit rates and heavy drinking.

Results

INT feasibility/acceptability was high among men but not women. More participants quit smoking in INT than SINGLE. This outcome was only in men, not significant, but had a medium effect size. Both conditions yielded significant drinking reductions.

Conclusion

Integrated tobacco and alcohol behavioural counselling plus varenicline may be feasible and promote smoking cessation among men who smoke and drink heavily, but a larger sample is needed to replicate this finding.

Keywords

Alcoholbehavioural treatmentcigarette smokingheavy drinkingsmoking cessationvarenicline
Type
Original Articles
Information
Journal of Smoking Cessation , Volume 15 , Issue 3 , September 2020 , pp. 119 - 127
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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