Journal review
Horn K, Gao X, Williams J, et al. Conjoint smoking and drinking: A case for dual-substance intervention among young emergency department patients. Acad Emerg Med 2000; 7:1,126-1,134.
It’s possible to identify conjoint cigarette smokers and drinkers in the ED setting through a brief screening, says this study from West Virginia University School of Medicine in Morgantown. The study found conjoint cigarette smoking and alcohol use was prevalent among the 1,169 young adult ED patients who were screened. The Alcohol Use Disorders Identification Test (AUDIT) screening tool was used to assess alcohol problems, and cigarette smoking status was determined by asking patients: "Do you currently smoke cigarettes?" Of the participants, 43% screened positive for alcohol problems, and 61% of those were current cigarette smokers. Here are key findings about conjoint users:
- Women were more likely to be conjoint users rather than drinkers only.
- Conjoint users were more likely than drinkers only to have high school or less education.
- Conjoint users were more likely than drinkers only to have emotional problems, which was self-reported by patients using a survey tool.
- Marijuana use was more common among conjoint users than drinkers who did not smoke commercial cigarettes.
- Young females who had low educational levels, were not currently students, had some emotional problems, and/or currently used marijuana were at highest risk of conjoint drinking and smoking commercial cigarettes.
The researchers suggest EDs use a screening and brief intervention approach to address conjoint use. For example, after asking if the patient smokes and administering the AUDIT test, providers could briefly address stress management and coping skills, give patients educational materials, and stress self-help techniques. "This type of approach includes minimal demands on providers’ time and resources, emphasizes self-help and behavioral self-management techniques, and has shown effectiveness with reducing hazardous drinking and smoking cessation," they wrote.
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