Book review: “Alcohol and tobacco. Aspects of use, abuse and addiction”

alcohol and tobacco

“Alcohol and tobacco. Medical and sociological aspects of use, abuse and addiction”, a book by Otto-Michael Lesch, Henriette Walter, Christian Wetschka, Michie Hesselbrock, Victor Hesselbrock. 2011 Springer, Vienna – New York, 353 pages

Review by Iannis Mouzas



Professor Otto Lesch, with more than 30 years experience in the field, and his colleagues deal in this book with two substances -alcohol and tobacco- and the many aspects of their use, abuse and addiction: medical, psychiatric, psychological, biological, pharmacological, and sociological. Alcohol and nicotine abuse and addiction usually occur together. Therapeutic – pharmacological, psychotherapeutic and motivational – strategies concerning both causes of addiction have been considerably improved during the last decades. However, a main breakthrough in the field consists of better identifying patient subgroups: clearly formulated clinical definitions of subgroups of alcohol and tobacco addicted persons enable an efficient, client-adapted therapeutic intervention.

In the 350 pages of the book divided into 10 chapters, there is abundant and firsthand information on: etiology of addiction, prevention strategies, diagnosis of abuse and addiction, alcoholism typology (a 30-pages chapter with a concise review of the Lesch typology both for tobacco and alcohol), motivation of dependent patients for seeking medical help, therapeutic strategies in alcohol and tobacco addiction (45 pages dealing with the various aspects of therapy and relapse prevention adapted to typology clusters), sociotherapy of alcohol and tobacco addiction with regard to Lesch’s typology (90 pages with -among others- the conclusions of a vast clinical experience with social psychiatric networks).

The book provides a concise overview of global epidemiology of tobacco and alcohol use, abuse and addiction. Prevention-based strategies, co-morbidity, medical and family consequences of abuse, psychological and pharmaceutic therapies, sociological interventions are discussed in depth.

I found as especially valuable the inclusion of abundant case studies. These case studies illustrate the theoretical and research data with a clinical approach so precious in the European classical tradition of clinical medicine. As main achievement of the authors I consider the in depth discussion and practical implementation throughout the book of Lesch’s typology in both diagnosis and treatment. Lesch’s typology of alcohol and nicotine dependence, recently re-evaluated and provided with a software program for use in clinical practice (LAT software), has proved to be a valuable tool in assessment and selection of appropriate differential treatment for patients with alcohol and nicotine dependence.

Apart from Henriette Walter, Lesch’s long-time co-worker, distinguished researchers and clinicians from the fields of social work (Michie Hessebrock), psychology (Victor Hesselbrock) and sociology (Christian Wetschka) contributed to the creation of this book. Clinical, biology and behavior researchers as well as clinicians and other health professionals in the field of alcohology will find in this book up-to-date practical information. Finally, this book will be instrumental in enhancing quality of care and quality of life of persons with alcohol and tobacco-related problems.

Iannis Mouzas, Medical School, University of Crete


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