Smoking and alcohol

۞يَسۡـَٔلُونَكَ عَنِ ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِۖ قُلۡ فِيهِمَآ إِثۡمࣱ كَبِيرࣱ وَمَنَٰفِعُ لِلنَّاسِ وَإِثۡمُهُمَآ أَكۡبَرُ مِن نَّفۡعِهِمَاۗ وَيَسۡـَٔلُونَكَ مَاذَا يُنفِقُونَۖ قُلِ ٱلۡعَفۡوَۗ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَتَفَكَّرُونَ

They ask you [Prophet] about intoxicants and gambling: say, ‘There is great sin in both, and some benefit for people: the sin is greater than the benefit.’ They ask you what they should give: say, ‘Give what you can spare.’ In this way, God makes His messages clear to you, so that you may reflect

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِنَّمَا ٱلۡخَمۡرُ وَٱلۡمَيۡسِرُ وَٱلۡأَنصَابُ وَٱلۡأَزۡلَٰمُ رِجۡسࣱ مِّنۡ عَمَلِ ٱلشَّيۡطَٰنِ فَٱجۡتَنِبُوهُ لَعَلَّكُمۡ تُفۡلِحُونَ

You who believe, intoxicants and gambling, idolatrous practices, and [divining with] arrows are repugnant acts- Satan’s doing- shun them so that you may prosper

إِنَّمَا يُرِيدُ ٱلشَّيۡطَٰنُ أَن يُوقِعَ بَيۡنَكُمُ ٱلۡعَدَٰوَةَ وَٱلۡبَغۡضَآءَ فِي ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِ وَيَصُدَّكُمۡ عَن ذِكۡرِ ٱللَّهِ وَعَنِ ٱلصَّلَوٰةِۖ فَهَلۡ أَنتُم مُّنتَهُونَ

With intoxicants and gambling, Satan seeks only to incite enmity and hatred among you, and to stop you remembering God and prayer. Will you not give them up

وَدَخَلَ مَعَهُ ٱلسِّجۡنَ فَتَيَانِۖ قَالَ أَحَدُهُمَآ إِنِّيٓ أَرَىٰنِيٓ أَعۡصِرُ خَمۡرࣰ اۖ وَقَالَ ٱلۡأٓخَرُ إِنِّيٓ أَرَىٰنِيٓ أَحۡمِلُ فَوۡقَ رَأۡسِي خُبۡزࣰ ا تَأۡكُلُ ٱلطَّيۡرُ مِنۡهُۖ نَبِّئۡنَا بِتَأۡوِيلِهِۦٓۖ إِنَّا نَرَىٰكَ مِنَ ٱلۡمُحۡسِنِينَ

Two young men went into prison alongside him. One of them said, ‘I dreamed that I was pressing grapes’; the other said, ‘I dreamed that I was carrying bread on my head and that the birds were eating it.’ [They said], ‘Tell us what this means- we can see that you are a knowledgeable man.’

يَٰصَٰحِبَيِ ٱلسِّجۡنِ أَمَّآ أَحَدُكُمَا فَيَسۡقِي رَبَّهُۥ خَمۡرࣰ اۖ وَأَمَّا ٱلۡأٓخَرُ فَيُصۡلَبُ فَتَأۡكُلُ ٱلطَّيۡرُ مِن رَّأۡسِهِۦۚ قُضِيَ ٱلۡأَمۡرُ ٱلَّذِي فِيهِ تَسۡتَفۡتِيَانِ

Fellow prisoners, one of you will serve his master with wine; the other will be crucified and the birds will peck at his head. That is the end of the matter on which you asked my opinion.’

وَقُل لِّلۡمُؤۡمِنَٰتِ يَغۡضُضۡنَ مِنۡ أَبۡصَٰرِهِنَّ وَيَحۡفَظۡنَ فُرُوجَهُنَّ وَلَا يُبۡدِينَ زِينَتَهُنَّ إِلَّا مَا ظَهَرَ مِنۡهَاۖ وَلۡيَضۡرِبۡنَ بِخُمُرِهِنَّ عَلَىٰ جُيُوبِهِنَّۖ وَلَا يُبۡدِينَ زِينَتَهُنَّ إِلَّا لِبُعُولَتِهِنَّ أَوۡ ءَابَآئِهِنَّ أَوۡ ءَابَآءِ بُعُولَتِهِنَّ أَوۡ أَبۡنَآئِهِنَّ أَوۡ أَبۡنَآءِ بُعُولَتِهِنَّ أَوۡ إِخۡوَٰنِهِنَّ أَوۡ بَنِيٓ إِخۡوَٰنِهِنَّ أَوۡ بَنِيٓ أَخَوَٰتِهِنَّ أَوۡ نِسَآئِهِنَّ أَوۡ مَا مَلَكَتۡ أَيۡمَٰنُهُنَّ أَوِ ٱلتَّٰبِعِينَ غَيۡرِ أُوْلِي ٱلۡإِرۡبَةِ مِنَ ٱلرِّجَالِ أَوِ ٱلطِّفۡلِ ٱلَّذِينَ لَمۡ يَظۡهَرُواْ عَلَىٰ عَوۡرَٰتِ ٱلنِّسَآءِۖ وَلَا يَضۡرِبۡنَ بِأَرۡجُلِهِنَّ لِيُعۡلَمَ مَا يُخۡفِينَ مِن زِينَتِهِنَّۚ وَتُوبُوٓاْ إِلَى ٱللَّهِ جَمِيعًا أَيُّهَ ٱلۡمُؤۡمِنُونَ لَعَلَّكُمۡ تُفۡلِحُونَ

And tell believing women that they should lower their glances, guard their private parts, and not display their charms beyond what [it is acceptable] to reveal; they should let their headscarves fall to cover their necklines and not reveal their charms except to their husbands, their fathers, their husbands’ fathers, their sons, their husbands’ sons, their brothers, their brothers’ sons, their sisters’ sons, their womenfolk, their slaves, such men as attend them who have no sexual desire, or children who are not yet aware of women’s nakedness; they should not stamp their feet so as to draw attention to any hidden charms. Believers, all of you, turn to God so that you may prosper

They ask thee about wine and gambling.... And they ask thee what they should expend. God has servants on the earth who drink the wine of recognition and are drunk from the cup of love. There is no more than a whiff of this wine's reality in this world, and nothing but a show of that drunkenness, for this world is a prison, and what can a prison put up with? Today there is no more than that. Nonetheless, wait until tomorrow, the assembly of repose and ease [56:89], the arena of union with the Beloved, when the servants will be gazing on the Real. Hope for union with you has added to my life. What can union itself be, when hope does that!? A man in turmoil entered the shop of a wine merchant with one dirham. He said, “Give me wine for this dirham.” The merchant replied, “There's no wine left.” The man said, “I'm already in turmoil. I can't tolerate wine's reality. Show me a drop so I may s

O you who have faith! Wine, arrow-shuffling, idols, and divining arrows are a filth and of the deeds of Satan. The Prophet said, “Wine is the gatherer of sin and the mother of loathsome things”: Wine is the root of loathsome things and the key to great sins, the basis of misdeeds, the seed of misguided acts, and the source of discord. It dries up the springhead of obedience, holds back the water of remembrance, and opens the door to heedlessness. The soul becomes drunk from wine and is held back from the prayer. The heart becomes drunk from heedlessness and is held back from secret whispering. The Pir of the Tariqah spoke to these heedless people in the tongue of admonition: “O drunk- ards full of appetite! O sleepers in heedlessness! Have shame before that Lord who knows the treachery of the eyes and sees the inside of the hearts! He knows the treachery of the eyes and what the breasts

They ask you about wine and divinatory arrows gambling and what the ruling is regarding them. Say to them ‘In both that is in the partaking of both is great sin a variant reading for kabīr ‘great’ has kathīr ‘much’ because of the fighting cursing and swearing that ensue from it; and profit for men by way of delight and enjoyment in wine and acquiring money effortlessly from gambling; but the sin in them that is the degenerate behaviour in which they result is greater graver than the usefulness’. When this verse was revealed some gave up drinking while others persisted until the verse of sūrat al-Mā’ida Q. 590-91 finally made it illicit. And they will ask you what that is to say how much they should expend. Say expend ‘Comfortably’ al-‘afwa in the accusative is also read in the nominative al-‘afwu implying a preceding huwa that is the surplus of your need and do not expend what you need r

O you who believe verily wine that intoxicates and overcomes the mind and games of chance gambling and idols and divinatory arrows are an abomination an evil deemed vile of Satan’s work which he adorns; so avoid it this abomination consisting of the things mentioned do not do it; so that you might prosper.

Satan desires only to precipitate enmity and hatred between you through wine and games of chance when you partake of them because of the evil and discord that result therefrom; and to bar you by your being preoccupied with them from the remembrance of God and from prayer — He has specifically mentioned it prayer so as to magnify it. So will you then desist? from partaking of them? In other words Desist!

O you who believe! Khamr, Maysir, Ansab, and Azlam are a Rijs of Shaytan's handiwork. So avoid that in order that you may be successful (90)Shaytan wants only to excite enmity and hatred between you with Khamr and Maysir, and hinder you from the remembrance of Allah and from the Salah (the prayer). So, will you not then abstai (91)And obey Allah and obey the Messenger, and beware. Then if you turn away, you should know that it is Our Messenger's duty to convey in the clearest way (92)Those who believe and do righteous good deeds, there is no sin on them for what they ate, if they have Taqwa and believe and do righteous good deeds, and they (again) have Taqwa and believe, and then (once again) have Taqwa and perform good. And Allah loves the good-doers (93) Prohibiting Khamr (Intoxicants) and Maysir (Gambling) Allah forbids His believing servants from consuming Khamr and Maysir which is

حَدَّثَنَا أَبُو زَكَرِيَّا، يَحْيَى بْنُ دُرُسْتَ الْبَصْرِيُّ حَدَّثَنَا حَمَّادُ بْنُ زَيْدٍ، عَنْ أَيُّوبَ، عَنْ نَافِعٍ، عَنِ ابْنِ عُمَرَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ كُلُّ مُسْكِرٍ خَمْرٌ وَكُلُّ مُسْكِرٍ حَرَامٌ وَمَنْ شَرِبَ الْخَمْرَ فِي الدُّنْيَا فَمَاتَ وَهُوَ يُدْمِنُهَا لَمْ يَشْرَبْهَا فِي الآخِرَةِ ‏"‏ ‏.‏ قَالَ وَفِي الْبَابِ عَنْ أَبِي هُرَيْرَةَ وَأَبِي سَعِيدٍ وَعَبْدِ اللَّهِ بْنِ عَمْرٍو وَابْنِ عَبَّاسٍ وَعُبَادَةَ وَأَبِي مَالِكٍ الأَشْعَرِيِّ ‏.‏ قَالَ أَبُو عِيسَى حَدِيثُ ابْنِ عُمَرَ حَدِيثٌ حَسَنٌ صَحِيحٌ وَقَدْ رُوِيَ مِنْ غَيْرِ وَجْهٍ عَنْ نَافِعٍ عَنِ ابْنِ عُمَرَ عَنِ النَّبِيِّ صلى الله عليه وسلم ‏.‏ وَرَوَاهُ مَالِكُ بْنُ أَنَسٍ عَنْ نَافِعٍ عَنِ ابْنِ عُمَرَ مَوْقُوفًا فَلَمْ يَرْفَعْهُ ‏.‏

Narrated Ibn 'Umar: That the Messenger of Allah (ﷺ) said: "Every intoxicant is Khamr, and every intoxicant is unlawful. Whoever drinks Khamr in this world, and dies continuing it, he will not drink it in the Hereafter. He said: There are narrations on this topic from Abu Hurairah, Abu Sa'eed, 'Abdullah bin 'Amr, 'Ubadah, Abu Malik Al-Ash'ari, and Ibn 'Abbas. [Abu 'Eisa said:] The Hadith of Ibn 'Umar is a Hasan Sahih Hadith. It has been reported through other routes from Nafi', from Ibn 'Umar, from the Prophet (ﷺ). Malik bin Anas reported it from Nafi' from Ibn 'Umar in Mawquf - not Marfu' form

حَدَّثَنَا قُتَيْبَةُ، حَدَّثَنَا جَرِيرُ بْنُ عَبْدِ الْحَمِيدِ، عَنْ عَطَاءِ بْنِ السَّائِبِ، عَنْ عَبْدِ اللَّهِ بْنِ عُبَيْدِ بْنِ عُمَيْرٍ، عَنْ أَبِيهِ، قَالَ قَالَ عَبْدُ اللَّهِ بْنُ عُمَرَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَنْ شَرِبَ الْخَمْرَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ تَابَ اللَّهُ عَلَيْهِ فَإِنْ عَادَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ تَابَ اللَّهُ عَلَيْهِ فَإِنْ عَادَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ تَابَ اللَّهُ عَلَيْهِ فَإِنْ عَادَ الرَّابِعَةَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ لَمْ يَتُبِ اللَّهُ عَلَيْهِ وَسَقَاهُ مِنْ نَهْرِ الْخَبَالِ ‏"‏ ‏.‏ قِيلَ يَا أَبَا عَبْدِ الرَّحْمَنِ وَمَا نَهْرُ الْخَبَالِ قَالَ نَهْرٌ مِنْ صَدِيدِ أَهْلِ النَّارِ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ وَقَدْ رُوِيَ نَحْوُ هَذَا عَنْ عَبْدِ اللَّهِ بْنِ عَمْرٍو وَابْنِ عَبَّاسٍ عَنِ النَّبِيِّ صلى الله عليه وسلم ‏.‏

Narrated 'Abdullah bin 'Umar: That the Messenger of Allah (ﷺ) said: "Whoever drinks Khamr, Salat is not accepted from him for forty days. If he repents, then Allah will accept his repentance. It he returns to it, then Allah will not accept his Salat for forty days. If he repents, then Allah will accept his repentance. If he returns to it, then Allah will not accepts his Salat for forty days. If he repents, then Allah will accept his repentance. If he returns to it a fourth time, Allah will not accept his Salat for forty days, and if he were to repent, Allah would not accept his repentance, and he will be given to drink from the river of Al-Khabal." They said: "O Aby 'Abdur-Rahman! What is the river of Al-Khabal?" He said: "A river of the pus from the inhabitants of the Fire." [Abu 'Eisa said:] This Hadith is Hasan. Similar to this has been reported from 'Abdullah bin 'Amr and Ibn 'Abbas from the Prophet (ﷺ)

حَدَّثَنَا أَحْمَدُ بْنُ حَنْبَلٍ، حَدَّثَنَا إِسْمَاعِيلُ بْنُ إِبْرَاهِيمَ، حَدَّثَنَا أَبُو حَيَّانَ، حَدَّثَنِي الشَّعْبِيُّ، عَنِ ابْنِ عُمَرَ، عَنْ عُمَرَ، قَالَ نَزَلَ تَحْرِيمُ الْخَمْرِ يَوْمَ نَزَلَ وَهِيَ مِنْ خَمْسَةِ أَشْيَاءَ مِنَ الْعِنَبِ وَالتَّمْرِ وَالْعَسَلِ وَالْحِنْطَةِ وَالشَّعِيرِ وَالْخَمْرُ مَا خَامَرَ الْعَقْلَ وَثَلاَثٌ وَدِدْتُ أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم لَمْ يُفَارِقْنَا حَتَّى يَعْهَدَ إِلَيْنَا فِيهِنَّ عَهْدًا نَنْتَهِي إِلَيْهِ الْجَدُّ وَالْكَلاَلَةُ وَأَبْوَابٌ مِنْ أَبْوَابِ الرِّبَا ‏.‏

’Umar said :The prohibition of wine came down when (the Quranic verse ) came down. It was made from five thing namely, grapes, dates, honey, wheat ,barley. Wine is what infects (khamara) the mind. There are three things I wished that the prophet (ﷺ) would not leave us until he explained them fully to our satisfaction: (share of) grandfather, one who leaves no descendants or ascendants as hairs, and the details of usury

حَدَّثَنَا عَبَّادُ بْنُ مُوسَى الْخُتَّلِيُّ، أَخْبَرَنَا إِسْمَاعِيلُ، - يَعْنِي ابْنَ جَعْفَرٍ - عَنْ إِسْرَائِيلَ، عَنْ أَبِي إِسْحَاقَ، عَنْ عَمْرٍو، عَنْ عُمَرَ بْنِ الْخَطَّابِ، قَالَ لَمَّا نَزَلَ تَحْرِيمُ الْخَمْرِ قَالَ عُمَرُ اللَّهُمَّ بَيِّنْ لَنَا فِي الْخَمْرِ بَيَانًا شِفَاءً فَنَزَلَتِ الآيَةُ الَّتِي فِي الْبَقَرَةِ ‏{‏ يَسْأَلُونَكَ عَنِ الْخَمْرِ وَالْمَيْسِرِ قُلْ فِيهِمَا إِثْمٌ كَبِيرٌ ‏}‏ الآيَةَ قَالَ فَدُعِيَ عُمَرُ فَقُرِئَتْ عَلَيْهِ قَالَ اللَّهُمَّ بَيِّنْ لَنَا فِي الْخَمْرِ بَيَانًا شِفَاءً فَنَزَلَتِ الآيَةُ الَّتِي فِي النِّسَاءِ ‏{‏ يَا أَيُّهَا الَّذِينَ آمَنُوا لاَ تَقْرَبُوا الصَّلاَةَ وَأَنْتُمْ سُكَارَى ‏}‏ فَكَانَ مُنَادِي رَسُولِ اللَّهِ صلى الله عليه وسلم إِذَا أُقِيمَتِ الصَّلاَةُ يُنَادِي أَلاَ لاَ يَقْرَبَنَّ الصَّلاَةَ سَكْرَانُ فَدُعِيَ عُمَرُ فَقُرِئَتْ عَلَيْهِ فَقَالَ اللَّهُمَّ بَيِّنْ لَنَا فِي الْخَمْرِ بَيَانًا شِفَاءً فَنَزَلَتْ هَذِهِ الآيَةُ ‏{‏ فَهَلْ أَنْتُمْ مُنْتَهُونَ ‏}‏ قَالَ عُمَرُ انْتَهَيْنَا ‏.‏

Narrated Umar ibn al-Khattab: When the prohibition of wine (was yet to be) declared, Umar said: O Allah, give us a satisfactory explanation about wine. So the following verse of Surat al-Baqarah revealed; "They ask thee concerning wine and gambling. Say: In them is great sin...." Umar was then called and it was recited to him. He said: O Allah, give us a satisfactory explanation about wine. Then the following verse of Surat an-Nisa' was revealed: "O ye who believe! approach not prayers with a mind befogged...." Thereafter the herald of the Messenger of Allah (ﷺ) would call when the (congregational) prayer was performed: Beware, one who is drunk should not come to prayer. Umar was again called and it was recited to him). He said: O Allah, give us a satisfactory explanation about wine. This verse was revealed: "Will ye not then abstain?" Umar said: We abstained

وأما النبات فلا يحرم منه إلا ما يزيل العقل أو يزيل الحياة أو الصحة فمزيل العقل البنج و الخمر وسائر المسكرات ومزيل الحياة السموم ومزيل الصحة الأدوية في غير وقتها وكأن مجموع هذا يرجع إلى الضرر إلا الخمر و المسكرات فإن الذي لا يسكر منها أيضا حرام مع قلته لعينه ولصفته وهي الشدة المطربة

وأما حديث عبدالله بن عمرو فروى أحمد في مسنده وأبو داود عنه أن النبيقال : إن الله تعالى حرم على أمتي الخمر والميسر والكوبة والغبيراء وكل مسكر حرام

أما الجمادات فطاهرة كلها إلا الخمر وكل منتبذ مسكر والحيوانات طاهرة كلها إلا الكلب والخنزير وما تولد منهما أو من أحدهما

وأما حديث ابن عباس ففي المسند أيضا : عنه أن رسول اللهقال : إن الله حرم الخمر والميسر والكوبة وكل مسكر حرام والكوبة الطبل قاله سفيان وقيل : البربط والقنين هو الطنبور بالحبشية والتقنين : الضرب به قاله ابن الأعرابي

وإنما أتي هؤلاء من حيث استحلوا المحرمات بما ظنوه من انتفاء الاسم ولم يلتفتوا إلى وجود المعنى المحرم وثبوته وهذا بعينه هو شبهة اليهود في استحلال بيع الشحم بعد جمله واستحلال أخذ الحيتان يوم الأحد بما أوقعوها به يوم السبت في الحفائر والشباك من فعلهم يوم الجمعة وقالوا : ليس هذا صيد يوم السبت ولا استباحة لنفس الشحم بل الذي يستحل الشراب المسكر زاعما أنه ليس خمرا مع علمه أن معناه معنى الخمر ومقصوده مقصوده وعمله عمله أفسد تأويلا فإن الخمر اسم لكل شراب مسكر كما دلت عليه النصوص الصحيحة الصريحة وقد جاء هذا الحديث عن النبيمن وجوه أخرى

وهذا بمنزلة السكر من شرب الخمر فإن تناول المسكر اختياري وما يتولد عنه السكر اضطراري فمتى كان السبب واقعا باختياره لم يكن معذورا فيما تولد عنه بغير اختياره فمتى كان السبب محظورا لم يكن السكران معذورا ولا ريب أن متابعة النظر واستدامة الفكر بمنزلة شرب المسكر فهو يلام على السبب ولهذا إذا حصل العشق بسبب غير محظور لم يلم عليه صاحبه كمن كان يعشق امرأته أو جاريته ثم فارقها وبقي عشقها غير مفارق له فهذا لا يلام على ذلك كما تقدم في قصة بريرة ومغيث وكذلك إذا نظر نظرة فجاءة ثم صرف بصره وقد تمكن العشق من قلبه بغير اختياره على أن عليه مدافعته وصرفه عن قلبه بضده فإذا جاء أمر يغلبه فهناك لا يلام بعد بذل الجهد في دفعه ومما يبين ما قلناه أن سكر العشق أعظم من سكر الخمر كما قال الله تعالى عن عشاق الصور من قوم لوط @QB@ لعمرك إنهم لفي سكرتهم يعمهون @QE@ وإذا كان أدنى السكرين لا يعذر صاحبه إذا تعاطى أسبابه فكيف يعذر صاحب السكر الأقوى مع تعاطي أسبابه وإذ قد وصلنا إلى هذا الموضع فلنذكر بابا في سكرة الحب وسببها

The impact of depressive symptoms on alcohol and cigarette consumption following treatment for alcohol and nicotine dependence.: Background: Although depression is common among alcohol and tobacco dependent patients, its impact on treatment outcomes is not well established. The purpose of this study was to examine the impact of depressive symptoms on abstinence from tobacco and alcohol after treatment for alcohol dependence and nicotine dependence. Methods: The Timing of Alcohol and Smoking Cessation Study (TASC) randomized adults receiving intensive alcohol dependence treatment, who were also smokers, to concurrent or de

Alcohol use and initial smoking lapses among heavy drinkers in smoking cessation treatment.: Introduction: This study examined alcohol use and its association with initial smoking lapses among heavy nondependent drinkers in smoking cessation treatment. Methods: Participants were 236 heavy drinking smokers in a randomized clinical trial testing the efficacy of incorporating brief alcohol intervention into smoking cessation treatment. Results: Of the 178 participants who reported a smoking lapse, 41.5% lapsed when drinking alcohol. Those who had alcohol-involved lapses had significantly l

Development and preliminary randomized controlled trial of a distress tolerance treatment for smokers with a history of early lapse.: Introduction: An inability to tolerate distress is a significant predictor of early smoking lapse following a cessation attempt. We conducted a preliminary randomized controlled trial to compare a distress tolerance (DT) treatment that incorporated elements of exposure-based therapies and Acceptance and Commitment Therapy to standard smoking cessation treatment (ST). Methods: Smokers with a history of early lapse in prior quit attempts received either DT (N = 27; 9 2-hr group and 6 50-min indivi

Smoking cessation in severe mental illness: what works?: Aims: The physical health of people with severe mental illness (SMI) is poor. Smoking-related illnesses are a major contributor to excess mortality and morbidity. An up-to-date review of the evidence for smoking cessation interventions in SMI is needed to inform clinical guidelines. Methods: We searched bibliographic databases for relevant studies and independently extracted data. Included studies were randomized controlled trials (RCTs) of smoking cessation or reduction conducted in adult smoke

Anxiety diagnoses in smokers seeking cessation treatment: relations with tobacco dependence, withdrawal, outcome and response to treatment.: Aims: To understand the relations among anxiety disorders and tobacco dependence, withdrawal symptoms, response to smoking cessation pharmacotherapy and ability to quit smoking. Design: Randomized placebo-controlled clinical trial. Participants received six 10-minute individual counseling sessions and either: placebo, bupropion SR, nicotine patch, nicotine lozenge, bupropion SR + nicotine lozenge or nicotine patch + nicotine lozenge. Setting: Two urban research sites. Participants: Data were col

Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials.: Background: Many placebo-controlled trials have demonstrated the efficacy of individual pharmacotherapies approved for smoking cessation. However, few direct or indirect comparisons of such interventions have been conducted. We performed a meta-analysis to compare the treatment effects of 7 approved pharmacologic interventions for smoking cessation. Methods: We searched the US Centers for Disease Control and Prevention's Tobacco Information and Prevention database as well as MEDLINE, EMBASE and

Online suicide risk screening and intervention with college students: a pilot randomized controlled trial.

Objective: This pilot randomized controlled trial examined the effect of an online intervention for college students at risk for suicide, Electronic Bridge to Mental Health Services (eBridge), which included personalized feedback and optional online counseling delivered in accordance with motivational interviewing principles. Primary outcomes were readiness to seek information or talk with family and friends about mental health treatment, readiness to seek mental health treatment, and actual treatment linkage. Method: Participants were 76 college students (45 women, 31 men; mean age = 22.9 years, SD = 5.0 years) at a large public university who screened positive for suicide risk, defined by at least 2 of the following: suicidal thoughts, history of suicide attempt, depression, and alcohol abuse. Racial/ethnic self-identifications were primarily Caucasian (n = 54) and Asian (n = 21). Stud…

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Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial.

Objective: To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents. Method: A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and several areas in Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study Web portal irrespective of mental health status at baseline. Families who accessed the Web portal were assigned randomly to 1 of 3 groups: BBN, which featured modules for adolescents and parents targeting adolescents' mental health symptoms; BBN plus additional modules targeting parents' mental health symptoms; or assessment only. The primary outcomes were ado…

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Evaluating guilt and shame in an expressive writing alcohol intervention.

Expressive writing interventions have shown positive physical and psychological health benefits over time, with the presumed mechanism being emotional disclosure. However, work utilizing expressive writing in behavior change has been minimal. The current research applied the expressive writing paradigm to reduce drinking intentions among college students, and evaluated the role of event-related guilt and shame in intervention effects. College students (N=429) completed a baseline survey and were randomly assigned to one of three conditions: Negative (write about a heavy drinking event that was negative); Positive (write about a heavy drinking event that was positive); or Neutral (write about their first day of college). After writing, readiness to change and future drinking intentions were assessed. Results revealed intervention effects on intended drinks per week and intended number of …

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Effects of Initiating Moderate Alcohol Intake on Cardiometabolic Risk in Adults With Type 2 Diabetes: A 2-Year Randomized, Controlled Trial.

Background: Recommendations for moderate alcohol consumption remain controversial, particularly in type 2 diabetes mellitus (T2DM). Long-term randomized, controlled trials (RCTs) are lacking. Objective: To assess cardiometabolic effects of initiating moderate alcohol intake in persons with T2DM and whether the type of wine matters. Design: 2-year RCT (CASCADE [CArdiovaSCulAr Diabetes & Ethanol] trial). (ClinicalTrials.gov: NCT00784433). Setting: Ben-Gurion University of the Negev-Soroka Medical Center and Nuclear Research Center Negev, Israel. Patients: Alcohol-abstaining adults with well-controlled T2DM. Intervention: Patients were randomly assigned to 150 mL of mineral water, white wine, or red wine with dinner for 2 years. Wines and mineral water were provided. All groups followed a Mediterranean diet without caloric restriction. Measurements: Primary outcomes were lipid and glycemic …

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Poor vitamin C status is associated with increased depression symptoms following acute illness in older people.

Background: Vitamin C has important physical and mental health benefits and plasma concentrations reflect recent intakes. Inflammation associated with any acute illness can lead to poor appetite and low food intake in older people. The aims of this report were to assess the prevalence and clinical significance of vitamin C deficiency among hospitalized acutely-ill older patients. Methods: Three hundred and twenty two patients (152 [47%] female), aged 65 yrs. and over who took part in a randomized, double blind, placebo-controlled trial had their nutritional status assessed from anthropometric, hematological and biochemical data at baseline, and after 6 weeks and 6 months. Vitamin C was measured using a fluorimetric technique and logistic regression analysis was performed to determine the influence of a number of clinical indicators, including tissue inflammation measured using C-reactive…

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[Effectiveness of forgiveness therapy on resilience, self-esteem, and spirituality of wives of alcoholics].

Purpose: In this study the effects of forgiveness therapy on the resilience, self-esteem, and spirituality of wives of men suffering from alcohol abuse was examined. Methods: The study design was a quasi-experimental design. Forgiveness therapy was conducted once a week for 12 weeks. Data were obtained from March 2012 to December 2013. Participants were chosen from women in two Alcohol Counseling Centers. Of the 29 participants, 16 were assigned to the experimental group and 13 to the control group. Data were analyzed using descriptive statistics, t-test, χ(2)-test, and repeated measure ANOVA. Results: There were statistically significantly differences for resilience, self-esteem, and spirituality between the experimental and control groups. Forgiveness therapy improved the resilience, self-esteem, and spirituality in the experimental group compared to the control group (p<.05). In follo…

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Effects of administered alcohol on intimate partner interactions in a conflict resolution paradigm.

Objective: Although couples' alcohol use has been associated with intimate partner aggression and poorer marital functioning, few studies have examined the proximal effects of alcohol on couple interactions. The current experimental study examined the effects of alcohol, administered independently to male and female intimate partners, on positive and negative interaction behaviors within a naturalistic conflict resolution paradigm. Method: Married and cohabiting couples (n = 152) were recruited from the community and each partner randomly assigned to receive either alcohol (target dose: .08 mg/kg) or no alcohol. They engaged in two 15-minute interactions regarding current disagreements in their relationship, one before and one after beverage administration. Videotaped interactions were coded by trained observers using the Rapid Marital Interaction Coding System, and positive and negative…

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A self-management programme for COPD: a randomised controlled trial.

Studies of programmes of self-management support for chronic obstructive pulmonary disease (COPD) have been inconclusive. The Self-Management Programme of Activity, Coping and Education (SPACE) FOR COPD is a 6-week self-management intervention for COPD, and this study aimed to evaluate the effectiveness of this intervention in primary care. A single-blind randomised controlled trial recruited people with COPD from primary care and randomised participants to receive usual care or SPACE FOR COPD. Outcome measures were performed at baseline, 6 weeks and 6 months. The primary outcome was symptom burden, measured by the self-reported Chronic Respiratory Questionnaire (CRQ-SR) dyspnoea domain. Secondary outcomes included other domains of the CRQ-SR, shuttle walking tests, disease knowledge, anxiety, depression, self-efficacy, smoking status and healthcare utilisation. 184 people with COPD were…

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Chronic care management for dependence on alcohol and other drugs: the AHEAD randomized trial.

Importance: People with substance dependence have health consequences, high health care utilization, and frequent comorbidity but often receive poor-quality care. Chronic care management (CCM) has been proposed as an approach to improve care and outcomes. Objective: To determine whether CCM for alcohol and other drug dependence improves substance use outcomes compared with usual primary care. Design, setting, and participants: The AHEAD study, a randomized trial conducted among 563 people with alcohol and other drug dependence at a Boston, Massachusetts, hospital-based primary care practice. Participants were recruited from September 2006 to September 2008 from a freestanding residential detoxification unit and referrals from an urban teaching hospital and advertisements; 95% completed 12-month follow-up. Interventions: Participants were randomized to receive CCM (n=282) or no CCM (n=281…

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The effect of rumination on craving across the continuum of drinking behaviour.

Background: Rumination is an abstract, persistent, and repetitive thinking style that can be adopted to control negative affect. Recent studies have suggested the role of rumination as direct or indirect cognitive predictor of craving experience in alcohol-related problems. Aims: The goal of this study was to explore the effect of rumination induction on craving across the continuum of drinking behaviour. Methods: Participants of three groups of alcohol-dependent drinkers (N=26), problem drinkers (N=26) and social drinkers (N=29) were randomly allocated to two thinking manipulation tasks: distraction versus rumination. Craving was measured before and after manipulation and after a resting phase. Results: Findings showed that rumination had a significant effect on increasing craving in alcohol-dependent drinkers, relative to distraction, but not in problem and social drinkers. This effect…

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Randomized clinical trial examining the incremental efficacy of a 90-minute motivational alcohol intervention as an adjunct to standard batterer intervention for men.

Aims: The efficacy of batterer intervention programs to reduce intimate partner violence (IPV) is questionable, with individuals with alcohol problems particularly unlikely to benefit. We examined whether adding adjunctive alcohol intervention to batterer intervention reduced the likelihood of substance use and violence relative to batterer intervention alone. Design: Randomized clinical trial. Setting: Batterer intervention programs in Rhode Island, USA. Participants: A total of 252 hazardous drinking men in batterer intervention programs. Participants were randomized to receive 40 hours of standard batterer program (SBP) or the SBP plus a 90-minute alcohol intervention (SBP + BAI). None withdrew due to adverse effects. Data were collected at baseline, 3-, 6- and 12-month follow-up, with follow-up rates of 95, 89 and 82%, respectively. Measurements: Substance use was measured with a wel…

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Six-months outcomes of a randomised trial of supportive text messaging for depression and comorbid alcohol use disorder.

Background and objectives: We have previously reported that supportive text messages delivered twice daily for three months have the potential to provide personalised support for patients with depression and co-morbid Alcohol Use Disorder (AUD). In this study we report the six months outcomes. Methods: Participants (n=54) with a DSM IV diagnosis of unipolar depression and AUD who completed an in-patient dual diagnosis treatment programme were randomised to receive daily twice supportive text messages (n=26) or a fortnightly thank you text message (n=28) for three months. Primary outcome measures at six months were Beck's Depression Inventory (BDI-II) scores and Cumulative Abstinence Duration (CAD). Trial registration: NCT0137868. Results: Unlike at three months, there was no statistically significant difference in six months BDI-II scores between the intervention (n=24) and control (n=24…

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A randomized study of cellphone technology to reinforce alcohol abstinence in the natural environment.

Aims: Contingency management (CM) uses tangible incentives to systematically reinforce abstinence and is among the most efficacious psychosocial substance abuse treatments. This study assessed the feasibility and initial efficacy of a portable CM procedure designed to address technical limitations for detecting drinking that have prevented using CM for alcohol problems. Design: Participants received a cellphone, breathalyzer and training on video-recording alcohol breath tests (BrACs) and texting results. For 4 weeks, staff texted participants one to three times daily indicating that a breath alcohol concentration test (BrAC) was due within the hour. Participants were randomized to (1) modest compensation for submitting dated time-stamped BrAC videos regardless of results or (2) the same plus CM with escalating vouchers for on-time alcohol-negative tests (n-BrAC; <02 g/dl). 'Thank-you' t…

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Randomized controlled trial of contingency management for stimulant use in community mental health patients with serious mental illness.

Objective: The primary objective of this study was to determine whether contingency management was associated with increased abstinence from stimulant drug use in stimulant-dependent patients with serious mental illness treated in a community mental health center. Secondary objectives were to determine whether contingency management was associated with reductions in use of other substances, psychiatric symptoms, HIV risk behavior, and inpatient service utilization. Method: A randomized controlled design was used to compare outcomes of 176 outpatients with serious mental illness and stimulant dependence. Participants were randomly assigned to receive 3 months of contingency management for stimulant abstinence plus treatment as usual or treatment as usual with reinforcement for study participation only. Urine drug tests and self report, clinician-report, and service utilization outcomes we…

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Synergy between seeking safety and twelve-step affiliation on substance use outcomes for women.

Objective: The Recovery Management paradigm provides a conceptual framework for the examination of joint impact of a focal treatment and post-treatment service utilization on substance abuse treatment outcomes. We test this framework by examining the interactive effects of a treatment for comorbid PTSD and substance use, Seeking Safety, and post-treatment Twelve-Step Affiliation (TSA) on alcohol and cocaine use. Method: Data from 353 women in a six-site, randomized controlled effectiveness trial within the NIDA Clinical Trials Network were analyzed under latent class pattern mixture modeling. LCPMM was used to model variation in Seeking Safety by TSA interaction effects on alcohol and cocaine use. Results: Significant reductions in alcohol use among women in Seeking Safety (compared to health education) were observed; women in the Seeking Safety condition who followed up with TSA had the…

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AESOPS: a randomised controlled trial of the clinical effectiveness and cost-effectiveness of opportunistic screening and stepped care interventions for older hazardous alcohol users in primary care.

Background: There is clear evidence of the detrimental impact of hazardous alcohol consumption on the physical and mental health of the population. Estimates suggest that hazardous alcohol consumption annually accounts for 150,000 hospital admissions and between 15,000 and 22,000 deaths in the UK. In the older population, hazardous alcohol consumption is associated with a wide range of physical, psychological and social problems. There is evidence of an association between increased alcohol consumption and increased risk of coronary heart disease, hypertension and haemorrhagic and ischaemic stroke, increased rates of alcohol-related liver disease and increased risk of a range of cancers. Alcohol is identified as one of the three main risk factors for falls. Excessive alcohol consumption in older age can also contribute to the onset of dementia and other age-related cognitive deficits and…

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Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders.

Aims This study aimed to test the efficacy of integrated cognitive behaviour therapy (CBT) for coexisting post traumatic stress disorder (PTSD) and alcohol use disorders (AUD). Setting Clinics across Sydney, Australia. Design Randomized controlled trial of 12 once-weekly individual sessions of either integrated CBT for PTSD and AUD(integrated therapy, IT; n = 33) or CBT for AUD plus supportive counselling (alcohol-support, AS; n = 29). Blind assessments were conducted at baseline and post-treatment and at 5 [standard deviation (SD) = 2.25] and 9.16(SD = 3.45) months post-treatment. Participants Sixty-two adults with concurrent PTSD and AUD. Measurements Outcomes included changes in alcohol consumption (time-line follow-back), PTSD severity [clinician-administered PTSD scale (CAPS)], alcohol dependence and problems, and depression and anxiety. Findings Reductions in PTSD severity were evi…

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A double-blind, placebo-controlled trial assessing the efficacy of varenicline tartrate for alcohol dependence.

Objectives: To assess the efficacy and safety of varenicline (Chantix) for the treatment of alcohol dependence. Varenicline is a partial α4β2 nicotinic acetylcholine agonist approved by the Food and Drug Administration for smoking cessation. It has reduced drinking in animal studies and in small studies of humans who were both heavy drinkers and smokers. This is the first multisite clinical trial of varenicline in a population of smokers and nonsmokers with alcohol dependence. Methods: Men and women (n = 200) meeting the criteria for alcohol dependence were recruited across 5 clinical sites. Patients received double-blind varenicline or placebo and a computerized behavioral intervention. Varenicline was titrated during the first week to 2 mg/d, which was maintained during weeks 2 to 13. Results: The varenicline group had significantly lower weekly percent heavy drinking days (primary out…

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Does active referral by a doctor or 12-Step peer improve 12-Step meeting attendance? Results from a pilot randomised control trial.

Background: Active engagement in 12-Step self-help groups (SHG) is associated with improvements in substance use outcomes during and after treatment, yet levels of participation in SHG meetings in the U.K. remain low. Method: An RCT investigating the impact of active referral to SHG, delivered by doctors or 12-Step peers during inpatient treatment on both inpatient and post-treatment meeting attendance was conducted. 151 inpatients with alcohol, opiate, crack-cocaine or benzodiazepine dependence undergoing detoxification, received one of two active referral interventions: 12-Step peer intervention (PI), doctor intervention (DI), or no intervention (NI). 83% of the sample was followed up, 2-3 months following discharge. Results: Active referral interventions significantly increased attendance at 12-Step meetings during inpatient treatment (88% versus 73%, p<.05). Rates of post-discharge m…

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Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial.

Background: Mobile phone text message technology has the potential to improve outcomes for patients with depression and co-morbid Alcohol Use Disorder (AUD). Aims: To perform a randomised rater-blinded trial to explore the effects of supportive text messages on mood and abstinence outcomes for patients with depression and co-morbid AUD. Methods: Participants (n=54) with a DSM IV diagnosis of unipolar depression and AUD who completed an in-patient dual diagnosis treatment programme were randomised to receive twice daily supportive text messages (n=26) or a fortnightly thank you text message (n=28) for three months. Primary outcome measures were Beck's Depression Inventory (BDI-II) scores and Cumulative Abstinence Duration (CAD) in days at three months. Trial registration: NCT0137868. Results: There was a statistically significant difference in three month BDI-II scores between the interve…

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Community Reinforcement and Family Training: a pilot comparison of group and self-directed delivery.

In a randomized clinical pilot study, 40 concerned significant others (CSOs) of treatment-refusing alcohol- and drug-using individuals were randomized to either Community Reinforcement and Family Training (CRAFT) conducted in a group format (Group CRAFT) or a Self-Directed CRAFT condition. Although results indicated no significant between-group difference in engaging treatment-refusing substance-using individuals (referred to as identified patients or IPs) into treatment, the engagement rate in Group CRAFT was similar to rates previously reported with individual CRAFT. For the intent-to-treat analysis, 60% of Group CRAFT CSOs engaged their loved one into treatment, as compared with 40% in Self-Directed CRAFT. Of CSOs in the Group condition who received at least one session of group therapy, 71% engaged their IP into treatment. CSOs in both conditions reported improvements in family cohes…

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Prazosin effects on stress- and cue-induced craving and stress response in alcohol-dependent individuals: preliminary findings.

Background: Stress, alcohol cues, and dysregulated stress responses increase alcohol craving and relapse susceptibility, but few pharmacologic agents are known to decrease stress- and cue-induced alcohol craving and associated stress dysregulation in humans. Here we report findings from a preliminary efficacy study of the alpha-1 receptor antagonist, prazosin, in modulating these relapse-relevant factors in alcohol-dependent individuals. Methods: Seventeen early abstinent, treatment-seeking alcohol-dependent individuals (12 men and 5 women) were randomly assigned to receive either placebo or 16 mg daily prazosin in a double-blind, placebo-controlled manner over 4 weeks. During week 4, all patients participated in a 3-day laboratory experiment involving 5-minute guided imagery exposure to stress, alcohol cue, and neutral-relaxing/control conditions, 1 exposure per day, on consecutive days…

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Determining the relative importance of the mechanisms of behavior change within Alcoholics Anonymous: a multiple mediator analysis.

Aims: Evidence indicates that Alcoholics Anonymous (AA) participation reduces relapse risk but less is known about the mechanisms through which AA confers this benefit. Initial studies indicate self-efficacy, negative affect, adaptive social networks and spiritual practices are mediators of this effect, but because these have been tested in isolation, their relative importance remains elusive. This study tested multiple mediators simultaneously to help determine the most influential pathways. Design: Prospective, statistically controlled, naturalistic investigation examined the extent to which these previously identified mechanisms mediated AA attendance effects on alcohol outcomes controlling for baseline outcome values, mediators, treatment, and other confounders. Setting: Nine clinical sites within the United States. Participants: Adults (n = 1726) suffering from alcohol use disorder …

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Ego depletion increases ad-lib alcohol consumption: investigating cognitive mediators and moderators.

When self-control resources are depleted ("ego depletion"), alcohol-seeking behavior becomes closely associated with automatic alcohol-related processing biases (e.g., Ostafin, Marlatt, & Greenwald, 2008). The current study aimed to replicate and extend these findings, and also to investigate whether the effects of ego depletion on drinking behavior would be mediated by temporary impairments in executive function or increases in impulsivity. Eighty heavy social drinkers (46 female) initially completed measures of automatic approach tendencies (stimulus response compatibility [SRC] task) and attentional bias (visual probe task) elicited by alcohol-related cues. Participants were then exposed to either an ego depletion manipulation or a control manipulation, before completing a bogus taste test in order to assess ad-lib alcohol consumption. In a subsequent testing session, we examined effe…

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Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial.

Objective: The current study examined the efficacy of an early intervention based on acceptance and commitment therapy (ACT) for depressive symptomatology. The ACT intervention is aimed at increasing the acceptance of negative thoughts and emotions and living a mindful and value-based life. Method: Adults with mild to moderate depressive symptomatology were randomly assigned to the ACT intervention (n=49) or to a waiting list (n=44). The mean age of the participants was 49 years. The majority of the participants was female and of Dutch origin. All the participants completed measures before and after the intervention, as well as three months later at follow-up to assess depression (CES-D), anxiety (HADS-A), fatigue (CIS), alcohol use and acceptance (AAQ-II). Results: The ACT intervention led to statistically significant reduction in depressive symptomatology (Cohen's d=.60). These reducti…

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