Changes in Alcohol Use Among Adults with Cancer Participating in the ECOG-ACRIN EAQ171CD Tobacco Treatment Trial.

BACKGROUND: Alcohol and tobacco use are known carcinogens. Treating alcohol and tobacco co-use can improve treatment and survivorship outcomes among patients diagnosed with cancer. METHODS: We conducted a post hoc analysis of ECOG-ACRIN EAQ171CD trial participants within the NCI Community Oncology Research Program (NCORP), examining changes in alcohol use among adults receiving the virtual sustained treatment (VST) for tobacco use intervention versus enhanced usual care (EUC; Quitline referral). Multivariable logistic regression assessed changes in alcohol use disorder risk at 3 and 6 months using the AUDIT-C. RESULTS: At baseline, participants (N = 305) were classified as no risk (31%), low/minimal risk (38%), moderate risk (23%), or high risk (8%) for alcohol use disorder. The mean age was 55.6 years, participants smoked for an average of 33 years, and 18% had alcohol-associated tumors. Participants randomized to EUC were more likely to shift to a lower alcohol risk category than those in the VST arm at 3 months (39% vs 27%) and 6 months (33% vs 27%). There was no significant difference in the odds of shifting to a lower risk category for VST vs EUC at 3 months (adjusted OR = 0.56, 95% CI 0.26-1.18, p = 0.125) or at 6 months (adjusted OR = 0.57, 95% CI 0.25-1.28, p = 0.172). CONCLUSIONS: Patients diagnosed with cancer and engaging in alcohol and tobacco co-use can achieve reductions in alcohol use and risk. IMPACT: Integrating tailored, co-use-focused strategies into cessation programs may improve changes in modifiable risk behaviors.