The frequency of smoking and problem drinking among general hospital inpatients in Brazil - using the AUDIT and Fagerström questionnaires

Abstract

OBJECTIVE:The aim of this study was to use the AUDIT and Fagerström questionnaires in a general hospital inpatient population to measure the frequency of problem drinking and nicotine dependence, and to see if levels varied between medical speciality. DESIGN:Retrospective cross-sectional study. SETTING:Federally funded public teaching hospital.SAMPLE: 275 inpatients from both genders. MAIN MEASUREMENTS:Socio-demographic data, AUDIT (Alcohol Use Disorders Identification Test) and Fagerström Test for Nicotine Dependence. RESULTS:We interviewed 275 inpatients, 49% of whom were men and 51% women. Thirty-four patients were identified as "cases" by the Audit questionnaire; 22% of the male patients and 3% of the females. Just over 21% of inpatients were current smokers. The gastroenterology (26%) and general medicine (16%) inpatient units had the largest number of individual cases. CONCLUSIONS:Only by knowing the prevalence of alcohol abuse/ dependence and nicotine dependence in a general hospital can we evaluate the need for a specialized liaison service to identify and treat these patients.KEY WORDS: AUDIT. Fagerström. Screening. Liaison psychiatry. Inpatients.• 140Research from other countries largely supports the finding that inpatients are more likely to have problems with alcohol. [9][10][11] The importance of identifying these patients lies in the possibility of providing some form of intervention aimed at reducing alcohol consumption and thereby reducing the risk that the patient will subsequently develop complications of alcohol misuse.Just how and by whom these patients should be identified is open to debate. Short screening instruments have the advantage that they do not take long to fill in and can be used with very little training by almost any health care professional. 12 The CAGE questionnaire is one of the most widely used alcohol screening instruments and has a high sensitivity and specificity for identifying patients with alcohol dependence. However, it has been criticized for not identifying people who are drinking heavily or who have alcohol-related problems but do not as yet show symptoms of alcohol dependence. Indeed it is these very patients who may benefit most from early therapeutic interventions. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire was developed by WHO 13 as a screening instrument specifically designed to identify problem drinkers, as well as those who were already dependent on alcohol. It has a reported sensitivity of 92% and a specificity of 93%.14 Skipsey, et al. 15 found an excellent level of internal consistency in the identification of "hard" drinkers and alcohol dependence. When compared with the MAST (Michigan Alcoholism Screening Test), the AUDIT was considered superior, as the MAST failed to identify recent problems brought on by heavy alcohol consumption. The AUDIT has been found to be a very promising instrument for the identification of alcohol abuse and dependence among patients in diverse medical settings. [16][17][18] It is estimated that 30% of ...

Health indicators associated with poor sleep quality among university students

“…This variable was calculated and analysed, taking into consideration the recommendation of the World Health Organisation, i.e. considered as low if the BMI < 18.5Kg/m 2 ; eutrophic, if ≥18.5 and <25.0; overweight for values located between 25.0 and 29.9 Kg/m 2 ; and obese for BMI ≥ 30 Kg/m 2 (19) .…”

Motivation to change drinking behavior: the differences between alcohol users from an outpatient gastroenterology clinic and a specialist alcohol treatment service

“…Of the 275 inpatients interviewed, 29% had a past history of alcohol consumption higher than the current level and, of these, 52% scored positive on AUDIT. 6 For some patients who have developed significant alcohol-related physical complications, total abstinence from alcohol may offer the best chance of survival. 7 However, if such patients underestimate the severity of their drinking problem or do not believe that their drinking behavior exacerbates their health problems, they may be unlikely to remain alcohol-free.…”

“…8 • At the gastrointestinal disease clinic: all At the gastrointestinal disease clinic: all outpatients were screened with the Portuguese version of AUDIT 6 and those scor- CONTEXT AND OBJECTIVE: For some patients who have developed significant alcohol-related physical disease, total abstinence from alcohol may offer the best chance of survival. The aim of this study was to investigate motivation for treatment in two groups of alcohol users: outpatients from the gastroenterology clinic and outpatients from the specialist alcohol treatment service.…”

Depression, alcohol use disorders and nicotine dependence among patients at a general hospital

“…1,3,8 The current prevalence of alcohol abuse and dependence, including alcohol use disorders (AUDs), ranges from 10% to 13%, [9][10][11] whereas that of nicotine dependence ranges from 17% to 21%. 10,12 Most studies carried out in general hospital settings in Brazil have involved relatively small patient samples and have therefore identified a limited number of patients with psychiatric disorders, making it difficult to perform multivariate statistical analyses. There is a need for larger studies in order to obtain a more complete picture of patient profiles according to their psychiatric morbidity.…”