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Prevalence and 1-Year Course of Alcohol Misuse and Smoking in Persons with Lower Extremity Amputation as a Result of Peripheral Arterial Disease

Turner, Aaron P. PhD; Williams, Rhonda M. PhD; Norvell, Daniel C. PhD; Henderson, Alison W. PhD; Hakimi, Kevin N. MD; Blake, Donna Jo MD; Czerniecki, Joseph M. MD

American Journal of Physical Medicine & Rehabilitation: June 2014 - Volume 93 - Issue 6 - p 493–502
doi: 10.1097/PHM.0000000000000055
Original Research Articles

Objective The aim of this study was to describe prevalence of alcohol misuse and smoking among individuals with amputations as a result of peripheral arterial disease before surgery and 12 mos after surgery, changes in these behaviors over time, and factors associated with change.

Design This is a prospective cohort study of 75 veterans experiencing their first major unilateral amputation. Measures included demographic and general health information, Alcohol Use Disorders Identification Test, smoking behaviors, and social support.

Results Sixteen percent of the participants reported engaging in alcohol misuse at presurgical baseline; and 13% at 12 mos after amputation. Thirty-seven percent of the participants were categorized as smokers at baseline; this number dropped to 29% at 12 mos after amputation. Among those who decreased drinking and quit smoking, there was a trend indicating greater social support.

Conclusions The participants endorsed drinking and smoking behaviors at levels consistent with other types of disability and with veterans using the Veterans Health Administration for their health care. Even with a variety of health concerns, after amputation, most of the smokers and those engaging in alcohol misuse continued to smoke and drink at their preamputation rate. The presence of social support may encourage health behavior change and is an important area for future research and intervention.

From the VA Puget Sound Health Care System, Seattle, Washington (APT, RMW, AWH, KNH, JMC); Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (APT, RMW, KNH, JMC); Spectrum Research, Inc, Tacoma, Washington (DCN); Denver VAMC, Denver, Colorado (DJB); and University of Colorado, Denver, Colorado (DJB).

All correspondence and requests for reprints should be addressed to: Aaron P. Turner, PhD, VA Puget Sound Health Care System, RCS-117, 1660 S. Columbian Way, Seattle, WA 98108.

Supported by the United States Department of Veterans Affairs, Office of Research and Development, Rehabilitation Research and Development (Merit Review A41241, Joseph M. Czerniecki, PI, and Career Development Award B4927W, Aaron P. Turner, PI).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins