{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:40:55Z","timestamp":1773268855684,"version":"3.50.1"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The co-use of alcohol and cigarettes is common and associated with poor health outcomes. However, little is known about the prevalence of cigarette smoking among American Indian and Alaska Native (AI\/AN) adults seeking treatment for alcohol use disorder (AUD), whether participation in AUD treatment is associated with changes in cigarette smoking or patterns of concurrent alcohol and cigarette use in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study reports a secondary analysis of concurrent alcohol and cigarette use among AI\/AN participants in a randomized controlled trial of contingency management (CM) for AUD (\n                      <jats:italic>N<\/jats:italic>\n                      \u202f=\u202f158). Participants completed Timeline Followback assessments of daily cigarette use and alcohol consumption for the 30\u202fdays before baseline and throughout the 20-week study period. Generalized linear mixed models were used to evaluate changes in smoking over time and associations between alcohol use, accounting for study period, repeated measures, and recent use behaviors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline assessments indicated a high prevalence of cigarette smoking (66.7%,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f96\/144). Across the study period, participants in both conditions demonstrated reductions in cigarette smoking, particularly during the post-baseline phase (\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f\u22120.54;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). No statistically significant differences in smoking outcomes were observed between the CM and control conditions. After controlling for recent use patterns, a significant positive association was observed between daily alcohol consumption and same-day cigarette smoking (\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f0.12;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Two-thirds of AI\/AN adults with AUD in this sample also smoked cigarettes. Reductions in smoking were observed over time across both study conditions, including during the pre-randomization observation phase, suggesting that changes were not attributable to the CM intervention. Daily alcohol consumption and cigarette smoking were positively correlated, indicating concurrent substance use. Given these findings, smoking cessation interventions should be provided to AI\/AN adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1749377","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T06:53:02Z","timestamp":1773211982000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Concurrent alcohol and smoking use among American Indian and Alaska Native adults participating in a contingency management clinical trial for alcohol use disorder"],"prefix":"10.3389","volume":"14","author":[{"given":"Kelley J.","family":"Jansen","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Alaska Anchorage","place":["Anchorage, AK, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Puzia","sequence":"additional","affiliation":[{"name":"Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University","place":["Spokane, WA, United States"]},{"name":"Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University","place":["Spokane, WA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jalene L.","family":"Herron","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of New Mexico","place":["Albuquerque, NM, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abram J.","family":"Lyons","sequence":"additional","affiliation":[{"name":"College of Education & Human Development, Social Work Program, University of Delaware","place":["Newark, DE, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"McDonell","sequence":"additional","affiliation":[{"name":"Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University","place":["Spokane, WA, United States"]},{"name":"Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University","place":["Spokane, WA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Hirchak","sequence":"additional","affiliation":[{"name":"Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University","place":["Spokane, WA, United States"]},{"name":"Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University","place":["Spokane, WA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"The HONOR Study Team","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"ref1","article-title":"Why quitting smoking is hard","year":"2023"},{"key":"ref2","article-title":"Current cigarette smoking among adults in the United States","year":"2020"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/j.amepre.2015.05.002","article-title":"Disparities in smoking-related mortality among American Indians\/Alaska natives","volume":"49","author":"Mowery","year":"2015","journal-title":"Am J Prev Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.15585\/mmwr.mm6650a2","article-title":"Prevalence and disparities in tobacco product use among American Indians\/Alaska natives - United States, 2010-2015","volume":"66","author":"Odani","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref5","volume-title":"Results from the 2018 National Survey on drug use and health: Detailed tables","year":"2019"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1177\/08901171241293419","article-title":"Commercial tobacco cessation interventions for American Indian and Alaska native persons living in the United States: a narrative systematic review of effectiveness using a health equity lens","volume":"39","author":"Alcantara","year":"2025","journal-title":"Am J Health Promot"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.amepre.2016.05.021","article-title":"All nations breath of life: a randomized trial of smoking cessation for American Indians","volume":"51","author":"Choi","year":"2016","journal-title":"Am J Prev Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1111\/1475-6773.13224","article-title":"Discrimination in the United States: experiences of native Americans","volume":"54","author":"Findling","year":"2019","journal-title":"Health Serv Res"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1037\/adb0000729","article-title":"Historical trauma and substance use among American Indian people with current substance use problems","volume":"35","author":"Gameon","year":"2021","journal-title":"Psychol Addict Behav"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e57","DOI":"10.1136\/tobaccocontrol-2017-053950","article-title":"Tobacco industry misappropriation of American Indian culture and traditional tobacco","volume":"27","author":"D'Silva","year":"2018","journal-title":"Tob Control"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1093\/ntr\/ntab180","article-title":"Decolonization of tobacco in indigenous communities of Turtle Island (North America)","volume":"24","author":"Nez Henderson","year":"2022","journal-title":"Nicotine Tob Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2170","DOI":"10.1056\/NEJMsa1407211","article-title":"Smoking and mortality\u2014beyond established causes","volume":"372","author":"Carter","year":"2015","journal-title":"N Engl J Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"E109","DOI":"10.5888\/pcd11.130293","article-title":"Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States","volume":"11","author":"Stahre","year":"2014","journal-title":"Prev Chronic Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1111\/jnc.13219","article-title":"Nicotine administration in the wake-promoting basal forebrain attenuates sleep-promoting effects of alcohol","volume":"135","author":"Sharma","year":"2015","journal-title":"J Neurochem"},{"key":"ref15","article-title":"Alcohol and tobacco","volume":"29","year":"2006","journal-title":"Alcohol Res Health"},{"key":"ref16","volume-title":"Concurrent alcohol and tobacco dependence: Mechanisms and treatment. 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