Alcohol and tobacco often go hand-in-hand. Studies have shown that approximately 90 percent of problem drinkers also smoke or chew tobacco. But tobacco use is not adequately addressed when patients undergo liver transplantation due to alcoholic liver disease, say authors of a new report.
Published in the June 2005 issue of Liver Transplantation, the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS), the report found--after a prospective study of 172 such patients--a need for more stringent monitoring of tobacco use in liver transplant populations and call for more intervention. The journal is available online via Wiley InterScience.
Little data is available on tobacco consumption among transplant recipients, but researchers had previously found high death rates from lung cancer and oropharyngeal cancers among patients who had received a liver transplant due to alcoholic liver disease and they believed tobacco to be the cause.
To test this hypothesis, researchers, led by Andrea DiMartini, M.D. of the University of Pittsburgh, investigated post-transplant tobacco use among 172 patients who received a liver transplant as a result of alcoholic liver disease (ALD). They asked patients to complete questionnaires about their health habits--including the Fagerstrom Test for Nicotine Dependence--every three months in the first post-transplant year, and every 6 months for the next two years. The researchers then analyzed the responses in relation to demographic data.
"The results show a disturbing trend in our ALD population," the authors report. "A significant percent (39-58 percent across time points) use tobacco post-liver transplant." They found that most smokers resumed their habit quickly and their consumption increased over the first post-transplant year. Nearly 50 percent of those who smoked at all post-transplant were found to be nicotine dependent.