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Themenschwerpunkt

Tabakentwöhnung bei stationären Patienten mit einer Alkohol- abhängigkeit – Motivationsfaktoren und Erfolgsaussichten

Published Online:October 12, 2011https://doi.org/10.1024/0939-5911.a000133

Abstract

Einleitung: Die Raucherprävalenz ist bei alkoholkranken Personen überdurchschnittlich hoch. Die gesundheitliche Bedeutung der Tabakabstinenz, aber auch potentielle synergistische Effekte auf die Alkoholabstinenz legen nahe, während einer stationären Alkoholbehandlung auch eine Tabakentwöhnung anzubieten. Ziel: Untersucht wurden die Aufhörbereitschaft und der Abstinenzerfolg nach einer Raucherentwöhnung während einer sechswöchigen stationären Alkoholismustherapie bei alkoholkranken Personen mit zusätzlicher psychiatrischer Komorbidität. Methodik: 90 von 94 Personen eines Behandlungsjahrgangs nahmen an der Untersuchung teil. Sie durchliefen eine Psychoedukation zur Tabakabhängigkeit und hatten nachfolgend die Gelegenheit, eine Raucherentwöhnungsgruppe zu besuchen. Erfasst wurden soziodemographische Daten, Motivation sowie die Abstinenzquoten von Tabak und Alkohol am Ende und drei Monate nach der Therapie. Ergebnisse: Wichtige Motivationsgründe für eine Tabakabstinenz sind die Vorteile des Nichtrauchens. 40 % (n = 28) der rauchenden Patienten (n = 69) ließen sich zu einer Tabakentwöhnung motivieren, 25 % (n = 7) schlossen die Behandlung abstinent ab. Auch wenn keiner der Patienten über drei Monate tabakabstinent blieb, so war doch der Anteil alkoholrückfälliger Patienten in der Raucherentwöhnungsgruppe niedriger (21,4 %; n = 6/28) als bei den übrigen Patienten (29,3 %; n = 12/41)). Diskussion: Die Tabakentwöhnung im Rahmen einer stationären Alkoholismusbehandlung scheint nicht von Nachteil für die Patienten zu sein. Bei der Einführung eines Therapieangebotes sollten motivationale Faktoren, Bewältigungsfertigkeiten für rückfallgefährliche Situationen sowie Begleitsymptome komorbider Störungen stärker im Vordergrund stehen als bei anderen Rauchern.


Smoking Cessation During Inpatient Alcoholism Treatment – Motivational Factors and Success Rates

Introduction: Smoking rates in alcohol dependent inpatients triple smoking prevalence in general population. Smoking related health consequences as well as therapy related synergistic effects support the idea of an inpatient smoking cessation therapy during alcoholism treatment. Methods: Inpatients admitted for alcoholism therapy during one year (n = 94) received information concerning tobacco dependence and had the opportunity to participate in a smoking cessation therapy (behavioural support in combination with medical management of withdrawal symptoms). N = 90 participated in this study. Sociodemographic data, motivational aspects and alcohol and tobacco related abstinence rates were collected at the end of the therapy and after three months. Results: 40 % (n = 28) of smoking inpatients (n = 69) could be motivated to undergo the smoking cessation therapy, 25 % (n = 7) became abstinent. Smoking cessation was motivated by positive aspects of non-smoking. Although all had relapsed within three months alcohol relapse rates were lower in patients participating in the smoking cessation group (21.4 % (n = 6/28) and 29.3 % (n = 12/41)). Discussion: Smoking cessation within an inpatient alcoholism treatment seems to be beneficial for alcohol related abstinence rates. Further efforts should focus on motivational factors and problem solving skills and address psychiatric co-morbidity in order to increase long-term smoking cessation results.

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