Alcohol and tobacco use and the diseases treated in general practice

The ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) questionnaire was answered by 300 randomly chosen subjects assigned to different groups according to the diseases being treated at the Outpatient General and Teaching Clinic of the Department of Internal Medicine, Hospital das Clínicas of the University of São Paulo's School of Medicine (HC-FMUSP, in the Portuguese acronym), São Paulo, Brazil. The consumption of tobacco and alcohol was characterized and its correlation with the groups of diseases being treated was calculated using Chi-square and Pearson test statistics.

Results:

Compared to alcohol, tobacco use was more prevalent, more intense and showed more health-, social-, legal- and financial-related damage. Tobacco smoking presented a positive significant (p<0.0001) correlation with respiratory diseases. According to the questionnaire's criteria, few alcohol users would be referred to clinical interventions in comparison to smokers.

Conclusion:

Respiratory diseases and tobacco use were well correlated based on the ASSIST questionnaire. The preventive value of the questionnaire was more evident in relation to tobacco than alcohol consumption.

Keywords:
alcohol abuse; tobacco use; screening; diagnosis

	CVD	RES	L&P	MET (N)	AIM	PSY	ONC	MIS
Sex					^* * Statistically significant difference of the frequency of diseases of the respective group between the sexes or between the age groups (p<0.05), detected using Chi-square method and Pearson's test.	^* * Statistically significant difference of the frequency of diseases of the respective group between the sexes or between the age groups (p<0.05), detected using Chi-square method and Pearson's test.
M	62	16	9	48	2	8	3	66
F	93	19	8	78	14	35	5	112
Age range	^* * Statistically significant difference of the frequency of diseases of the respective group between the sexes or between the age groups (p<0.05), detected using Chi-square method and Pearson's test.			^* * Statistically significant difference of the frequency of diseases of the respective group between the sexes or between the age groups (p<0.05), detected using Chi-square method and Pearson's test.
≤ 30 years	2	2	0	3	2	2	0	10
31 to 60 years	70	14	10	62	9	25	3	88
> 60 years	83	19	7	61	5	16	5	80

	Alcohol	Tobacco
	n (%)	n (%)
1. Have you ever used alcohol/tobacco?
No	41 (13.7)	89 (24.7)
Yes	259 (86.3)	211 (70.3)
2. How often have you used it in the past 3 months?
Never	182 (71.6)	138 (65.4)
Once or twice	23 (9.0)	2 (0.9)
Monthly	15 (5.9)	3 (1.4)
Weekly	29 (11.4)	4 (1.9)
Daily or almost daily	6 (2.4)	64 (30.3)
In the last three months (questions 3 to 5):
3. How often you had a strong desire or urge to use?
Never	238 (95.8%)	144 (68.2)
Once or twice	3 (1.2)	2 (0.9)
Monthly	1 (0.4)	2 (0.9)
Weekly	3 (1.2)	2 (0.9)
Daily or almost daily	4 (1.6)	61 (28.4)
4. How often has drinking/smoking led to health, social, legal, or financial problems?
Never	247 (99.6)	189 (89.5)
Once or twice	0 (0.0)	4 (1.9)
Monthly	0 (0.0)	1 (0.5)
Weekly	0 (0.0)	2 (0.9)
Daily or almost daily	1 (0.4)	15 (7.1)
5. How often have you failed to do what was normally expected of you because of your drinking/smoking habit?
Never	244 (98.4)	193 (91.9)
Once or twice	2 (0.8)	7 (3.3.)
Monthly	1 (0.4)	3 (1.4)
Weekly	1 (0.4)	5 (2.4)
Daily or almost daily	0 (0.0)	2 (1.0)
6. Has a friend or relative or anyone else ever expressed concern about your drinking or smoking?
No	186 (75.6)	84 (40.8)
Yes, but not in the last 3 months	49 (19.9)	71 (34.5)
Yes, in the last 3 months	11 (4.5)	52 (24.8)
7. Have you ever tried to control, cut down or stop using alcohol/tobacco?
No	223 (91.0)	108 (52.7)
Yes, but not in the last 3 months	17 (6.9)	62 (30.2)
Yes, in the last 3 months	5 (2.0)	35 (17.1)
Suggested intervention according to the ASSIST questionnaire score
None	293 (97.7)	191 (63.7)
Brief	5 (1.7)	95 (31.6)

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

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[1] *Correspondence: Address: Av. Dr. Enéas de Carvalho Aguiar, 455 São Paulo, SP - Brazil. Postal code: 05403-000. mariofj@uol.com.br