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Alcohol & Alcoholism Vol. 38, No. 6, pp. 606-612, 2003
© 2003 Medical Council on Alcohol

STRENGTH OF THE RELATIONSHIP BETWEEN TOBACCO SMOKING, NICOTINE DEPENDENCE AND THE SEVERITY OF ALCOHOL DEPENDENCE SYNDROME CRITERIA IN A POPULATION-BASED SAMPLE

Ulrich John1,*, Christian Meyer1, Hans-Jürgen Rumpf2, Anja Schumann1, Jochen René Thyrian1 and Ulfert Hapke1

1 Institute of Epidemiology and Social Medicine, University of Greifswald, Greifswald and 2 Department for Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany

(Received 15 May 2003; first review notified 15 June 2003; in revised form 8 July 2003; accepted 31 July 2003)

* Author to whom correspondence should be addressed at: Institute of Epidemiology and Social Medicine, University of Greifswald, Walther-Rathenau-Strasse 48, D-17487 Greifswald, Germany. Tel.: +3 834 867700; Fax: +3 834 867701; E-mail: ujohn{at}uni-greifswald.de; http://www.medizin.uni-greifswald.de

Aims: Little is known about the relationship between current and past smoking behaviour and the severity of alcohol dependence. The purpose was to explore the strength of this relationship. Methods: A random population sample of 18 to 64 year-olds from northern Germany was used (n = 4075; participation rate: 70%). It included 761 cigarette smokers fulfilling at least one alcohol-dependence criterion. The severity of alcohol dependence according to the alcohol-dependence syndrome criteria frequency (ASF) was estimated by a standardized questionnaire based on diagnostic instruments of the alcohol dependence syndrome and which included five response categories, from 'never' to 'daily'. Nicotine dependence was diagnosed according to the Diagnostic and Statistical Manual of mental disorders (DSM-IV) with the Composite International Diagnostic Interview (CIDI). As a second measure, the Fagerström Test of Nicotine Dependence (FTND) was used. Results: The number of cigarettes and years of daily smoking, nicotine dependence, and the number of nicotine dependence symptoms each showed a relationship with the ASF. Effect size (w) were 0.17–0.21 for chi-squared ({chi}2) tests. In a general linear regression model with the ASF as the dependent variable (R2 = 0.17), number of years of daily smoking, age at onset of smoking, number of attempts to reduce or quit, the number of nicotine-dependence symptoms according to DSM-IV and the FTND sum score were retained as independent variables. Conclusions: Long-term smoking, a large number of nicotine-dependence symptoms according to DSM and a strong urge to smoke according to the FTND are related with a high ASF.


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