Tobacco and alcohol use among drug users receiving methadone maintenance treatment: a cross-sectional study in a rural prefecture of Yunnan Province, Southwest China

Abstract

ObjectiveTo estimate the prevalence of ever, current and heavy tobacco and alcohol use and their correlates among patients undergoing methadone maintenance treatment (MMT).DesignCross-sectional study.SettingThe study was conducted in all of the 5 MMT clinics in Dehong Prefecture, China.Participants2121 (81.6%) eligible MMT participants were included in the study population.AnalysisOrdinal logistic regression was used to estimate the ORs and their 95% CIs.ResultsThe overall prevalence of ever, current and heavy smoking was 98.6%, 97.8% and 66.3%, respectively; while that of ever, current and hazardous alcohol drinking was 86.6%, 58.6% and 16.6%, respectively. Among HIV-infected participants, the proportions of those experiencing harmful effects of tobacco and alcohol on AIDS were 53.6% and 72.5%, respectively, and 16.9% and 49.3% had ever tried to quit after diagnosis with HIV. After adjusting for potential confounders, heavier smokers and more hazardous drinkers were more likely to be men, older and less educated. Ethnic minorities were less likely to heavily smoke, but more likely to engage in hazardous drinking. In addition, hazardous drinking was negatively associated with longer years of MMT and HIV infection. Moreover, heavier smoking (OR≥2=2.08, 95% CI 1.16 to 3.73) and more hazardous drinking (OR≥2=2.46, 95% CI 1.53 to 3.97) were positively associated with having multiple sexual partners, and both were positively associated with each other.ConclusionsThe prevalence of tobacco and alcohol consumption was extraordinarily high among MMT participants in China, suggesting the urgent need of enhancing MMT patients' awareness of the harmful effects of tobacco and alcohol consumption and implementing comprehensive education and effective intervention programmes.

Substance Abuse in Rural and Remote Areas

“…For example, in rural Taiwan, Aboriginal Taiwanese chewed betel quid (i.e., typically areca nut and slaked lime wrapped in a betel leaf) more than their Chinese counterparts (Chen et al 2001). In a study of rural inhabitants of an area in southwest China, ethnic minorities (i.e., Jingpo and Dai) had a higher prevalence of alcohol use than Han Chinese (Duan et al 2017). In rural Bangladesh, some groups (Oraon and Santal) were more likely than other groups (Hindu and Muslim) to engage in regular consumption of arrack, an alcohol beverage typically made from palm and/or date juice (Uddin 2008).…”

Alcohol and tobacco use among methadone maintenance patients in Vietnamese rural mountainside areas

“…Meanwhile, Huyen et al in Vietnam suggested that being employed was a negative predictor of level of nicotine dependence ( Do et al, 2017 ). Patients with HIV positive were found to have lower likelihood of smoking and alcohol abusing than those with HIV negative ( Do et al, 2017 , Duan et al, 2017 ). With these variabilities of potential markers for predicting alcohol and smoking addicts among MMT patients, understanding the factors associated with these risk behaviors is essential in order to ensure the effectiveness of MMT program.…”

“…Some studies found that people with higher duration of MMT were less likely to drink hazardously or smoking heavily ( Baran-Furga et al, 2005 , Do et al, 2017 , Duan et al, 2017 ), while others indicates no association ( Stark & Campbell, 1993b ). Song Duan et al (2017) in China found that male, older and less educated patients had higher likelihood to be heavy smokers and hazardous drinkers ( Duan et al, 2017 ). Meanwhile, Huyen et al in Vietnam suggested that being employed was a negative predictor of level of nicotine dependence ( Do et al, 2017 ).…”

COVID-19 and Substance Use Disorders as Brain Diseases: Recommendations to a Comprehensive Healthcare Response. An International Society of Addiction Medicine (ISAM) Practice and Policy Interest Group Position Paper

“…Additionally, it is essential to understand how PWUD differently perceive danger and risk-taking behaviors during an epidemic, making them more risk averse ( Manfredi & D’Onofrio, 2013 ; Rhodes, 1997 ). PWUD have a higher rate of smoking and different studies estimated the current smoking rate of more than 70% among them ( Duan et al, 2017 ; Sutherland et al, 2016 ; Weinberger, Gbedemah, & Goodwin, 2017 ). Several studies found smoking a significant risk factor for Middle East Respiratory Syndrome (MERS) transmission ( Alraddadi et al, 2016 ; Nam, Park, Ki, Yeon, Kim, & Kim, 2017 ; Sherbini Iskandrani, Kharaba, Khalid, Abduljawad, & Hamdan, 2017 ).…”