P1588 - Psychosocial Determinants of Concurrent Alcohol Use and Active Smoking in Adults With HCV in the Last Decade: An Analysis of NHANES

Mohammad Alabbas, MD¹, Yuqi Guo, PhD², Jingyi Shi, PhD³, Hongke Wu, MD, MPH, MS⁴, Walaa Mahmoud, MD⁴, Shreya Sengupta, MD⁴, Omar Sims, PhD⁵
1Cleveland Clinic Foundation, South Euclid, OH; 2University of North Carolina, Charlotte, NC; 3mississippi state university, Starkville, MS; 4Cleveland Clinic Foundation, Cleveland, OH; 5Cleveland Clinic Foundation, Hoover, AL

Introduction: Co-occurring alcohol consumption and cigarette smoking accelerate liver injury and hepatocarcinogenesis among persons with hepatitis C virus (HCV). Contemporary estimates of the combined prevalence and determinants of concurrent alcohol use and active smoking are needed to inform prevention strategies.

Methods: Pooled National Health and Nutrition Examination Survey (NHANES) data from 2007–2018 were analyzed of adults ≥20 years with serologic evidence of HCV (weighted n=3,312,914). Participants were categorized as having (1) concurrent alcohol use and active smoking, (2) either behavior alone, or (3) neither behavior (reference). Survey-weighted multinomial logistic regression generated adjusted odds ratios (aORs, 95 % CIs) for associations between demographic/clinical variables and behavior category.

Results: Concurrent alcohol use and active smoking was observed in 39.5 % (95 % CI 32.3–47.0) of HCV-infected U.S. adults, representing 1,308,364 individuals; whereas, 44.4 % reported only one behavior. Lifetime substance use (aOR=5.98, 95 % CI 5.87–6.10), current marijuana use (aOR=2.88, 2.84–2.92), depression (aOR=2.59, 2.55–2.63), and a history of cancer (aOR=1.50, 1.45–1.54) increased the likelihood of active smoking. Older age (per-year aOR=0.97, 0.97–0.98), non-Hispanic Black ethnicity (aOR=0.78, 0.76–0.79), health-insurance coverage (aOR=0.18, 0.18–0.19), middle or high income (aOR=0.34, 0.34–0.34), and obesity (aOR=0.25, 0.25–0.26) were protective.

Discussion: Nearly two in five U.S. adults with HCV simultaneously drink alcohol and smoke, driven chiefly by broader substance-use patterns and depressive symptoms, whereas socioeconomic stability and health-care access mitigate this dual exposure. Embedding addiction and mental-health services within HCV management pathways may curb these behaviors and, in turn, reduce preventable progression to cirrhosis and hepatocellular carcinoma.

Disclosures:
Mohammad Alabbas indicated no relevant financial relationships.
Yuqi Guo indicated no relevant financial relationships.
Jingyi Shi indicated no relevant financial relationships.
Hongke Wu indicated no relevant financial relationships.
Walaa Mahmoud indicated no relevant financial relationships.
Shreya Sengupta indicated no relevant financial relationships.
Omar Sims indicated no relevant financial relationships.

Mohammad Alabbas, MD¹, Yuqi Guo, PhD², Jingyi Shi, PhD³, Hongke Wu, MD, MPH, MS⁴, Walaa Mahmoud, MD⁴, Shreya Sengupta, MD⁴, Omar Sims, PhD⁵. P1588 - Psychosocial Determinants of Concurrent Alcohol Use and Active Smoking in Adults With HCV in the Last Decade: An Analysis of NHANES, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.