The Impact of Depressive Symptoms on Alcohol and Cigarette Consumption Following Treatment for Alcohol and Nicotine Dependence

Authors

  • Molly M. Kodl,

    1. From the Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center (MMK, SSF, MLW, AG, DBN, AMJ), Minneapolis, Minnesota; and Department of Medicine (SSF, AMJ) and Department of Psychiatry (MLW), University of Minnesota, Minneapolis, Minnesota. Current address: National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland (MLW); Department of Medicine, University of Minnesota, Minneapolis, Minnesota (AMJ).
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  • Steven S. Fu,

    1. From the Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center (MMK, SSF, MLW, AG, DBN, AMJ), Minneapolis, Minnesota; and Department of Medicine (SSF, AMJ) and Department of Psychiatry (MLW), University of Minnesota, Minneapolis, Minnesota. Current address: National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland (MLW); Department of Medicine, University of Minnesota, Minneapolis, Minnesota (AMJ).
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  • Mark L. Willenbring,

    1. From the Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center (MMK, SSF, MLW, AG, DBN, AMJ), Minneapolis, Minnesota; and Department of Medicine (SSF, AMJ) and Department of Psychiatry (MLW), University of Minnesota, Minneapolis, Minnesota. Current address: National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland (MLW); Department of Medicine, University of Minnesota, Minneapolis, Minnesota (AMJ).
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  • Amy Gravely,

    1. From the Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center (MMK, SSF, MLW, AG, DBN, AMJ), Minneapolis, Minnesota; and Department of Medicine (SSF, AMJ) and Department of Psychiatry (MLW), University of Minnesota, Minneapolis, Minnesota. Current address: National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland (MLW); Department of Medicine, University of Minnesota, Minneapolis, Minnesota (AMJ).
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  • David B. Nelson,

    1. From the Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center (MMK, SSF, MLW, AG, DBN, AMJ), Minneapolis, Minnesota; and Department of Medicine (SSF, AMJ) and Department of Psychiatry (MLW), University of Minnesota, Minneapolis, Minnesota. Current address: National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland (MLW); Department of Medicine, University of Minnesota, Minneapolis, Minnesota (AMJ).
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  • Anne Marie Joseph

    1. From the Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center (MMK, SSF, MLW, AG, DBN, AMJ), Minneapolis, Minnesota; and Department of Medicine (SSF, AMJ) and Department of Psychiatry (MLW), University of Minnesota, Minneapolis, Minnesota. Current address: National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland (MLW); Department of Medicine, University of Minnesota, Minneapolis, Minnesota (AMJ).
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  • This work was presented at the Society for Research on Nicotine and Tobacco, Austin, Texas, February, 2007.

Reprint requests: Molly Kodl, PhD, Minneapolis VA Medical Center, One Veterans Drive, Route 116A6-1L 102, Minneapolis, MN 55417; Fax: (612) 727-5633; E-mail: Molly.Kodl@va.gov

Abstract

Background:  Although depression is common among alcohol and tobacco dependent patients, its impact on treatment outcomes is not well established. The purpose of this study was to examine the impact of depressive symptoms on abstinence from tobacco and alcohol after treatment for alcohol dependence and nicotine dependence.

Methods:  The Timing of Alcohol and Smoking Cessation Study (TASC) randomized adults receiving intensive alcohol dependence treatment, who were also smokers, to concurrent or delayed smoking cessation treatment. The sample consisted of 462 adults who completed depression and substance use (alcohol and smoking) assessments at treatment entry and 6, 12, and 18 months posttreatment. Longitudinal regression models were used to examine the relationships between depression and subsequent abstinence from alcohol and tobacco after baseline characteristics, including alcohol and smoking histories, were considered.

Results:  Depressive symptoms were prospectively related to nonabstinence from alcohol. Depressive symptoms at the previous assessment increased the odds of drinking at the subsequent time point by a factor of 1.67 (95% CI 1.14, 2.43), p < 0.01. Depressive symptoms were not significantly related to subsequent abstinence from cigarettes.

Conclusions:  Depression is an important negative predictor of the ability to maintain abstinence from alcohol within the context of intensive alcoholism and smoking treatment. It may be important to include depression-specific interventions for alcohol and tobacco dependent individuals to facilitate successful drinking treatment outcomes.

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