Are population trends in high-risk alcohol consumption in smokers associated with trends in quit attempts and quit success? A time-series analysis

OBJECTIVES: Monthly changes in the prevalence of high-risk drinking and smoking in England appear to be positively correlated. This study aimed to assess how far monthly changes in high-risk drinking were specifically associated with attempts to stop smoking and the success of quit attempts. DESIGN: Data were used from the Alcohol and Smoking Toolkit Studies between April 2014 and June 2018. These involve monthly household face-to-face surveys of representative samples of ~1800 adults. SETTING: England. PARTICIPANTS: Data were aggregated on 17 560 past-year smokers over the study period. PRIMARY AND SECONDARY OUTCOME MEASURES: Autoregressive integrated moving average with exogenous input (ARIMAX) modelling was used to assess the association over time between monthly prevalence of high-risk drinking among smokers and (a) prevalence of attempts to quit smoking and (b) prevalence of successful quit attempts in those attempting to quit. Bayes factors (BF) were calculated to compare the null hypothesis with the hypothesis of an effect sufficiently large (β=0.6) to explain the established association between overall prevalence in smoking and high-risk drinking. RESULTS: No statistically significant associations were found between monthly changes in prevalence of high-risk drinking among smokers and attempts to quit smoking (β=0.156, 95% CI −0.079 to 0.391, p=0.194) or quit success (β=0.066, 95% CI −0.524 to 0.655, p=0.827). BF indicated that the data were insensitive but suggested there is weak evidence for the null hypothesis in the case of both quit attempts (BF=0.80) and quit success (BF=0.53). CONCLUSIONS: Monthly changes in prevalence of high-risk alcohol consumption in England are not clearly associated with changes in quit attempt or quit success rates.